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revefenacin

Brand Name :

Yupelri

Synonyms :

revefenacin

Class :

Inhaled Anticholinergics





No data available for drug.

Actions and Spectrum: 

Mechanism of Action: 

  • Muscarinic Receptor Antagonism: revefenacin selectively antagonizes the M3 subtype of muscarinic receptors in the airway smooth muscles. By blocking these receptors, it inhibits the binding of acetylcholine, a neurotransmitter, thereby preventing its broncho-constrictive effects. 
  • Bronchodilation: By blocking the M3 receptors, revefenacin relaxes the smooth muscles surrounding the airways, leading to bronchodilation. This helps to alleviate bronchoconstriction, improve airflow, and reduce symptoms in patients with COPD. 

Spectrum of Activity: 

  • Chronic Obstructive Pulmonary Disease (COPD): revefenacin is especially prescribed for the maintenance therapy of COPD patients. It is used to prevent and treat COPD symptoms such as shortness of breath, coughing,chest tightness and wheezing. 
  • Extended Duration of Action: revefenacin is formulated as a once-daily inhaled medication, providing a sustained effect throughout the day. Its prolonged action duration helps maintain bronchodilation and symptom control, reducing the need for frequent dosing. 

DRUG INTERACTION

revefenacin

&

  • carmellose sodium
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  • ursodeoxycholic acid
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  • butamirate citrate
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  • methionine
  • amino acids and electrolytes in dextrose with calcium
  • slippery elm
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  • zoliflodacin (pending FDA approval)
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  • fluorine F18 DCFPyL
  • debamestrocel
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  • sabizabulin(Pending FDA approval)
  • fexapotide(Phase 3 Clinical trial)
  • diatrizoic acid
  • drotaverine
  • diethyl phthalate
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  • etizolam
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  • finger millet
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  • dichloroxylenol
  • pneumococcal 7-valent vaccine
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  • dipivefrin ophthalmic
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  • sodium sulfate, magnesium sulfate and potassium sulfate
  • almitrine
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  • betiatide
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  • amlexanox
  • acetaminophen/salicylamide/phenyltoloxamine
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  • zilucoplan
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  • toripalimab
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  • meningococcal A C Y and W polysaccharide tetanus toxoid conjugate vaccine
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  • tetradecyl Sulfuric Acid
  • benzoyl peroxide, clindamycin phosphate, adapalene
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  • actarit
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  • melitracen
  • amitriptylinoxide(Phase 4 Clinical Trials)
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  • allantoin/triclosan/vitamin e/zinc oxide
  • alpha-Lipoic acid/minerals/multivitamins
  • alprazolam/paracetamol
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  • mesterolone
  • mosapride and pantoprazole
  • atorvastatin, co enzyme q10, vitamin e, zinc, and selenium
  • azithromycin and benzalkonium chloride
  • beta carotene, vitamin c, vitamin e, minerals, lutein, eicosapentaenoic acid, docosahexenoic acid and vit b12
  • alpha-galactosidase
  • aloe vera gel/vitamin e/lactic acid
  • aloe vera gel/jojoba/vitamin e/glycerine
  • famotidine and domperidone
  • faropenem medoxomil
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  • ambroxol/salbutamol
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  • desloratadine/ambroxol
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  • diastase
  • diastase and simethicone
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  • dexketoprofen /paracetamol
  • beta carotene/vitamin C/minerals
  • aloe vera gel/urea
  • aloe vera gel/glycerine
  • alpha-lipoic acid/benfotiamine/chromium/folic acid/mecobalamin / vit b6
  • alprazolam/propranolol
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  • eucalyptol
  • sodium tetradecyl sulfate
  • sugammadex
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  • cephapirin
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  • etilefrine
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  • halazepam
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  • dapiprazole
  • soapwort
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  • carbocisteine
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  • technetium Tc-99m tetrofosmin
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  • technetium Tc-99m labeled red blood cells
  • amylmetacresol/dextromethorphan hydrobromide
  • anileridine phosphate
  • pyrethrins
  • pyrantel pamoate
  • quinagolide
  • spiramycin
  • standard hyperkalemic cardioplegia solution
  • technetium tc-99m mertiatide
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  • bemotrizinol / bisoctrizole
  • benfotiamine
  • bemotrizinol + titanium dioxide + zinc oxide
  • technetium Tc-99m oxidronate
  • technetium Tc-99m pentetate
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  • benziodarone
  • octinoxate/bisoctrizole
  • bicisate dihydrochloride
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  • norelgestromin/ethinyl estradiol
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  • ximelagatran (investigational)
  • xamoterol
  • trioxsalen
  • poly-urea urethane
  • rilmenidine
  • pemirolast
  • oxitriptan
  • beclomethasone, intranasal
  • thimerosal
  • camphor gel
  • camphor
  • mumps virus vaccine, live
  • rubella virus vaccine, live
  • aluminum chloride (dental)
  • alum irrigation
  • framycetin, phenylephrine, and gramicidin
  • ombitasvir, paritaprevir, ritonavir, and dasabuvir
  • olipudase alfa
  • etonogestrel/ethinyl estradiol
  • mycophenolate
  • fluoroestradiol F 18
  • donor organ cardioplegia solution
  • fluciclovine F 18
  • fusidic acid (ophthalmic)
  • fusidic acid and hydrocortisone
  • framycetin, dexamethasone, and gramicidin
  • fludeoxyglucose F-18
  • fluorouracil/salicylic acid
  • indium In-111 oxyquinoline
  • indium In-111 pentetreotide
  • indium In-111 capromab pendetide
  • lusutrombopag
  • mitomycin (ophthalmic)
  • mifepristone and misoprostol
  • minoxidil (systemic)
  • methyl aminolevulinate (topical)
  • methyl folate, methylcobalamin, and acetylcysteine
  • ciclesonide/formoterol/tiotropium
  • nedocromil (Oral Inhalation)
  • batefenterol (Investigational)
  • neostigmine and glycopyrrolate
  • nepafenac ophthalmic
  • netupitant/palonosetron
  • meperidine and promethazine
  • mepivacaine and levonordefrin
  • maltodextrin
  • medical cannabis
  • medium chain triglycerides
  • mometasone/glycopyrrolate (glycopyrronium)/ indacaterol
  • moxifloxacin ophthalmic
  • neomycin/fluocinolone
  • nadroparin
  • iodine I-125 iothalamate
  • amikacin liposome (oral inhalation)
  • bupivacaine liposome
  • natamycin
  • lopinavir and ritonavir
  • lysine
  • macitentan and tadalafil
  • mitomycin pyelocalyceal
  • moclobemide
  • mometasone and indacaterol
  • efinaconazole
  • blue-green algae
  • indocyanine green
  • follitropin beta
  • lumasiran
  • glycerin/lidocaine
  • edrophonium/atropine
  • indigo carmine
  • lutropin alfa
  • instant glucose/intravenous dextrose
  • iobenguane I-123
  • ixekizumab
  • isosulfan blue dye
  • levofloxacin ophthalmic
  • levonorgestrel oral/ferrous bisglycinate/ ethinylestradiol
  • ethinyl estradiol/levonorgestrel transdermal
  • hydroquinone
  • hydroxypropyl methylcellulose
  • icodextrin
  • lipid emulsion (soybean, medium-chain triglyceride, olive, and fish oils; [SMOF])
  • iodinated I 125 albumin
  • iodinated I 131 albumin
  • lipid emulsion (plant oil-based)
  • levonorgestrel intrauterine
  • levonorgestrel oral/ethinyl estradiol
  • lactic acid and sodium-PCA
  • lactated Ringer solution
  • ketotifen (systemic)
  • lanolin
  • leuprolide and norethindrone
  • levodopa and benserazide
  • gonadorelin acetate
  • hemodialysis solutions
  • nirsevimab
  • gentian violet
  • gallium ga-68 dotatate
  • fusidic acid and betamethasone
  • gallium citrate Ga-67
  • gadopentetate dimeglumine
  • gadofosveset
  • follitropin delta
  • follitropin alfa and lutropin alfa
  • follitropin alfa
  • rocatinlimab
  • grass pollens allergen extract
  • flotufolastat F18
  • fluorescein ophthalmic
  • barium
  • balanced salt solution
  • air polymer type A intrauterine device
  • clodronate
  • bentoquatam
  • clobetasone
  • alfacalcidol
  • citric acid/glucono-delta-lactone/magnesium carbonate
  • benzoin
  • desirudin
  • immune globulin IV (IGIV)
  • dequalinium
  • pseudoephedrine/desloratadine
  • clofedanol
  • cyproterone and ethinyl estradiol
  • dextranomer and hyaluronic acid or derivatives
  • diatrizoate meglumine and diatrizoate sodium
