Select a medication above to begin.
Cardamyst
etripamil nasal
Adult Dosing .
Dosage forms: SPRAY: 70 mg per device
Special Note
- [dosing clarification]
- Info: each device delivers 2 sprays
PSVT conversion
- [70 mg intranasally x1 given as 1 spray in each nostril]
- Max: 140 mg/24h; Info: may give additional dose x1 after 10min
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- heart failure, NYHA Class II-IV
- WPW syndrome
- Lown-Ganong-Levine (LGL) syndrome
- pre-excitation delta wave on ECG
- sick sinus syndrome (patients w/o pacemaker)
- AV block, 2nd-3rd degree
- avoid: breastfeeding x12h after tx
- caution: hypotension history
- caution: syncope history
- caution: hemodynamically unstable patients
Drug Interactions .
Overview
etripamil nasal
CCB, non-dihydropyridine nasal
- delays atrioventricular conduction
- hypotensive effects
Avoid/Use Alternative
- aldesleukin
- brigatinib
- ceritinib
- clonidine
- crizotinib
- etrasimod
- fingolimod
- lofexidine
- ozanimod
- ponesimod
- siponimod
Monitor/Modify Tx
- adenosine
- alectinib
- alfentanil
- alfuzosin
- aliskiren
- amantadine
- amifostine
- amiloride
- amiodarone
- amitriptyline
- amoxapine
- apomorphine
- apraclonidine ophthalmic
- aprocitentan
- aripiprazole bimonthly injection
- aripiprazole lauroxil
- aripiprazole monthly injection
- aripiprazole oral
- arsenic trioxide
- articaine
- asenapine
- atazanavir
- avanafil
- azilsartan medoxomil
- benazepril
- berberine
- bethanechol
- bexagliflozin
- bortezomib
- brexpiprazole
- brimonidine ophthalmic
- brimonidine topical
- bromocriptine
- bumetanide
- bupivacaine
- bupivacaine liposomal
- buprenorphine
- butorphanol
- cabergoline
- canagliflozin
- candesartan cilexetil
- cannabis
- captopril
- carbamazepine
- cariprazine
- chloroprocaine
- chlorothiazide
- chlorpromazine
- chlorthalidone
- cilostazol
- clofarabine
- clomipramine
- clozapine
- codeine
- coenzyme Q-10
- dapagliflozin
- denileukin diftitox
- desflurane
- desipramine
- dexmedetomidine
- dexmedetomidine injection
- digoxin
- dihydrocodeine
- dinutuximab
- dipyridamole
- disopyramide
- donepezil
- doxazosin
- doxepin
- dronabinol
- dronedarone
- dulaglutide
- duloxetine
- eliglustat
- empagliflozin
- enalapril
- enalaprilat
- ensartinib
- entacapone
- entrectinib
- eplerenone
- epoprostenol
- ertugliflozin
- ethacrynic acid
- ethanol
- fenoldopam
- fentanyl
- ferumoxytol
- flaxseed
- flecainide
- flibanserin
- fluphenazine
- fosinopril
- foslevodopa
- fosphenytoin
- furosemide
- gadobenate dimeglumine
- galantamine
- garlic
- gilteritinib
- guanfacine
- haloperidol
- hydralazine
- hydrochlorothiazide
- hydrocodone
- hydromorphone
- iloperidone
- iloprost
- iloprost inhaled
- imipramine
- indapamide
- irbesartan
- iron sucrose
- isocarboxazid
- isoflurane
- isosorbide dinitrate
- isosorbide mononitrate
- ivabradine
- lacosamide
- lamotrigine
- lanreotide
- lasmiditan
- levodopa
- levorphanol
- lidocaine
- lisinopril
- lopinavir/ritonavir
- lorlatinib
- losartan
- loxapine
- lubiprostone
- lumateperone
- lurasidone
- magnesium sulfate
- maraviroc
- mefloquine
- meperidine
- mepivacaine
- methadone
- methohexital
- methyldopa
- methylene blue injection
- metolazone
- midazolam
- midodrine
- milrinone
- minoxidil
- mirtazapine
- moexipril
- molindone
- morphine
- nalbuphine
- nattokinase
- naxitamab
- neostigmine
- niacin (vitamin B3)
- nitric oxide
- nitrite
- nitroglycerin
- nitroprusside
- nortriptyline
- obinutuzumab
- octreotide
- olanzapine
- oliceridine
- olmesartan medoxomil
- opicapone
- opium
- oxazepam
- oxycodone
- oxymorphone
- paliperidone
- palopegteriparatide
- paltusotine
- pasireotide
- pentamidine
- pentazocine
- pentobarbital
- perindopril
- perphenazine
- phenelzine
- phenobarbital
- phenoxybenzamine
- phentolamine
- phenytoin
- pramipexole
- praziquantel
- prazosin
- procainamide
- procarbazine
- prochlorperazine
- promethazine
- propafenone
- propofol
- protriptyline
- pyridostigmine
- quetiapine
- quinapril
- quinidine (antiarrhythmic)
- quinine
- ramipril
- rasagiline
- regadenoson
- remifentanil
- remimazolam
- riociguat
- risperidone
- ritonavir
- rivastigmine
- ropinirole
- ropivacaine
- rotigotine transdermal
- sacubitril
- safinamide
- selegiline
- selegiline transdermal
- sevoflurane
- sildenafil
- silodosin
- sodium ferric gluconate complex
- sotagliflozin
- sparsentan
- spironolactone
- succinylcholine
- sufentanil
- sugammadex
- tadalafil
- tagraxofusp
- tamsulosin
- tapentadol
- taurine
- telmisartan
- terazosin
- thalidomide
- thioridazine
- thiothixene
- ticagrelor
- tizanidine
- tolcapone
- torsemide
- tramadol
- trandolapril
- tranylcypromine
- trazodone
- treprostinil
- triamterene
- trifluoperazine
- trimipramine
- valsartan
- vardenafil
- vosoritide
- yohimbe
- ziprasidone
Adverse Reactions .
Serious Reactions
- hypotension
- syncope
Common Reactions
- nasal discomfort
- nasal congestion
- rhinorrhea
- throat irritation
- epistaxis
Safety/Monitoring .
Monitoring Parameters
BP, HR; ECG
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; no human data available; no known risk of fetal harm or malformations based on animal data w/ IV route at 0.4x and 10x MRHD
Lactation
Clinical Summary
avoid breastfeeding x12h after tx; no human data available, though theoretical risk of infant hypotension and bradycardia based on drug's mechanism of action; no human data available to assess effects on milk production
Pharmacology .
Metabolism: for etripamil: blood esterases, liver; CYP450: 3A4, 3A5 substrate
Excretion: for etripamil: urine 29% (<0.05% unchanged), feces 26% (<0.05% unchanged); Half-life: 2.5h
Subclass: Antiarrhythmics, Intranasal ; Calcium Channel Blockers (CCBs), Non-dihydropyridines
Mechanism of Action
for etripamil: inhibits calcium ion influx into vascular smooth muscle and myocardium (class IV antiarrhythmic)
Formulary .
No Formulary Selected
Join Now to View Patient Handouts!
Create a FREE epocrates Online account to access patient medication instructions. Your patients and caregivers will appreciate you printing these friendly handouts, available in English and Spanish. Each handout addresses common concerns such as how to take the medication, and possible side effects.
Current Members: Sign In.
Pill Pictures
Join Now to View Pill Pictures!
Create a FREE epocrates Online account to access full-color images of medications within the drug monograph.
Current Members: Sign In.