Milestone Pharmaceuticals reports early commercial progress for CARDAMYST™ (etripamil) nasal spray in the U.S., with strong initial prescriptions and expanding market access for PSVT.
Written By: Chikkula Pavan Kumar, PharmD
Reviewed By: Pharmacally Editorial Team
Milestone Pharmaceuticals has reported encouraging early commercial progress for CARDAMYST™ (etripamil) nasal spray, following its recent U.S. launch for the treatment of acute symptomatic episodes of paroxysmal supraventricular tachycardia (PSVT) in adults. The update was shared alongside the company’s fourth‑quarter and full‑year 2025 financial results.
CARDAMYST received U.S. Food and Drug Administration (FDA) approval on December 12, 2025, and became broadly available through retail pharmacies in the United States in late January 2026, marking Milestone’s transition into a commercial‑stage cardiovascular company. Early prescription data indicate underlying demand for a rapid, self‑administered treatment option that patients can use outside of emergency departments or inpatient settings.
Initial prescriptions have largely comprised new patient starts, written by physicians already engaged through the company’s field‑based commercial outreach. This reflects the impact of targeted physician education and pre‑launch preparation. Milestone’s reimbursement readiness and patient‑support infrastructure have also helped facilitate early prescription fills, including prior to broad payer coverage expansion.
To accelerate adoption, Milestone deployed a national sales force of approximately 60 representatives within eight weeks of FDA approval, focusing on cardiologists, electrophysiologists, and advanced practice providers managing arrhythmia patients in office‑based settings. Promotional activities began in mid‑February 2026, positioning CARDAMYST as an on‑demand, self‑administered therapy for PSVT episodes. Early feedback from prescribers highlights interest in a convenient option that may reduce emergency visits and improve patient episode management.
Milestone is further expanding awareness through scientific engagement, including upcoming presentations of etripamil clinical data, highlighting minimal effects on blood pressure at the American College of Cardiology (ACC) Scientific Session. The company views this platform as a key opportunity to introduce CARDAMYST to a broader cardiology audience as commercial activities scale.
Beyond the U.S. launch, Milestone is pursuing regulatory expansion in Europe, where the European Medicines Agency (EMA) has accepted the marketing authorization application for etripamil nasal spray in PSVT. If approved, the product would be marketed in Europe under the brand name TACHYMIST™, with a regulatory decision anticipated in the first half of 2027.
The company is also advancing etripamil for atrial fibrillation with rapid ventricular rate (AFib‑RVR) and plans to initiate a Phase 3 registrational study evaluating the nasal spray as a self‑administered treatment for AFib‑RVR. This program could support a supplemental regulatory submission building on the existing PSVT approval.
With the successful approval and initial market entry of CARDAMYST, Milestone is focused on scaling adoption, expanding physician engagement, and establishing the therapy as a new standard on‑demand treatment option for PSVT episodes.
Reference
Milestone Pharmaceuticals Reports Fourth Quarter and Full Year 2025 Financial Results and Provides Update on the Commercial Launch of CARDAMYST™ (etripamil) Nasal Spray for the Treatment of PSVT, 20 March 2026, Milestone Pharmaceuticals Reports Fourth Quarter and Full Year 2025 Financial Results and Provides Update on the Commercial Launch of CARDAMYST™ (etripamil) Nasal Spray for the Treatment of PSVT | Milestone Pharmaceuticals, Inc.
About the Writer
Chikkula Pavan Kumar, PharmD is a Doctor of Pharmacy with a keen interest in clinical pharmacy, pharmacovigilance, and evidence-based practice. In his words, he is passionate about patient safety and translating complex medical information into clear, research-driven communication.