  • glucosamine sulfate, chondroitin sulfate and Msm
  • squill
  • gotu kola
  • blessed thistle
  • bitter melon
  • apraclonidine
  • chlophedianol/dexbrompheniramine/pseudoephedrine
  • wild jujube
  • chitosan
  • cilazapril/hydrochlorothiazide
  • dexbrompheniramine and phenylephrine
  • diethylene triamine penta-acetic acid
  • dexchlorpheniramine and pseudoephedrine
  • lily of the valley
  • diflucortolone
  • corydalis
  • lemon balm
  • MSM
  • calcium polystyrene sulfonate
  • caprylidene
  • peppermint oil
  • efavirenz/lamivudine/tenofovir DF
  • emtricitabine/tenofovir DF /efavirenz
  • dutasteride/tamsulosin
  • milk thistle
  • centaury
  • horseweed
  • lycopus
  • agrimony
  • alfalfa
  • kava
  • cetrorelix
  • cetylpyridinium
  • chlophedianol and dexbrompheniramine
  • betahistine
  • choline C-11
  • boric acid vaginal suppository
  • aluminum acetate
  • aluminum chloride hexahydrate
  • 14-C urea breath test
  • absorbable collagen
  • valoctocogene roxaparvovec-rvox
  • amlodipine and celecoxib
  • aspirin and omeprazole
  • azilsartan and chlorthalidone
  • landiolol (Pending FDA approval)
  • isosorbide dinitrate/hydralazine
  • losartan/hydrochorothiazide
  • udenafil
  • dextromethorphan/quinidine
  • onasemnogene abeparvovec
  • orphenadrine/aspirin/caffeine
  • trace elements
  • sodium phenylbutyrate/ taurursodiol
  • fish oil triglycerides
  • infant formula
  • glutamine
  • chloroquine phosphate
  • afatinib
  • quinidine gluconate
  • methylergonovine
  • prothrombin complex concentrate, human
  • BCG intravesical live
  • capivasertib
  • cedazuridine
  • carbonyl iron
  • iron dextran complex
  • lovotibeglogene autotemcel (FDA Approval Pending)
  • sodium benzoate/sodium phenylacetate
  • mineral oil otic
  • zolmitriptan transdermal
  • midazolam intranasal
  • fosinopril/hydrochlorothiazide
  • caplacizumab
  • arginine
  • sodium phenylbutyrate
  • meloxicam/rizatriptan
  • manganese
  • acetaminophen/pamabrom/pyridoxine
  • varicella zoster immune globulin, human
  • amitriptyline/perphenazine
  • narsoplimab (Pending FDA Approval)
  • amlodipine/perindopril
  • imiglucerase
  • canagliflozin/metformin
  • tafamidis meglumine
  • somatrogon-ghla
  • glimepiride/rosiglitazone
  • becaplermin
  • lithium
  • loxapine inhaled
  • nicotine transdermal
  • tixagevimab and cilgavimab (Investigational)
  • muromonab CD3
  • ansuvimab
  • coal tar bath products
  • fibrin sealant
  • arimoclomol (FDA Approval Pending)
  • varenicline intranasal
  • aducanumab
  • oxycodone/naloxone
  • ritlecitinib
  • sodium polystyrene sulfonate
  • calcipotriene/betamethasone
  • calcium hydroxylapatite
  • cantharidin topical
  • doxepin cream
  • clocortolone
  • formaldehyde topical
  • sodium sulfide topical
  • collagenase
  • selegiline transdermal
  • foscarbidopa/foslevodopa (FDA approval pending)
  • saxagliptin/metformin
  • linagliptin/metformin
  • linzagolix (FDA approval pending)
  • efgartigimod/hyaluronidase SC
  • elamipretide (Pending FDA approval)
  • rozanolixizumab
  • diazoxide
  • glimepiride/pioglitazone
  • cipaglucosidase alfa
  • dihydroergotamine intranasal
  • delandistrogene moxeparvovec
  • beremagene geperpavec
  • hyaluronic acid and derivatives
  • hyaluronic acid, non-animal stabilized
  • eplontersen (FDA Approval Pending)
  • nitric oxide gas
  • sodium phenylbutyrate and taurursodiol
  • treprostinil SC
  • viltolarsen
  • albuterol/ipratropium
  • budesonide inhaled
  • budesonide rectal
  • palovarotene
  • sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol
  • amino acids mixture
  • aminobenzoate potassium
  • elivaldogene autotemcel
  • naproxen and sumatriptan
  • sumatriptan intranasal
  • alglucerase
  • metformin/rosiglitazone
  • ertugliflozin/metformin
  • elosulfase alfa
  • calcium carbonate/magnesium hydroxide
  • starch suppository
  • abicipar pegol (FDA Approval Pending)
  • riboflavin 5′-phosphate ophthalmic
  • povidone ophthalmic
  • glycerin oropharyngeal
  • dimethicone topical
  • menthol topical, dimethicone topical
  • pramoxine topical, menthol topical and dimethicone topical
  • phosphorated carbohydrate
  • brilliant blue G ophthalmic
  • brolucizumab intravitreal
  • purified water, ophthalmic
  • hydroxyethyl cellulose ophthalmic
  • ranibizumab intravitreal implant
  • sodium chloride hypertonic, ophthalmic 
  • cetirizine ophthalmic
  • phentolamine ophthalmic
  • ganciclovir ophthalmic
  • triamcinolone intravitreal
  • ocriplasmin intravitreal
  • atoltivimab/maftivimab/odesivimab
  • pegcetacoplan intravitreal
  • triamcinolone acetonide extended-release injectable suspension
  • tobramycin/loteprednol ophthalmic
  • 2-octyl cyanoacrylate
  • vitamins A & D topical
  • diphenhydramine/allantoin topical
  • pyrethrins/piperonyl butoxide
  • lodoxamide ophthalmic
  • obeticholic acid
  • fluocinolone intravitreal implant
  • sincalide
  • linaclotide
  • nedocromil ophthalmic
  • cysteamine ophthalmic
  • avacincaptad pegol intravitreal
  • azelastine ophthalmic
  • bacitracin ophthalmic
  • propylene glycol ophthalmic
  • rimexolone ophthalmic
  • metoclopramide intranasal
  • mirikizumab
  • netarsudil ophthalmic
  • cenegermin
  • dexamethasone ophthalmic insert
  • prednisolone ophthalmic
  • phenylephrine and cocoa butter rectal
  • phenylephrine and witch hazel topical
  • phenylephrine, pramoxine, glycerin and petrolatum rectal
  • bisacodyl rectal
  • aluminum hydroxide/magnesium carbonate
  • aluminum hydroxide/magnesium hydroxide
  • hyoscyamine spray
  • methenamine/methylene blue/ hyoscyamine/ sodium phosphate monobasic/ phenyl salicylate
  • phenylephrine
  • chlorophyll
  • castor oil
  • cholic acid
  • phenol oropharyngeal
  • articaine/epinephrine
  • antithymocyte globulin equine
  • aluminum hydroxide/magnesium trisilicate
  • methenamine/hyoscyamine
  • hydrocortisone topical/pramoxine topical 
  • sodium fluoride topical
  • mesna
  • C1 esterase inhibitor recombinant
  • menthol and pectin
  • menthol oropharyngeal
  • pectin oropharyngeal
  • gepirone
  • Goldenseal
  • polyethylene glycol and electrolytes
  • polyethylene glycol/electrolytes/sodium ascorbate/ascorbic acid
  • brompheniramine/pseudoephedrine/dextromethorphan
  • brompheniramine phenylephrine
  • acetaminophen/doxylamine/phenylephrine
  • doxylamine/acetaminophen/pseudoephedrine/dextromethorphan
  • acetaminophen/doxylamine/dextromethorphan
  • acetaminophen/doxylamine/dextromethorphan/phenylephrine
  • eslicarbazepine
  • fluticasone and salmeterol
  • codeine, acetaminophen, butalbital and caffeine
  • codeine, chlorpheniramine and phenylephrine
  • iodine
  • povidone iodine
  • butalbital/aspirin/caffeine/codeine
  • polyethylene glycol 400/propylene glycol ophthalmic 
  • pegvaliase
  • amivantamab
  • iopamidol
  • codeine and pseudoephedrine
  • emtricitabine, rilpivirine, tenofovir DF
  • penicillin G aqueous
  • miconazole topical
  • miconazole vaginal
  • ciprofloxacin inhaled (Pending FDA approval)
  • ceftazidime/avibactam
  • ceftolozane/​tazobactam
  • aztreonam inhalation
  • amphotericin B cholesteryl sulfate
  • miconazole oral
  • elvitegravir/cobicistat/emtricitabine/tenofovir DF
  • isavuconazonium sulfate
  • dapivirine intravaginal (FDA Approval Pending)
  • lamivudine/raltegravir
  • codeine/triprolidine/pseudoephedrine
  • cadexomer iodine
  • brompheniramine/pseudoephedrine
  • codeine/acetaminophen
  • codeine/guaifenesin
  • beclomethasone inhaled
  • epoetin beta/methoxy polyethylene glycol
  • voreloxin(Orphan Drug)
  • rociletinib
  • pitcher plant
  • phosphatidylserine
  • telotristat ethyl
  • copper CU 64 dotatate
  • urea topical
  • exenatide subdermal implant
  • asenapine transdermal
  • ethiodized oil
  • urea oral
  • miglustat
  • acalisib(Investigational)
  • acetophenazine
  • guggul
  • aceneuramic acid
  • mestranol/norethindrone
  • reishi
  • lactitol
  • vonoprazan fumarate
  • motherwort
  • silver nitrate
  • salicylic acid/sulfur shampoo
  • salicylic acid topical
  • ketorolac ophthalmic
  • ketoconazole topical
  • Japanese encephalitis virus vaccine
  • dibucaine topical ointment
  • ketorolac intranasal
  • ketorolac/phenylephrine ophthalmic
  • rotavirus oral vaccine, live
  • guarana
  • hops
  • krill oil
  • salicylic acid/coal tar shampoo
  • sufentanil SL
  • pancrelipase
  • passion flower
  • pepdite one plus
  • nivolumab and relatlimab
  • relatlimab (Pending FDA Approval)
  • benzalkonium chloride/benzocaine
  • ketotifen, drug-eluting contact lens
  • calcitriol topical
  • oxymetazoline topical
  • alclometasone topical
  • capsaicin topical
  • diclofenac/misoprostol
  • diclofenac ophthalmic
  • diclofenac topical
  • pramoxine/calamine topical
  • veverimer
  • tolazoline
  • olopatadine ophthalmic
  • lutetium lu 177-dota-tate
  • lutetium lu 177 vipivotide tetraxetan
  • strontium 89 chloride
  • interferon alfa n3
  • lutetium Lu 177- Diethylenetriamine Pentaacetic acid-omburtamab (FDA Approval Pending)
  • samarium sm 153 lexidronam
  • cytomegalovirus immune globulin (CMV IG)
  • antithymocyte globulin rabbit
  • inolimomab (Pending FDA Approval)
  • olopatadine intranasal
  • olopatadine intranasal/​mometasone, intranasal
  • benzocaine/butamben/tetracaine topical
