What are the most common adverse effects of etripamil (generic name)?

Most Common Adverse Effects of Etripamil

The most common adverse effects of etripamil nasal spray are localized nasal symptoms, with nasal discomfort occurring in 23-30% of patients, followed by nasal congestion (12-14%), rhinorrhea (9-13%), epistaxis (6-7%), and throat irritation (6-7%). 1, 2

Top 5 Adverse Effects with Rates

Based on the highest quality primary research and consistent findings across multiple studies:

1. Nasal discomfort: 23-30% 1, 2, 3

   • Most frequently reported adverse event
   • Typically mild to moderate in severity
   • Transient and resolves without intervention

2. Nasal congestion: 12-14% 1, 2, 3

   • Second most common localized effect
   • Related to intranasal administration route
   • Generally well-tolerated

3. Rhinorrhea: 9-13% 1, 2, 3

   • Nasal discharge occurring in approximately 1 in 10 patients
   • Mild to moderate severity
   • Self-limiting

4. Epistaxis: 6-7% 1, 2, 4

   • Nosebleeds reported in less than 1 in 10 patients
   • Typically minor bleeding episodes
   • No serious bleeding events reported

5. Throat irritation: 6-7% 2

   • Occurs in approximately 1 in 15 patients
   • Related to nasal spray administration
   • Transient symptom

Important Clinical Characteristics

Adverse event patterns show favorable trends with repeated use: 1

• TEAE frequencies decreased across multiple PSVT episodes
• Similar safety profile for single versus repeat doses
• Consistent tolerability over long-term follow-up (median 232 days) 3

All adverse events were:

• Predominantly localized to the administration site 2
• Mild to moderate in severity 1, 2, 3
• Transient and resolved without intervention 2
• No serious etripamil-related adverse events or deaths reported 2

Dose-Related Considerations

No clear dose-dependent adverse event pattern was identified in the clinical trials, as the therapeutic regimen consistently used 70 mg doses (with optional repeat dosing at 10 minutes if symptoms persisted). 2 The repeat-dose regimen showed similar adverse event profiles to single-dose administration. 1

Serious Adverse Events

No serious cardiac safety events occurred within 24 hours of etripamil administration. 3 Specifically:

• No increased bradyarrhythmia 4
• No increased atrial fibrillation 4
• No non-sustained ventricular tachycardia 4
• No deaths related to etripamil 2

Common Pitfall to Avoid

Do not confuse the localized nasal adverse effects with systemic toxicity—these are administration-site reactions that are expected with intranasal delivery and do not indicate systemic drug intolerance. 2 The high frequency of nasal symptoms should be discussed with patients during counseling to set appropriate expectations and prevent premature discontinuation.