Nasal spray for paroxysmal supraventricular tachycardia enters US market
Milestone Pharmaceuticals said it plans to begin U.S. commercialization of its etripamil (Cardamyst) nasal spray, indicated for the conversion of acute symptomatic episodes of paroxysmal supraventricular tachycardia (PSVT) to sinus rhythm in adults by mid-February.
The first of its kind prescription nasal spray gained U.S. Food and Drug Administration (FDA) approval in December 2025.
“Many patients have been waiting for help to take greater control of their PSVT condition. Now that Cardamyst is available, patients have access to a convenient, self-administered option designed to treat episodes of PSVT wherever and whenever they occur,” Joseph Oliveto, president and chief executive officer of Milestone Pharmaceuticals, explained in a statement. “Beyond availability, our team continues to engage insurers with the goal of having Cardamyst widely covered and affordable.”
The company said it will launch a patient assistance platform as Milestone continues to negotiate with health insurers for formulary placement and coverage. Milestone said it will provide benefits verification, reimbursement support and copay assistance for most patients with commercial insurance that covers Cardamyst to help reduce financial and administrative barriers to treatment.
For eligible patients, the company said copays are expected to be capped at $25 to make the drug affordable for patients.
About 2 million people in the U.S. have been diagnosed with PSVT. The cardiac arrhythmia causes episodes of sudden onset, rapid heart rates often exceeding 150-200 beats per minute that can last several hours. The rapid heart rate often causes disabling shortness of breath, chest discomfort, dizziness and distress, forcing patients to limit their daily activities. Milestone said there has been lack of effective treatment options beyond trips to the emergency department and invasive cardiac ablation procedures.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]