  • antipyrine/benzocaine/phenylephrine
  • dyclonine/menthol
  • surufatinib
  • fruquintinib
  • tepotinib 
  • dostarlimab
  • hepatitis B immune globulin (HBIG)
  • remestemcel-L
  • benzocaine/menthol oropharyngeal
  • interferon beta 1b
  • tetracaine/oxymetazoline intranasal
  • benzocaine oropharyngeal
  • benzalkonium chloride/menthol/petrolatum topical
  • inamrinone
  • alpha 1 proteinase inhibitor
  • potassium bicarbonate/potassium citrate
  • potassium phosphate/sodium acid phosphate
  • asparaginase Erwinia chrysanthemi recombinant
  • motixafortide
  • pegloticase
  • etesevimab
  • Rho(D) immune globulin
  • tetanus immune globulin (TIG)
  • reltecimod (pending FDA approval)
  • avasopasem
  • trimethoprim/polymyxin B ophthalmic
  • naphazoline ophthalmic
  • sulfacetamide topical
  • sirolimus intravitreal (pending FDA approval)
  • sirolimus protein bound
  • sirolimus topical
  • glycopyrronium tosylate topical
  • sofpironium
  • olmesartan, amlodipine and hydrochlorothiazide
  • dovitinib (Pending FDA Approval)
  • epinephrine inhaled
  • quizartinib (Pending FDA Approval)
  • ranibizumab intravitreal injection
  • sodium hyaluronate
  • bacitracin and lidocaine topical
  • brimonidine topical
  • benzoyl peroxide and tretinoin topical
  • talquetamab
  • betrixaban
  • acetaminophen/caffeine/pyrilamine
  • fentanyl transmucosal
  • bacitracin topical
  • buprenorphine,long-acting injection
  • buprenorphine buccal
  • nalmefene intranasal
  • sulbactam/durlobactam
  • metronidazole topical 
  • daratumumab/hyaluronidase
  • glofitamab
  • rituximab-hyaluronidase
  • drospirenone/ethinyl estradiol/levomefolate
  • loncastuximab tesirine
  • ingenol mebutate topical
  • momelotinib
  • trastuzumab/deruxtecan
  • trastuzumab/hyaluronidase
  • trastuzumab duocarmazine
  • lifileucel
  • umbralisib
  • eflornithine/sulindac
  • cytarabine/daunorubicin liposomal
  • doxorubicin liposomal
  • epcoritamab
  • lanadelumab  
  • esomeprazole/naproxen 
  • terbinafine topical
  • ravulizumab
  • clotrimazole topical
  • choline magnesium trisalicylate
  • tacrolimus ointment
  • mechlorethamine topical
  • donislecel
  • pozelimab (Pending FDA Approval)
  • human rabies immune globulin (HRIG)
  • melphalan flufenamide
  • sintilimab (Pending FDA Approval)
  • oportuzumab monatox (Pending FDA Approval)
  • sotorasib
  • irinotecan liposomal
  • sulfur topical
  • silver sulfadiazine
  • capsaicin transdermal
  • sutimlimab
  • tretinoin topical
  • acetaminophen rectal
  • menthol topical
  • naftifine
  • oatmeal, colloidal topical
  • oxiconazole
  • methylsalicylate/menthol topical
  • C1 inhibitor human
  • lifitegrast ophthalmic
  • prednisolone/sulfacetamide ophthalmic
  • mannitol inhalation
  • ofloxacin otic
  • petrolatum & mineral oil topical
  • clascoterone topical
  • gefapixant (Pending FDA Approval)
  • colesevelam
  • technetium Tc 99m succimer
  • nebivolol/valsartan
  • ciprofloxacin/fluocinolone acetonide, otic
  • finafloxacin otic
  • magnesium hydroxide/mineral oil
  • phenylephrine/mineral oil/petrolatum rectal
  • carbamide peroxide oral
  • atropine ophthalmic
  • sodium sulfacetamide/sulfur
  • sulfacetamide ophthalmic
  • lucinactant
  • benzonatate
  • besifloxacin ophthalmic
  • benzhydrocodone/acetaminophen
  • beractant
  • trimagnesium citrate anhydrous
  • vitamin b2
  • carbamide peroxide otic
  • mineral oil topical
  • ethyl alcohol intranasal
  • boric acid/alcohol otic
  • absorbable gelatin compressed sponge, USP
  • absorbable gelatin sponge, USP
  • vincristine liposomal
  • technetium Tc 99m albumin aggregated injection
  • metaproterenol
  • budesonide inhaled/formoterol/glycopyrrolate inhaled
  • epinephrine racemic
  • umeclidinium bromide/vilanterol inhaled
  • indacaterol, inhaled/glycopyrrolate inhaled
  • betaine  
  • laronidase 
  • estrogens esterified/methyltestosterone            
  • cerliponase alfa
  • ertugliflozin/sitagliptin
  • hawthorn
  • shepherd’s purse
  • thiamine
  • naphazoline/glycerin ophthalmic
  • oxymetazoline ophthalmic
  • dorzolamide
  • dexamethasone intraocular
  • dexamethasone/ciprofloxacin
  • dexamethasone ophthalmic
  • metipranolol ophthalmic
  • timolol ophthalmic
  • boron
  • fezolinetant
  • pegunigalsidase alfa-iwxj
  • biotin
  • pantothenic acid
  • silicon
  • sodium acid phosphate
  • hypochlorous acid topical
  • methenamine/sodium acid phosphate
  • aviptadil 
  • bremelanotide
  • glucagon intranasal
  • metformin and repaglinide
  • bai ji
  • pau d’arco
  • juzentaihoto
  • mistletoe
  • quercetin
  • rosemary
  • sheng di huang
  • chasteberry
  • maitake
  • grapefruit
  • lentinan
  • juniper
  • nettle
  • parsley
  • rose hips
  • tongkat ali
  • horny goat weed
  • damiana
  • yohimbe
  • insulin NPH
  • aprocitentan
  • noni Juice
  • sodium iodide I-131
  • green tea
  • sea cucumber
  • wheat germ extract
  • fenofibrate micronized 
  • rogisen
  • danshen
  • lutein
  • witch hazel
  • dextroamphetamine transdermal
  • amphetamine/dextroamphetamine
  • hoodia
  • kolanut
  • boswellia
  • opuntia ficus indica
  • lavender
  • nadh
  • tea tree oil
  • metformin/sitagliptin 
  • dapagliflozin/ metformin/saxagliptin  
  • antihemophilic factor recombinant
  • inclisiran
  • bempedoic acid/ezetimibe
  • volanesorsen  
  • omega 3 carboxylic acids
  • pericyazine
  • levomepromazine (methotrimeprazine)
  • betaxolol ophthalmic
  • respiratory syncytial virus vaccine, adjuvanted
  • phenylephrine hydrochloride and tropicamide ophthalmic
  • alirocumab
  • neomycin/polymyxin B/gramicidin ophthalmic
  • factor IX
  • gentamicin topical
  • ansofaxine (Pending FDA Approval)
  • zuranolone
  • factor IX, recombinant
  • factor IX complex
  • factor XIII A-subunit, recombinant
  • factor X, human
  • mesalamine rectal
  • etrasimod
  • anti-inhibitor coagulant complex
  • factor IX, recombinant/albumin fusion protein
  • fibrinogen, human
  • aminocaproic acid
  • metyrosine
  • nonoxynol-9 vaginal
  • progesterone intravaginal gel
  • ipecac syrup
  • botulinum antitoxin, heptavalent
  • pentetate calcium trisodium
  • crotalidae polyvalent immune FAB (ovine)
  • dehydrated alcohol injection 
  • gold sodium thiomalate (Discontinued)
  • lactic acid/citric acid/potassium bitartrate vaginal
  • von Willebrand factor, recombinant
  • luspatercept
  • digoxin immune FAB (Antidote)
  • crotalidae immune FAB (equine)
  • magnesium (Antidote)
  • pyridoxine (Antidote)
  • edetate calcium disodium
  • albumin IV
  • nitroglycerin sublingual
  • obiltoxaximab
  • anthrax immune globulin
  • nitroglycerin topical
  • dextrose
  • nesiritide
  • estradiol vaginal
  • bazedoxifene/conjugated estrogens
  • botulism immune globulin iv
  • amoxicillin/omeprazole/rifabutin
  • synthetic human angiotensin II
  • nitroglycerin IV
  • nitroglycerin translingual
  • nitroprusside sodium
  • tetrahydrozoline/zinc sulfate/hypromellose ophthalmic
  • sodium citrate/citric acid
  • pemetrexate
  • methicillin
  • plasminogen 
  • acai
  • american ginseng
  • cordyceps
  • tramadol/acetaminophen
  • belladonna alkaloids/phenobarbital
  • erythromycin topical/benzoyl peroxide
  • glucosamine sulfate
  • panax ginseng (suppl/herb)
  • tolnaftate
  • sulopenem etzadroxil/probenecid
  • sulfur hexafluoride
  • sotrovimab
  • arbaclofen
  • rifampin/isoniazid
  • clindamycin /tretinoin topical
  • benzoyl peroxide/clindamycin topical
  • apremilast
  • antivenins, centuroides (scorpion)
  • bamlanivimab and etesevimab
  • vilobelimab
  • gadobenate
  • pentosan polysulfate sodium
  • methylsalicylate/menthol/camphor topical
  • antivenin, black widow spider
  • benzoyl peroxide and hydrocortisone
  • clindamycin topical
  • isometheptene, dichloralphenazone and acetaminophen
  • acetaminophen and phenyltoloxamine
  • erythromycin topical
  • erythromycin ophthalmic
  • alpha hydroxy acids, topical
  • buprenorphine transdermal
  • butalbital/acetaminophen/caffeine
  • buprenorphine/samidorphan
  • buprenorphine subdermal implant
  • celecoxib/tramadol
  • drospirenone/ethinyl estradiol
  • resorcinol/sulfur
  • eflornithine
  • rifampin/isoniazid/pyrazinamide
  • tofersen
  • devil’s claw
  • ticarcillin/clavulanate
  • atropine/pralidoxime
  • aprepitant
  • suramin
  • phenelzine 
  • artichoke
  • american dogwood
  • attapulgite
  • atlantic cedar
  • axalimogene filolisbac
  • sodium thiosulfate & sodium nitrite
  • ataluren
  • omidubicel-onlv
  • capsicum
  • ginger
  • cryoprecipitate
  • bictegravir/emtricitabine/tenofovir DF
  • emtricitabine/tenofovir DF
  • fo-ti
  • siberian ginseng
  • granulocytes
  • zinc substituted heme C
  • zinc trihydroxide
  • ashwagandha 
  • cat’s claw
  • glandular products
  • SAMe
  • shark cartilage
  • altovis
  • feverfew
  • horse chestnut
  • magnesium aspartate
  • octacosanol
  • pleurisy root
  • star anise
  • butterbur
  • elderberry
  • licorice (Suppl/herb)
  • aconite
  • pentetate zinc trisodium
  • menthol topical/zinc oxide topical
  • corn-starch/kaolin/zinc oxide topical
  • 5-htp
  • butcher’s broom
  • articulin
  • bearberry
  • goldenrod
  • progesterone, natural
  • black cohosh
  • wild yam
  • cranberry
  • dong quai
  • phytoestrogens
  • norethindrone
  • false Unicorn Root
  • raspberry Leaf
