Milestone Pharmaceuticals said it is cutting 20% of staff and leadership headcount following FDA approval of its heart arrhythmia treatment, with two top executives departing its leadership team. The company attributed the changes to cost and operational pressures as it transitions from approval-driven development into commercialization execution. The reductions come amid evidence of early commercial traction, with Cardamyst sales reported at $1 million in Q3, per the company’s earnings commentary. The move signals how small-cap biotechs are tightening budgets post-approval to extend cash runway. For investors and partners, the restructuring underscores the execution risk that can follow regulatory wins when commercialization needs outpace early revenue generation.