Medication Monitor

Generic Name (Trade Name—Company)
November 14, 2018

Revefenacin inhalation solution

(Yupelri—Theravance BioPharma, Mylan)
New drug approved for maintenance treatment of adults with COPD

FDA approved revefenacin inhalation solution for maintenance treatment of patients with chronic obstructive pulmonary disease (COPD). Revefenacin is a long-acting muscarinic antagonist, a class of medicines that improve lung function in patients with COPD. The agent is administered once daily via a standard jet nebulizer.  

As with other inhaled medicines, revefenacin can cause paradoxical bronchospasm (wheezing). If paradoxical bronchospasm occurs, patients should discontinue use. Patients should also be alert for signs and symptoms of acute narrow-angle glaucoma (e.g., eye pain or discomfort, blurred vision, visual changes). Patients should consult a health professional immediately if any of these signs or symptoms develop.

The most common adverse reactions include cough, nasopharyngitis, upper respiratory tract infection, headache, and back pain. Health professionals should avoid administering revefenacin with other anticholinergic-containing drugs. The agency does not recommend administering revefenacin at the same time as OATP1B1 and OATP1B3 inhibitors (e.g. rifampicin, cyclosporine, etc.), as it may lead to an increase in exposure of the active metabolite.