  • asafoetida
  • turmeric
  • dehydroepiandrosterone (DHEA)
  • hyaluronan
  • aliskiren/amlodipine
  • octreotide (Antidote)
  • tranexamic acid injection
  • duocal
  • neocate infant formula
  • pediatric Eo28
  • aloe
  • red clover
  • propolis
  • androstenedione
  • heartsease
  • comfrey
  • bilberry
  • chamomile
  • eyebright
  • calendula
  • sage
  • yucca
  • polypody
  • odevixibat
  • vinpocetine
  • olanzapine/samidorphan
  • creatine
  • yerba mate
  • spesolimab
  • azficel-T
  • tiludronate
  • estetrol and drospirenone
  • pseudoephedrine/fexofenadine
  • lincomycin
  • neomycin oral
  • fluocinolone acetonide, otic
  • tretinoin/ hydroquinone/ fluocinolone
  • halobetasol topical
  • hydrocortisone/​iodoquinol
  • penicillin G procaine /penicillin G benzathine
  • hydrocortisone probutate topical
  • colistin/neomycin/hydrocortisone/thonzonium otic
  • ebola zaire vaccine
  • hepatitis a/​b vaccine
  • vibegron
  • lindane
  • nystatin topical
  • respiratory syncytial virus (RSV) vaccine
  • chikungunya vaccine, live
  • tenecteplase
  • reteplase
  • anthrax vaccine adsorbed, adjuvanted
  • meningococcal ABCWY pentavalent vaccine
  • eculizumab
  • cholestyramine
  • tinzaparin
  • taurolidine/​citrate/​heparin
  • protein C concentrate
  • antithrombin alfa
  • antithrombin III
  • multivitamins, vision
  • ibuprofen/​chlorpheniramine/​pseudoephedrine
  • acetaminophen/ibuprofen
  • ibuprofen/pseudoephedrine
  • paclitaxel protein-bound
  • acetic acid vaginal
  • acetic acid otic
  • hydrocodone/ ibuprofen
  • methyl salicylate / isopropanol/ citronellyl acetate/ citric acid
  • ibuprofen and phenylephrine
  • acetylcysteine (Antidote)
  • iron/​folic acid/​vitamin/​mineral
  • iobenguane I-131
  • dolutegravir/rilpivirine
  • chlorhexidine topical
  • chlorhexidine oral
  • thyroid desiccated
  • proparacaine ophthalmic
  • podophyllum resin
  • phendimetrazine
  • phenoxybenzamine
  • polidocanol
  • phentermine and topiramate
  • piflufolastat F18
  • piperacillin/tazobactam
  • prednisolone and gentamicin ophthalmic
  • promethazine and codeine
  • poractant alfa
  • protamine sulfate
  • aflibercept intravitreal
  • prednicarbate
  • promethazine/dextromethorphan
  • codeine, phenylephrine, and promethazine
  • potassium phosphate
  • glatiramer acetate
  • gentamicin (Ophthalmic)
  • leniolisib
  • rezafungin
  • fluorometholone
  • dalfampridine
  • hydrocortisone topical 
  • empagliflozin and linagliptin
  • triamcinolone topical
  • minocycline topical
  • minocycline dental
  • ketotifen ophthalmic
  • darunavir and cobicistat
  • lidocaine topical
  • neomycin/polymyxin B/bacitracin/lidocaine (OTC)
  • lidocaine/ hydrocortisone
  • lidocaine anesthetic
  • lidocaine ophthalmic
  • lidocaine/tetracaine
  • desonide
  • dabigatran
  • fexofenadine
  • fluoride
  • decitabine and cedazuridine
  • dasiglucagon
  • hydroxypropyl cellulose ophthalmic
  • epoetin alfa
  • ibritumomab tiuxetan
  • trimethobenzamide
  • dexamethasone/ tobramycin
  • tafasitamab
  • valacyclovir
  • mebendazole
  • levoleucovorin
  • flaxseed
  • germanium
  • glutathione
  • lycopene
  • pygeum
  • horseradish
  • ziv-aflibercept
  • micafungin
  • trofinetide
  • taliglucerase alfa
  • tildrakizumab
  • sulopenem (Pending FDA Approval)
  • thyrotropin alfa
  • birch
  • thrombin, topical
  • tivozanib
  • tafluprost
  • methohexital
  • urea and hydrocortisone
  • unoprostone ophthalmic
  • trihexyphenidyl
  • ezetimibe
  • evolocumab
  • trifluridine and tipiracil
  • methenamine
  • misoprostol
  • miltefosine
  • rimantadine
  • maralixibat
  • coenzyme Q10
  • chlorella
  • garlic
  • forskolin
  • zavegepant
  • menotropins
  • margetuximab
  • meprobamate
  • melarsoprol
  • evening primrose oil
  • lemongrass
  • molindone
  • fenugreek
  • phytosterols
  • red yeast rice
  • uridine triacetate
  • tropicamide
  • incobotulinumtoxinA
  • Grape Seed Extract
  • carbachol ophthalmic
  • cosyntropin
  • cyclopentolate and phenylephrine
  • carteolol ophthalmic
  • pentazocine/naloxone
  • pentazocine/acetaminophen
  • casimersen
  • carisoprodol, aspirin, and codeine
  • carisoprodol
  • carboprost tromethamine
  • flurandrenolide
  • brinzolamide/brimonidine
  • betamethasone topical
  • omaveloxolone
  • bardoxolone
  • allogeneic processed thymus tissue
  • fluocinolone topical
  • tacrolimus topical
  • ruxolitinib topical
  • pimecrolimus topical
  • sofosbuvir, velpatasvir and voxilaprevir
  • sofosbuvir/velpatasvir
  • mitotane
  • elbasvir/​grazoprevir
  • wheat dextrin
  • vanadium
  • iron/folic acid/vitamin/mineral
  • molybdenum
  • sparsentan
  • velmanase alfa-tycv
  • pegcetacoplan
  • ferrous sulfate
  • cyclosporine ophthalmic
  • ferric pyrophosphate
  • ammonium lactate
  • etelcalcetide
  • iodoquinol
  • sucroferric oxyhydroxide
  • doxercalciferol
  • terconazole vaginal
  • cortisone
  • pyronaridine
  • tetrahydrozoline, ophthalmic
  • tenapanor
  • tesamorelin
  • benazepril/hydrochlorothiazide
  • nadolol and bendroflumethiazide
  • spironolactone and hydrochlorothiazide
  • COVID-19 Vaccine, mRNA
  • atosiban
  • bisoprolol and hydrochlorothiazide
  • ephedrine/guaifenesin
  • clonidine/chlorthalidone
  • captopril/hydrochlorothiazide
  • amlodipine/valsartan/hydrochlorothiazide
  • hydrochlorothiazide and irbesartan
  • candesartan/hydrochlorothiazide
  • ciclesonide intranasal
  • cromolyn sodium ophthalmic
  • methyldopa/hydrochlorothiazide
  • valsartan/hydrochlorothiazide
  • hydrochlorothiazide and triamterene
  • moexipril/hydrochlorothiazide
  • mometasone/intranasal
  • ofloxacin ophthalmic
  • cysteamine
  • metoprolol/hydrochlorothiazide
  • amlodipine/olmesartan
  • eprosartan/hydrochlorothiazide
  • amlodipine/telmisartan
  • hydrochlorothiazide/aliskiren
  • betamethasone/clotrimazole
  • telmisartan/hydrochlorothiazide
  • benazepril/amlodipine
  • bezlotoxumab
  • propranolol/hydrochlorothiazide
  • bupropion/naltrexone
  • burosumab
  • acetylcholine chloride intraocular solution
  • bupivacaine and meloxicam
  • budesonide and formoterol (inhalation)
  • valerian
  • entacapone/levodopa/carbidopa
  • carbidopa/levodopa
  • calaspargase pegol
  • cabotegravir
  • cefixime
  • calfactant
  • brinzolamide
  • daprodustat
  • brimonidine and timolol
  • brodalumab
  • buprenorphine and naloxone
  • hydrocortisone acetic acid otic
  • butorphanol
  • butoconazole
  • adapalene and benzoyl peroxide
  • acrivastine and pseudoephedrine
  • neomycin/polymyxin B/bacitracin topical
  • midodrine
  • baloxavir marboxil
  • bacitracin, neomycin, polymyxin B, and hydrocortisone topical
  • avatrombopag
  • glucagon
  • atenolol/chlorthalidone
  • adefovir
  • activated charcoal
  • avalglucosidase alfa
  • aclidinium and formoterol
  • iclaprim (Pending FDA Approval)
  • ampicillin/sulbactam
  • quinupristin/dalfopristin
  • lamivudine/zidovudine/abacavir
  • acetaminophen and caffeine
  • acetaminophen/pamabrom
  • abacavir and lamivudine
  • anifrolumab
  • elacestrant
  • anidulafungin
  • acetohydroxamic acid
  • alogliptin/pioglitazone
  • anthralin
  • pirtobrutinib
  • gabapentin
  • galsulfase
  • gadoterate meglumine
  • ferric gluconate
  • ferric derisomaltose
  • ethanolamine oleate
  • eteplirsen
  • vasopressin
  • desmopressin
  • meropenem/vaborbactam
  • ecallantide
  • econazole topical
  • dornase alfa
  • aspirin/dipyridamole
  • dipyridamole
  • difenoxin and atropine
  • diflorasone
  • difluprednate ophthalmic
  • eptinezumab
  • diethylpropion
  • dexchlorpheniramine
  • dexmethylphenidate
  • serdexmethylphenidate/​dexmethylphenidate
  • bexagliflozin
  • galcanezumab
  • fremanezumab
  • tapinarof topical
  • darifenacin
  • dalbavancin
  • darbepoetin alfa
  • azilsartan
  • colestipol
  • corticorelin
  • crotamiton
  • crofelemer
  • allogeneic cultured keratinocytes/fibroblasts in bovine collagen
  • tapentadol
  • cyclopentolate
  • polymyxin B/bacitracin topical
  • tavaborole
  • tagraxofusp
  • crisaborole
  • crizanlizumab
  • satralizumab
  • spinosad
  • sacubitril/valsartan
  • sargramostim
  • sebelipase alfa
  • regadenoson
  • ribociclib/letrozole
  • ragweed allergen extract
  • radium-223 dichloride
  • secnidazole
  • setmelanotide
  • polycarbophil
  • plecanatide
  • sacituzumab govitecan
  • pertuzumab
  • pertuzumab/trastuzumab/hyaluronidase
  • pamidronate
  • halcinonide
  • glecaprevir/​pibrentasvir
  • glucarpidase
  • golodirsen
  • dextrose (antidote)
  • hexaminolevulinate
  • iohexol
  • ferric citrate
  • elapegademase
  • emicizumab
  • erenumab
  • danaparoid
  • dantrolene
  • eflapegrastim
  • edaravone
  • amcinonide
  • carglumic acid
  • alcaftadine ophthalmic
  • agalsidase beta
  • afamelanotide
  • fosdenopterin
  • lidocaine and chlorhexidine
  • levorphanol
  • calcifediol
  • factor VIIa, recombinant
  • triheptanoin
  • peanut oral allergen powder
  • teprotumumab
  • poly-L-lactic acid/carboxymethylcellulose/mannitol
  • xenon Xe 129 hyperpolarized
  • ublituximab
  • anacaulase
  • glatiramer
  • peginterferon beta-1a
  • interferon beta-1a
  • onabotulinumtoxinA
  • cycloserine
  • ethionamide
  • cabotegravir and rilpivirine
  • vericiguat
  • omidenepag isopropyl
  • azelastine/fluticasone intranasal
revefenacin + 

