Nasal Spray Approved for Supraventricular Tachycardia

Etripamil is a fast-acting, self-administered agent that allows patients to quickly convert to sinus rhythm without a trip to the ED.

In December 2025, the U.S. Food and Drug Administration approved the nasal spray etripamil (Cardamyst) for the outpatient treatment of supraventricular tachycardias (SVTs).

Context

Acute treatment of SVT currently requires a trip to the emergency department (ED) and, in many cases, intravenous adenosine. But this agent can cause severe, unpleasant reactions such as flushing, chest pain, and a feeling of dread. Oral treatments take 2 to 3 hours to reach peak serum levels — too slow for patients with severe symptoms. In contrast, etripamil is a fast-acting, self-administered, intranasal calcium-channel blocker.

Supporting Data

In the trial that led to FDA approval, 690 adults with prior SVTs documented on electrocardiogram (ECG) were randomly ass…

Author

Mark S. Link, M.D.

Disclosures

Editorial BoardsCirculation; UpToDate