secretin 

may decrease the therapeutic effect of Anticholinergic Agents

trofinetide 

may enhance the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates

agmatine

revefenacin: they may increase the bradycardic effect of Bradycardia-Causing Agents

mibefradil

revefenacin: they may increase the bradycardic effect of Bradycardia-Causing Agents

donepezil

revefenacin: they may increase the bradycardic effect of Bradycardia-Causing Agents

rivastigmine

revefenacin: they may increase the bradycardic effect of Bradycardia-Causing Agents

labetalol 

revefenacin: they may increase the bradycardic effect of Bradycardia-Causing Agents

bempedoic acid

OATP1B1/1B3 inhibitors increase the concentration of active metabolites of revefenacin in the serum

darolutamide

OATP1B1/1B3 inhibitors increase the concentration of active metabolites of revefenacin in the serum

sotagliflozin

OATP1B1/1B3 inhibitors increase the concentration of active metabolites of revefenacin in the serum

ubrogepant

OATP1B1/1B3 inhibitors increase the concentration of active metabolites of revefenacin in the serum

clarithromycin

OATP1B1/1B3 inhibitors increase the concentration of active metabolites of revefenacin in the serum

aclidinium 

may increase the anticholinergic effect of Anticholinergic Agents

neostigmine

may increase the anticholinergic effect of each other when combined

isoflurophate

may increase the anticholinergic effect of each other when combined

memantine/donepezil

may increase the anticholinergic effect of each other when combined

donepezil (Rx)

may increase the anticholinergic effect of each other when combined

donepezil transdermal

may increase the anticholinergic effect of each other when combined

methacholine 

may decrease the therapeutic effect of Long-acting muscarinic antagonists

tiotropium 

may increase the anticholinergic effect of Anticholinergic Agents

umeclidinium 

may increase the anticholinergic effect of Anticholinergic Agents

caspofungin

BCRP/ABCG2 inhibitors increase the concentration of pazobanib in the serum

lonafarnib

BCRP/ABCG2 inhibitors increase the concentration of pazobanib in the serum

hydroxyzine

revefenacin: they may decrease the therapeutic effect of antihistamines

levocabastine

revefenacin: they may decrease the therapeutic effect of antihistamines

mepyramine

revefenacin: they may decrease the therapeutic effect of antihistamines

acrivastine

revefenacin: they may decrease the therapeutic effect of antihistamines

alimemazine

revefenacin: they may decrease the therapeutic effect of antihistamines

cyclopentolate

it increases the effect of anticholinergic agents

pancuronium

it increases the effect of anticholinergic agents

botulinum toxin

it increases the effect of anticholinergic agents

atropine

it increases the effect of anticholinergic agents

abobotulinumtoxinA

it increases the effect of anticholinergic agents

diphenoxylate/atropine

revefenacin: they may increase the CNS depressant effect of CNS Depressants

phenobarbital

revefenacin: they may increase the CNS depressant effect of CNS Depressants

clorazepic acid

revefenacin: they may increase the CNS depressant effect of CNS Depressants

isoflurane

revefenacin: they may increase the CNS depressant effect of CNS Depressants

promazine

revefenacin: they may increase the CNS depressant effect of CNS Depressants

aclidinium and formoterol 

may increase the anticholinergic effect of anticholinergic agents

simeprevir 

may enhance the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Inhibitors

elbasvir/​grazoprevir 

may enhance the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Inhibitors

carbinoxamine 

may increase the anticholinergic effect of anticholinergic agents

atropine 

may increase the anticholinergic effect of anticholinergic agents

molindone 

may increase the anticholinergic effect of Anticholinergic Agents

atropine/pralidoxime 

may increase the anticholinergic effect of Anticholinergic Agents

acetaminophen/doxylamine/dextromethorphan 

may increase the anticholinergic effect of Anticholinergic Agents

taurursodiol 

may enhance the concentration of serum when combined with OAT1/3 substrates

donepezil (Rx)

may decrease the therapeutic effect of Anticholinergic Agents

prabotulinumtoxinA

may decrease the therapeutic effect of Anticholinergic Agents

itopride 

may decrease the therapeutic effect of Anticholinergic Agents

mirabegron 

may increase the adverse effect of Anticholinergic Agents

hydrochlorothiazide

may enhance the serum concentration of Anticholinergic Agents

metolazone

may enhance the serum concentration of Anticholinergic Agents

quinethazone

may enhance the serum concentration of Anticholinergic Agents

trichlormethiazide

may enhance the serum concentration of Anticholinergic Agents

topiramate 

may increase the adverse effect of Anticholinergic Agents

abediterol

revefenacin: they may increase the hypertensive effect of sympathomimetics

noradrenaline

revefenacin: they may increase the hypertensive effect of sympathomimetics

dextroamphetamine

revefenacin: they may increase the hypertensive effect of sympathomimetics

tetrahydrozoline nasal

revefenacin: they may increase the hypertensive effect of sympathomimetics

oxymetazoline

revefenacin: they may increase the hypertensive effect of sympathomimetics

maralixibat

revefenacin: they may enhance the serum concentration of CYP3A4 Inhibitors

lenacapavir

revefenacin: they may enhance the serum concentration of CYP3A4 Inhibitors

curcumin

revefenacin: they may enhance the serum concentration of CYP3A4 Inhibitors

glecaprevir

revefenacin: they may enhance the serum concentration of CYP3A4 Inhibitors

caspofungin

revefenacin: they may enhance the serum concentration of CYP3A4 Inhibitors

aminohippuric acid 

aminohippuric acid may result in a decreased excretion rate of revefenacin, potentially causing elevated serum levels

flavoxate 

may increase the anti-cholinergic effect

pretomanid 

may increase the serum concentration of OAT1/3 substrates

zavegepant 

may result in a significant increase in zavegepant exposure

raltegravir 

may diminish the serum concentration of each other when combined

methacholine 

long-acting muscarinic antagonists decrease the efficacy of methacholine

 

Dosage Forms & Strengths 

Oral Inhalation Solution 

175mcg/3ml vial 

Chronic Obstructive Pulmonary Disease (COPD) 

Using a mouthpiece on a nebulizer, inhale 175 mcg orally every day
Administer every day at the same time
Do not exceed 175mg daily once



Dose Adjustments

Renal impairment
Any level of impairment: No change in dose is necessary.
Patients with COPD with substantial renal impairment should be monitored for systemic antimuscarinic side effects.

Hepatic impairment
Mild-to-severe: Safety has not been determined; individuals with any degree of hepatic impairment are not recommended

 

Not suggested 

 

Refer adult dosing 

Frequency defined 

1-10% 

Nasopharyngitis (4%) 

Upper respiratory tract infection (3%) 

Hypertension (1-2%) 

Oropharyngeal pain (1-2%) 

Cough (4%) 

Headache (4%) 

Back pain (2%) 

Dizziness (1-2%) 

Bronchitis (1-2%) 

Frequency not defined 

Worsening narrow-angle glaucoma 

Immediate hypersensitivity reactions 

Dry mouth 

Paradoxical bronchospasm 

Worsening urinary retention 

Contraindications/caution: 

Contraindications: 

  • Hypersensitivity: revefenacin is contraindicated in individuals with known hypersensitivity or allergic reactions to revefenacin or any of its components. Allergic reactions can range from mild skin to severe systemic reactions requiring immediate medical attention. 
  • Acute bronchospasm: revefenacin should not be used to treat acute episodes of bronchospasm or acute exacerbations of chronic obstructive pulmonary disease (COPD). It is intended for maintenance treatment and not for immediate relief of acute symptoms. 
  • Urinary Retention: Individuals with a history of urinary retention or urinary bladder obstruction should avoid revefenacin due to the potential for worsening these conditions. LAMAs, including revefenacin, can have anticholinergic effects that may exacerbate urinary retention. 
  • Severe Hypersensitivity to Milk Proteins: Some formulations of revefenacin may contain lactose, which can be derived from milk proteins. Individuals with severe hypersensitivity to milk proteins should avoid revefenacin products that contain lactose. 

Caution: 

  • Hypersensitivity Reactions: Although hypersensitivity reactions are rare, they have been reported using revefenacin. Seek immediate medical attention if you experience rash,swelling,tching,  or difficulty breathing. 
  • Cardiovascular Effects: revefenacin, like other long-acting muscarinic antagonists (LAMAs), may have potential cardiovascular effects. Caution should be exercised in patients with pre-existing cardiovascular conditions such as coronary artery disease, arrhythmias, or hypertension. Close monitoring is recommended in these patients. 

 

  • Worsening of Urinary Retention: LAMAs, including revefenacin, can have anticholinergic effects that may exacerbate urinary retention. Patients with a history of urinary retention or bladder obstruction should use revefenacin cautiously and be monitored closely. 
  • Narrow-Angle Glaucoma: revefenacin should be used cautiously in individuals with narrow-angle glaucoma. LAMAs can induce pupillary dilation, which can potentially increase intraocular pressure. Regular eye examinations are recommended for patients with glaucoma. 
  • Paradoxical Bronchospasm: Rare cases of paradoxical bronchospasm (wheezing and shortness of breath) have been reported using revefenacin. If this occurs, discontinue the medication and seek medical assistance. 
  • Drug Interactions: revefenacin has a low potential for drug interactions as it is primarily metabolized by hydrolysis rather than through the cytochrome P450 enzyme system.  
  • Pregnancy and Lactation: Limited information about using revefenacin in pregnant or lactating women is available. It should be used only during pregnancy or breastfeeding if the potential benefits outweigh the risks. 

Pregnancy consideration: Insufficient data available 

Lactation: Excretion of the drug in human breast milk is unknown 

Pregnancy category: 

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 

<b>Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category 

Pharmacology: 

revefenacin is a long-acting muscarinic antagonist (LAMA) used as a bronchodilator for treating chronic obstructive pulmonary disease (COPD). The medication works by blocking the action of acetylcholine at muscarinic receptors in the airways, leading to the relaxation of the smooth muscle and dilation of the airways. 

Specifically, revefenacin is a selective antagonist of the M3 muscarinic receptor subtype found primarily in the airway smooth muscle. By blocking the M3 receptor, revefenacin reduces bronchoconstriction and increases airflow, making breathing easier for individuals with COPD. 

Pharmacodynamics: 

The pharmacodynamics of revefenacin are primarily related to its action as a long-acting muscarinic antagonist (LAMA). Here are the vital pharmacodynamic effects of revefenacin: 

  • Muscarinic Receptor Antagonism: revefenacin selectively blocks acetylcholine binding to the M3 subtype of muscarinic receptors in smooth airway muscles. By antagonizing these receptors, revefenacin inhibits the bronchoconstrictive effects of acetylcholine, leading to bronchodilation. 
  • Bronchodilation: The blockade of M3 muscarinic receptors in the airways by revefenacin causes relaxation of the smooth muscles surrounding the bronchioles. This results in the dilation of the airways, leading to improved airflow and reduced airway resistance. Bronchodilation helps alleviate symptoms such as coughing, wheezing, and shortness of breath in chronic obstructive pulmonary disease (COPD) patients. 
  • Decreased Mucus Secretion: revefenacin’s antagonism of M3 muscarinic receptors can also reduce mucus secretion in the airways. This can help alleviate symptoms related to excessive mucus production, such as phlegm and congestion. 
  • Reduction of Airway Inflammation: LAMAs, including revefenacin, have been shown to have anti-inflammatory effects in the airways. By inhibiting muscarinic receptor activation, revefenacin may contribute to a reduction in airway inflammation. 

Pharmacokinetics: 

Absorption 

revefenacin is administered via inhalation using a handheld inhaler device. When inhaled, the medication reaches the lungs, which are absorbed through the respiratory epithelium and into the bloodstream. The inhalation route allows for targeted lung delivery while minimizing systemic absorption.  

Distribution 

After absorption, revefenacin is distributed throughout the body. It primarily targets the muscarinic receptors in the smooth muscles of the airways, exerting bronchodilatory effects. The exact extent of distribution to other tissues and organs needs to be better characterized.  

Metabolism 

revefenacin undergoes metabolism primarily through hydrolysis, which is the breakdown of the molecule by adding water. The specific enzymes involved in the metabolism of revefenacin have yet to be fully elucidated. The metabolites formed because of hydrolysis are pharmacologically inactive.  

Elimination and Excretion 

The elimination of revefenacin and its metabolites occurs primarily through renal excretion. After metabolism, the drug and its metabolites are eliminated from the body through the urine. The exact proportion of revefenacin excreted unchanged versus as metabolites need to be better established. 

Administration: 

Oral Inhalation: 

  • Do not swallow or inject the solution. 
  • Use a standard jet nebulizer connected to an air compressor for administration. The safety and efficacy of administration via non compressor nebulizer systems have not been established. 
  • Before use, remove the unit-dose vial from the foil pouch and open it. Discard the vial and any remaining content after use. 
  • Do not mix revefenacin with other drugs in the nebulizer unless compatibility, efficacy, and safety have been established.

Storage: 

  • Store revefenacin at room temperature between 68-77°F (20-25°C). Excursions between 59-86°F (15-30°C) are permitted. 
  • Keep the medication in the foil pouch until it is ready to be administered. 
  • Protect revefenacin from direct light. 

Patient information leaflet 

Generic Name: revefenacin 

Why do we use revefenacin?  

revefenacin is a medication used for the maintenance treatment of chronic obstructive pulmonary disease (COPD) in adults. Here are the specific uses of revefenacin: 

Maintenance Treatment of COPD: revefenacin is indicated as a long-term maintenance treatment for patients with COPD. It improves symptoms and prevents exacerbations (flare-ups) in individuals with COPD, including chronic bronchitis and emphysema. 

The medication helps to alleviate symptoms such as shortness of breath, coughing, and wheezing by promoting bronchodilation and improving airflow. 

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revefenacin

Brand Name :

Yupelri

Synonyms :

revefenacin

Class :

Inhaled Anticholinergics




No data available for drug.

Dosage Forms & Strengths 

Oral Inhalation Solution 

175mcg/3ml vial 

Chronic Obstructive Pulmonary Disease (COPD) 

Using a mouthpiece on a nebulizer, inhale 175 mcg orally every day
Administer every day at the same time
Do not exceed 175mg daily once



Dose Adjustments

Renal impairment
Any level of impairment: No change in dose is necessary.
Patients with COPD with substantial renal impairment should be monitored for systemic antimuscarinic side effects.

Hepatic impairment
Mild-to-severe: Safety has not been determined; individuals with any degree of hepatic impairment are not recommended

Not suggested 

Refer adult dosing 

DRUG INTERACTION

revefenacin

&

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  • octinoxate/bisoctrizole
  • bicisate dihydrochloride
  • technetium Tc-99m bicisate
  • norelgestromin/ethinyl estradiol
  • norgestimate/ethinyl estradiol
  • ximelagatran (investigational)
  • xamoterol
  • trioxsalen
  • poly-urea urethane
  • rilmenidine
  • pemirolast
  • oxitriptan
  • beclomethasone, intranasal
  • thimerosal
  • camphor gel
  • camphor
  • mumps virus vaccine, live
  • rubella virus vaccine, live
  • aluminum chloride (dental)
  • alum irrigation
  • framycetin, phenylephrine, and gramicidin
  • ombitasvir, paritaprevir, ritonavir, and dasabuvir
  • olipudase alfa
  • etonogestrel/ethinyl estradiol
  • mycophenolate
  • fluoroestradiol F 18
  • donor organ cardioplegia solution
  • fluciclovine F 18
  • fusidic acid (ophthalmic)
  • fusidic acid and hydrocortisone
  • framycetin, dexamethasone, and gramicidin
  • fludeoxyglucose F-18
  • fluorouracil/salicylic acid
  • indium In-111 oxyquinoline
  • indium In-111 pentetreotide
  • indium In-111 capromab pendetide
  • lusutrombopag
  • mitomycin (ophthalmic)
  • mifepristone and misoprostol
  • minoxidil (systemic)
  • methyl aminolevulinate (topical)
  • methyl folate, methylcobalamin, and acetylcysteine
  • ciclesonide/formoterol/tiotropium
  • nedocromil (Oral Inhalation)
  • batefenterol (Investigational)
  • neostigmine and glycopyrrolate
  • nepafenac ophthalmic
  • netupitant/palonosetron
  • meperidine and promethazine
  • mepivacaine and levonordefrin
  • maltodextrin
  • medical cannabis
  • medium chain triglycerides
  • mometasone/glycopyrrolate (glycopyrronium)/ indacaterol
  • moxifloxacin ophthalmic
  • neomycin/fluocinolone
  • nadroparin
  • iodine I-125 iothalamate
  • amikacin liposome (oral inhalation)
  • bupivacaine liposome
  • natamycin
  • lopinavir and ritonavir
  • lysine
  • macitentan and tadalafil
  • mitomycin pyelocalyceal
  • moclobemide
  • mometasone and indacaterol
  • efinaconazole
  • blue-green algae
  • indocyanine green
  • follitropin beta
  • lumasiran
  • glycerin/lidocaine
  • edrophonium/atropine
  • indigo carmine
  • lutropin alfa
  • instant glucose/intravenous dextrose
  • iobenguane I-123
  • ixekizumab
  • isosulfan blue dye
  • levofloxacin ophthalmic
  • levonorgestrel oral/ferrous bisglycinate/ ethinylestradiol
  • ethinyl estradiol/levonorgestrel transdermal
  • hydroquinone
  • hydroxypropyl methylcellulose
  • icodextrin
  • lipid emulsion (soybean, medium-chain triglyceride, olive, and fish oils; [SMOF])
  • iodinated I 125 albumin
  • iodinated I 131 albumin
  • lipid emulsion (plant oil-based)
  • levonorgestrel intrauterine
  • levonorgestrel oral/ethinyl estradiol
  • lactic acid and sodium-PCA
  • lactated Ringer solution
  • ketotifen (systemic)
  • lanolin
  • leuprolide and norethindrone
  • levodopa and benserazide
  • gonadorelin acetate
  • hemodialysis solutions
  • nirsevimab
  • gentian violet
  • gallium ga-68 dotatate
  • fusidic acid and betamethasone
  • gallium citrate Ga-67
  • gadopentetate dimeglumine
  • gadofosveset
  • follitropin delta
  • follitropin alfa and lutropin alfa
  • follitropin alfa
  • rocatinlimab
  • grass pollens allergen extract
  • flotufolastat F18
  • fluorescein ophthalmic
  • barium
  • balanced salt solution
  • air polymer type A intrauterine device
  • clodronate
  • bentoquatam
  • clobetasone
  • alfacalcidol
  • citric acid/glucono-delta-lactone/magnesium carbonate
  • benzoin
  • desirudin
  • immune globulin IV (IGIV)
  • dequalinium
  • pseudoephedrine/desloratadine
  • clofedanol
  • cyproterone and ethinyl estradiol
  • dextranomer and hyaluronic acid or derivatives
  • diatrizoate meglumine and diatrizoate sodium
  • glucosamine sulfate, chondroitin sulfate and Msm
  • squill
  • gotu kola
  • blessed thistle
  • bitter melon
  • apraclonidine
  • chlophedianol/dexbrompheniramine/pseudoephedrine
  • wild jujube
  • chitosan
  • cilazapril/hydrochlorothiazide
  • dexbrompheniramine and phenylephrine
  • diethylene triamine penta-acetic acid
  • dexchlorpheniramine and pseudoephedrine
  • lily of the valley
  • diflucortolone
  • corydalis
  • lemon balm
  • MSM
  • calcium polystyrene sulfonate
  • caprylidene
  • peppermint oil
  • efavirenz/lamivudine/tenofovir DF
  • emtricitabine/tenofovir DF /efavirenz
  • dutasteride/tamsulosin
  • milk thistle
  • centaury
  • horseweed
  • lycopus
  • agrimony
  • alfalfa
  • kava
  • cetrorelix
  • cetylpyridinium
  • chlophedianol and dexbrompheniramine
  • betahistine
  • choline C-11
  • boric acid vaginal suppository
  • aluminum acetate
  • aluminum chloride hexahydrate
  • 14-C urea breath test
  • absorbable collagen
  • valoctocogene roxaparvovec-rvox
  • amlodipine and celecoxib
  • aspirin and omeprazole
  • azilsartan and chlorthalidone
  • landiolol (Pending FDA approval)
  • isosorbide dinitrate/hydralazine
  • losartan/hydrochorothiazide
  • udenafil
  • dextromethorphan/quinidine
  • onasemnogene abeparvovec
  • orphenadrine/aspirin/caffeine
  • trace elements
  • sodium phenylbutyrate/ taurursodiol
  • fish oil triglycerides
  • infant formula
  • glutamine
  • chloroquine phosphate
  • afatinib
  • quinidine gluconate
  • methylergonovine
  • prothrombin complex concentrate, human
  • BCG intravesical live
  • capivasertib
  • cedazuridine
  • carbonyl iron
  • iron dextran complex
  • lovotibeglogene autotemcel (FDA Approval Pending)
  • sodium benzoate/sodium phenylacetate
  • mineral oil otic
  • zolmitriptan transdermal
  • midazolam intranasal
  • fosinopril/hydrochlorothiazide
  • caplacizumab
  • arginine
  • sodium phenylbutyrate
  • meloxicam/rizatriptan
  • manganese
  • acetaminophen/pamabrom/pyridoxine
  • varicella zoster immune globulin, human
  • amitriptyline/perphenazine
  • narsoplimab (Pending FDA Approval)
  • amlodipine/perindopril
  • imiglucerase
  • canagliflozin/metformin
  • tafamidis meglumine
  • somatrogon-ghla
  • glimepiride/rosiglitazone
  • becaplermin
  • lithium
  • loxapine inhaled
  • nicotine transdermal
  • tixagevimab and cilgavimab (Investigational)
  • muromonab CD3
  • ansuvimab
  • coal tar bath products
  • fibrin sealant
  • arimoclomol (FDA Approval Pending)
  • varenicline intranasal
  • aducanumab
  • oxycodone/naloxone
  • ritlecitinib
  • sodium polystyrene sulfonate
  • calcipotriene/betamethasone
  • calcium hydroxylapatite
  • cantharidin topical
  • doxepin cream
  • clocortolone
  • formaldehyde topical
  • sodium sulfide topical
  • collagenase
  • selegiline transdermal
  • foscarbidopa/foslevodopa (FDA approval pending)
  • saxagliptin/metformin
  • linagliptin/metformin
  • linzagolix (FDA approval pending)
  • efgartigimod/hyaluronidase SC
  • elamipretide (Pending FDA approval)
  • rozanolixizumab
  • diazoxide
  • glimepiride/pioglitazone
  • cipaglucosidase alfa
  • dihydroergotamine intranasal
  • delandistrogene moxeparvovec
  • beremagene geperpavec
  • hyaluronic acid and derivatives
  • hyaluronic acid, non-animal stabilized
  • eplontersen (FDA Approval Pending)
  • nitric oxide gas
  • sodium phenylbutyrate and taurursodiol
  • treprostinil SC
  • viltolarsen
  • albuterol/ipratropium
  • budesonide inhaled
  • budesonide rectal
  • palovarotene
  • sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol
  • amino acids mixture
  • aminobenzoate potassium
  • elivaldogene autotemcel
  • naproxen and sumatriptan
  • sumatriptan intranasal
  • alglucerase
  • metformin/rosiglitazone
  • ertugliflozin/metformin
  • elosulfase alfa
  • calcium carbonate/magnesium hydroxide
  • starch suppository
  • abicipar pegol (FDA Approval Pending)
  • riboflavin 5′-phosphate ophthalmic
  • povidone ophthalmic
  • glycerin oropharyngeal
  • dimethicone topical
  • menthol topical, dimethicone topical
  • pramoxine topical, menthol topical and dimethicone topical
  • phosphorated carbohydrate
  • brilliant blue G ophthalmic
  • brolucizumab intravitreal
  • purified water, ophthalmic
  • hydroxyethyl cellulose ophthalmic
  • ranibizumab intravitreal implant
  • sodium chloride hypertonic, ophthalmic 
  • cetirizine ophthalmic
  • phentolamine ophthalmic
  • ganciclovir ophthalmic
  • triamcinolone intravitreal
  • ocriplasmin intravitreal
  • atoltivimab/maftivimab/odesivimab
  • pegcetacoplan intravitreal
  • triamcinolone acetonide extended-release injectable suspension
  • tobramycin/loteprednol ophthalmic
  • 2-octyl cyanoacrylate
  • vitamins A & D topical
  • diphenhydramine/allantoin topical
  • pyrethrins/piperonyl butoxide
  • lodoxamide ophthalmic
  • obeticholic acid
  • fluocinolone intravitreal implant
  • sincalide
  • linaclotide
  • nedocromil ophthalmic
  • cysteamine ophthalmic
  • avacincaptad pegol intravitreal
  • azelastine ophthalmic
  • bacitracin ophthalmic
  • propylene glycol ophthalmic
  • rimexolone ophthalmic
  • metoclopramide intranasal
  • mirikizumab
  • netarsudil ophthalmic
  • cenegermin
  • dexamethasone ophthalmic insert
  • prednisolone ophthalmic
  • phenylephrine and cocoa butter rectal
  • phenylephrine and witch hazel topical
  • phenylephrine, pramoxine, glycerin and petrolatum rectal
  • bisacodyl rectal
  • aluminum hydroxide/magnesium carbonate
  • aluminum hydroxide/magnesium hydroxide
  • hyoscyamine spray
  • methenamine/methylene blue/ hyoscyamine/ sodium phosphate monobasic/ phenyl salicylate
  • phenylephrine
  • chlorophyll
  • castor oil
  • cholic acid
  • phenol oropharyngeal
  • articaine/epinephrine
  • antithymocyte globulin equine
  • aluminum hydroxide/magnesium trisilicate
  • methenamine/hyoscyamine
  • hydrocortisone topical/pramoxine topical 
  • sodium fluoride topical
  • mesna
  • C1 esterase inhibitor recombinant
  • menthol and pectin
  • menthol oropharyngeal
  • pectin oropharyngeal
  • gepirone
  • Goldenseal
  • polyethylene glycol and electrolytes
  • polyethylene glycol/electrolytes/sodium ascorbate/ascorbic acid
  • brompheniramine/pseudoephedrine/dextromethorphan
  • brompheniramine phenylephrine
  • acetaminophen/doxylamine/phenylephrine
  • doxylamine/acetaminophen/pseudoephedrine/dextromethorphan
  • acetaminophen/doxylamine/dextromethorphan
  • acetaminophen/doxylamine/dextromethorphan/phenylephrine
  • eslicarbazepine
  • fluticasone and salmeterol
  • codeine, acetaminophen, butalbital and caffeine
  • codeine, chlorpheniramine and phenylephrine
  • iodine
  • povidone iodine
  • butalbital/aspirin/caffeine/codeine
  • polyethylene glycol 400/propylene glycol ophthalmic 
  • pegvaliase
  • amivantamab
  • iopamidol
  • codeine and pseudoephedrine
  • emtricitabine, rilpivirine, tenofovir DF
  • penicillin G aqueous
  • miconazole topical
  • miconazole vaginal
  • ciprofloxacin inhaled (Pending FDA approval)
  • ceftazidime/avibactam
  • ceftolozane/​tazobactam
  • aztreonam inhalation
  • amphotericin B cholesteryl sulfate
  • miconazole oral
  • elvitegravir/cobicistat/emtricitabine/tenofovir DF
  • isavuconazonium sulfate
  • dapivirine intravaginal (FDA Approval Pending)
  • lamivudine/raltegravir
  • codeine/triprolidine/pseudoephedrine
  • cadexomer iodine
  • brompheniramine/pseudoephedrine
  • codeine/acetaminophen
  • codeine/guaifenesin
  • beclomethasone inhaled
  • epoetin beta/methoxy polyethylene glycol
  • voreloxin(Orphan Drug)
  • rociletinib
  • pitcher plant
  • phosphatidylserine
  • telotristat ethyl
  • copper CU 64 dotatate
  • urea topical
  • exenatide subdermal implant
  • asenapine transdermal
  • ethiodized oil
  • urea oral
  • miglustat
  • acalisib(Investigational)
  • acetophenazine
  • guggul
  • aceneuramic acid
  • mestranol/norethindrone
  • reishi
  • lactitol
  • vonoprazan fumarate
  • motherwort
  • silver nitrate
  • salicylic acid/sulfur shampoo
  • salicylic acid topical
  • ketorolac ophthalmic
  • ketoconazole topical
  • Japanese encephalitis virus vaccine
  • dibucaine topical ointment
  • ketorolac intranasal
  • ketorolac/phenylephrine ophthalmic
  • rotavirus oral vaccine, live
  • guarana
  • hops
  • krill oil
  • salicylic acid/coal tar shampoo
  • sufentanil SL
  • pancrelipase
  • passion flower
  • pepdite one plus
  • nivolumab and relatlimab
  • relatlimab (Pending FDA Approval)
  • benzalkonium chloride/benzocaine
  • ketotifen, drug-eluting contact lens
  • calcitriol topical
  • oxymetazoline topical
  • alclometasone topical
  • capsaicin topical
  • diclofenac/misoprostol
  • diclofenac ophthalmic
  • diclofenac topical
  • pramoxine/calamine topical
  • veverimer
  • tolazoline
  • olopatadine ophthalmic
  • lutetium lu 177-dota-tate
  • lutetium lu 177 vipivotide tetraxetan
  • strontium 89 chloride
  • interferon alfa n3
  • lutetium Lu 177- Diethylenetriamine Pentaacetic acid-omburtamab (FDA Approval Pending)
  • samarium sm 153 lexidronam
  • cytomegalovirus immune globulin (CMV IG)
  • antithymocyte globulin rabbit
  • inolimomab (Pending FDA Approval)
  • olopatadine intranasal
  • olopatadine intranasal/​mometasone, intranasal
  • benzocaine/butamben/tetracaine topical
  • antipyrine/benzocaine/phenylephrine
  • dyclonine/menthol
  • surufatinib
  • fruquintinib
  • tepotinib 
  • dostarlimab
  • hepatitis B immune globulin (HBIG)
  • remestemcel-L
  • benzocaine/menthol oropharyngeal
  • interferon beta 1b
  • tetracaine/oxymetazoline intranasal
  • benzocaine oropharyngeal
  • benzalkonium chloride/menthol/petrolatum topical
  • inamrinone
  • alpha 1 proteinase inhibitor
  • potassium bicarbonate/potassium citrate
  • potassium phosphate/sodium acid phosphate
  • asparaginase Erwinia chrysanthemi recombinant
  • motixafortide
  • pegloticase
  • etesevimab
  • Rho(D) immune globulin
  • tetanus immune globulin (TIG)
  • reltecimod (pending FDA approval)
  • avasopasem
  • trimethoprim/polymyxin B ophthalmic
  • naphazoline ophthalmic
  • sulfacetamide topical
  • sirolimus intravitreal (pending FDA approval)
  • sirolimus protein bound
  • sirolimus topical
  • glycopyrronium tosylate topical
  • sofpironium
  • olmesartan, amlodipine and hydrochlorothiazide
  • dovitinib (Pending FDA Approval)
  • epinephrine inhaled
  • quizartinib (Pending FDA Approval)
  • ranibizumab intravitreal injection
  • sodium hyaluronate
  • bacitracin and lidocaine topical
  • brimonidine topical
  • benzoyl peroxide and tretinoin topical
  • talquetamab
  • betrixaban
  • acetaminophen/caffeine/pyrilamine
  • fentanyl transmucosal
  • bacitracin topical
  • buprenorphine,long-acting injection
  • buprenorphine buccal
  • nalmefene intranasal
  • sulbactam/durlobactam
  • metronidazole topical 
  • daratumumab/hyaluronidase
  • glofitamab
  • rituximab-hyaluronidase
  • drospirenone/ethinyl estradiol/levomefolate
  • loncastuximab tesirine
  • ingenol mebutate topical
  • momelotinib
  • trastuzumab/deruxtecan
  • trastuzumab/hyaluronidase
  • trastuzumab duocarmazine
  • lifileucel
  • umbralisib
  • eflornithine/sulindac
  • cytarabine/daunorubicin liposomal
  • doxorubicin liposomal
  • epcoritamab
  • lanadelumab  
  • esomeprazole/naproxen 
  • terbinafine topical
  • ravulizumab
  • clotrimazole topical
  • choline magnesium trisalicylate
  • tacrolimus ointment
  • mechlorethamine topical
  • donislecel
  • pozelimab (Pending FDA Approval)
  • human rabies immune globulin (HRIG)
  • melphalan flufenamide
  • sintilimab (Pending FDA Approval)
  • oportuzumab monatox (Pending FDA Approval)
  • sotorasib
  • irinotecan liposomal
  • sulfur topical
  • silver sulfadiazine
  • capsaicin transdermal
  • sutimlimab
  • tretinoin topical
  • acetaminophen rectal
  • menthol topical
  • naftifine
  • oatmeal, colloidal topical
  • oxiconazole
  • methylsalicylate/menthol topical
  • C1 inhibitor human
  • lifitegrast ophthalmic
  • prednisolone/sulfacetamide ophthalmic
  • mannitol inhalation
  • ofloxacin otic
  • petrolatum & mineral oil topical
  • clascoterone topical
  • gefapixant (Pending FDA Approval)
  • colesevelam
  • technetium Tc 99m succimer
  • nebivolol/valsartan
  • ciprofloxacin/fluocinolone acetonide, otic
  • finafloxacin otic
  • magnesium hydroxide/mineral oil
  • phenylephrine/mineral oil/petrolatum rectal
  • carbamide peroxide oral
  • atropine ophthalmic
  • sodium sulfacetamide/sulfur
  • sulfacetamide ophthalmic
  • lucinactant
  • benzonatate
  • besifloxacin ophthalmic
  • benzhydrocodone/acetaminophen
  • beractant
  • trimagnesium citrate anhydrous
  • vitamin b2
  • carbamide peroxide otic
  • mineral oil topical
  • ethyl alcohol intranasal
  • boric acid/alcohol otic
  • absorbable gelatin compressed sponge, USP
  • absorbable gelatin sponge, USP
  • vincristine liposomal
  • technetium Tc 99m albumin aggregated injection
  • metaproterenol
  • budesonide inhaled/formoterol/glycopyrrolate inhaled
  • epinephrine racemic
  • umeclidinium bromide/vilanterol inhaled
  • indacaterol, inhaled/glycopyrrolate inhaled
  • betaine  
  • laronidase 
  • estrogens esterified/methyltestosterone            
  • cerliponase alfa
  • ertugliflozin/sitagliptin
  • hawthorn
  • shepherd’s purse
  • thiamine
  • naphazoline/glycerin ophthalmic
  • oxymetazoline ophthalmic
  • dorzolamide
  • dexamethasone intraocular
  • dexamethasone/ciprofloxacin
  • dexamethasone ophthalmic
  • metipranolol ophthalmic
  • timolol ophthalmic
  • boron
  • fezolinetant
  • pegunigalsidase alfa-iwxj
  • biotin
  • pantothenic acid
  • silicon
  • sodium acid phosphate
  • hypochlorous acid topical
  • methenamine/sodium acid phosphate
  • aviptadil 
  • bremelanotide
  • glucagon intranasal
  • metformin and repaglinide
  • bai ji
  • pau d’arco
  • juzentaihoto
  • mistletoe
  • quercetin
  • rosemary
  • sheng di huang
  • chasteberry
  • maitake
  • grapefruit
  • lentinan
  • juniper
  • nettle
  • parsley
  • rose hips
  • tongkat ali
  • horny goat weed
  • damiana
  • yohimbe
  • insulin NPH
  • aprocitentan
  • noni Juice
  • sodium iodide I-131
  • green tea
  • sea cucumber
  • wheat germ extract
  • fenofibrate micronized 
  • rogisen
  • danshen
  • lutein
  • witch hazel
  • dextroamphetamine transdermal
  • amphetamine/dextroamphetamine
  • hoodia
  • kolanut
  • boswellia
  • opuntia ficus indica
  • lavender
  • nadh
  • tea tree oil
  • metformin/sitagliptin 
  • dapagliflozin/ metformin/saxagliptin  
  • antihemophilic factor recombinant
  • inclisiran
  • bempedoic acid/ezetimibe
  • volanesorsen  
  • omega 3 carboxylic acids
  • pericyazine
  • levomepromazine (methotrimeprazine)
  • betaxolol ophthalmic
  • respiratory syncytial virus vaccine, adjuvanted
  • phenylephrine hydrochloride and tropicamide ophthalmic
  • alirocumab
  • neomycin/polymyxin B/gramicidin ophthalmic
  • factor IX
  • gentamicin topical
  • ansofaxine (Pending FDA Approval)
  • zuranolone
  • factor IX, recombinant
  • factor IX complex
  • factor XIII A-subunit, recombinant
  • factor X, human
  • mesalamine rectal
  • etrasimod
  • anti-inhibitor coagulant complex
  • factor IX, recombinant/albumin fusion protein
  • fibrinogen, human
  • aminocaproic acid
  • metyrosine
  • nonoxynol-9 vaginal
  • progesterone intravaginal gel
  • ipecac syrup
  • botulinum antitoxin, heptavalent
  • pentetate calcium trisodium
  • crotalidae polyvalent immune FAB (ovine)
  • dehydrated alcohol injection 
  • gold sodium thiomalate (Discontinued)
  • lactic acid/citric acid/potassium bitartrate vaginal
  • von Willebrand factor, recombinant
  • luspatercept
  • digoxin immune FAB (Antidote)
  • crotalidae immune FAB (equine)
  • magnesium (Antidote)
  • pyridoxine (Antidote)
  • edetate calcium disodium
  • albumin IV
  • nitroglycerin sublingual
  • obiltoxaximab
  • anthrax immune globulin
  • nitroglycerin topical
  • dextrose
  • nesiritide
  • estradiol vaginal
  • bazedoxifene/conjugated estrogens
  • botulism immune globulin iv
  • amoxicillin/omeprazole/rifabutin
  • synthetic human angiotensin II
  • nitroglycerin IV
  • nitroglycerin translingual
  • nitroprusside sodium
  • tetrahydrozoline/zinc sulfate/hypromellose ophthalmic
  • sodium citrate/citric acid
  • pemetrexate
  • methicillin
  • plasminogen 
  • acai
  • american ginseng
  • cordyceps
  • tramadol/acetaminophen
  • belladonna alkaloids/phenobarbital
  • erythromycin topical/benzoyl peroxide
  • glucosamine sulfate
  • panax ginseng (suppl/herb)
  • tolnaftate
  • sulopenem etzadroxil/probenecid
  • sulfur hexafluoride
  • sotrovimab
  • arbaclofen
  • rifampin/isoniazid
  • clindamycin /tretinoin topical
  • benzoyl peroxide/clindamycin topical
  • apremilast
  • antivenins, centuroides (scorpion)
  • bamlanivimab and etesevimab
  • vilobelimab
  • gadobenate
  • pentosan polysulfate sodium
  • methylsalicylate/menthol/camphor topical
  • antivenin, black widow spider
  • benzoyl peroxide and hydrocortisone
  • clindamycin topical
  • isometheptene, dichloralphenazone and acetaminophen
  • acetaminophen and phenyltoloxamine
  • erythromycin topical
  • erythromycin ophthalmic
  • alpha hydroxy acids, topical
  • buprenorphine transdermal
  • butalbital/acetaminophen/caffeine
  • buprenorphine/samidorphan
  • buprenorphine subdermal implant
  • celecoxib/tramadol
  • drospirenone/ethinyl estradiol
  • resorcinol/sulfur
  • eflornithine
  • rifampin/isoniazid/pyrazinamide
  • tofersen
  • devil’s claw
  • ticarcillin/clavulanate
  • atropine/pralidoxime
  • aprepitant
  • suramin
  • phenelzine 
  • artichoke
  • american dogwood
  • attapulgite
  • atlantic cedar
  • axalimogene filolisbac
  • sodium thiosulfate & sodium nitrite
  • ataluren
  • omidubicel-onlv
  • capsicum
  • ginger
  • cryoprecipitate
  • bictegravir/emtricitabine/tenofovir DF
  • emtricitabine/tenofovir DF
  • fo-ti
  • siberian ginseng
  • granulocytes
  • zinc substituted heme C
  • zinc trihydroxide
  • ashwagandha 
  • cat’s claw
  • glandular products
  • SAMe
  • shark cartilage
  • altovis
  • feverfew
  • horse chestnut
  • magnesium aspartate
  • octacosanol
  • pleurisy root
  • star anise
  • butterbur
  • elderberry
  • licorice (Suppl/herb)
  • aconite
  • pentetate zinc trisodium
  • menthol topical/zinc oxide topical
  • corn-starch/kaolin/zinc oxide topical
  • 5-htp
  • butcher’s broom
  • articulin
  • bearberry
  • goldenrod
  • progesterone, natural
  • black cohosh
  • wild yam
  • cranberry
  • dong quai
  • phytoestrogens
  • norethindrone
  • false Unicorn Root
  • raspberry Leaf
  • asafoetida
  • turmeric
  • dehydroepiandrosterone (DHEA)
  • hyaluronan
  • aliskiren/amlodipine
  • octreotide (Antidote)
  • tranexamic acid injection
  • duocal
  • neocate infant formula
  • pediatric Eo28
  • aloe
  • red clover
  • propolis
  • androstenedione
  • heartsease
  • comfrey
  • bilberry
  • chamomile
  • eyebright
  • calendula
  • sage
  • yucca
  • polypody
  • odevixibat
  • vinpocetine
  • olanzapine/samidorphan
  • creatine
  • yerba mate
  • spesolimab
  • azficel-T
  • tiludronate
  • estetrol and drospirenone
  • pseudoephedrine/fexofenadine
  • lincomycin
  • neomycin oral
  • fluocinolone acetonide, otic
  • tretinoin/ hydroquinone/ fluocinolone
  • halobetasol topical
  • hydrocortisone/​iodoquinol
  • penicillin G procaine /penicillin G benzathine
  • hydrocortisone probutate topical
  • colistin/neomycin/hydrocortisone/thonzonium otic
  • ebola zaire vaccine
  • hepatitis a/​b vaccine
  • vibegron
  • lindane
  • nystatin topical
  • respiratory syncytial virus (RSV) vaccine
  • chikungunya vaccine, live
  • tenecteplase
  • reteplase
  • anthrax vaccine adsorbed, adjuvanted
  • meningococcal ABCWY pentavalent vaccine
  • eculizumab
  • cholestyramine
  • tinzaparin
  • taurolidine/​citrate/​heparin
  • protein C concentrate
  • antithrombin alfa
  • antithrombin III
  • multivitamins, vision
  • ibuprofen/​chlorpheniramine/​pseudoephedrine
  • acetaminophen/ibuprofen
  • ibuprofen/pseudoephedrine
  • paclitaxel protein-bound
  • acetic acid vaginal
  • acetic acid otic
  • hydrocodone/ ibuprofen
  • methyl salicylate / isopropanol/ citronellyl acetate/ citric acid
  • ibuprofen and phenylephrine
  • acetylcysteine (Antidote)
  • iron/​folic acid/​vitamin/​mineral
  • iobenguane I-131
  • dolutegravir/rilpivirine
  • chlorhexidine topical
  • chlorhexidine oral
  • thyroid desiccated
  • proparacaine ophthalmic
  • podophyllum resin
  • phendimetrazine
  • phenoxybenzamine
  • polidocanol
  • phentermine and topiramate
  • piflufolastat F18
  • piperacillin/tazobactam
  • prednisolone and gentamicin ophthalmic
  • promethazine and codeine
  • poractant alfa
  • protamine sulfate
  • aflibercept intravitreal
  • prednicarbate
  • promethazine/dextromethorphan
  • codeine, phenylephrine, and promethazine
  • potassium phosphate
  • glatiramer acetate
  • gentamicin (Ophthalmic)
  • leniolisib
  • rezafungin
  • fluorometholone
  • dalfampridine
  • hydrocortisone topical 
  • empagliflozin and linagliptin
  • triamcinolone topical
  • minocycline topical
  • minocycline dental
  • ketotifen ophthalmic
  • darunavir and cobicistat
  • lidocaine topical
  • neomycin/polymyxin B/bacitracin/lidocaine (OTC)
  • lidocaine/ hydrocortisone
  • lidocaine anesthetic
  • lidocaine ophthalmic
  • lidocaine/tetracaine
  • desonide
  • dabigatran
  • fexofenadine
  • fluoride
  • decitabine and cedazuridine
  • dasiglucagon
  • hydroxypropyl cellulose ophthalmic
  • epoetin alfa
  • ibritumomab tiuxetan
  • trimethobenzamide
  • dexamethasone/ tobramycin
  • tafasitamab
  • valacyclovir
  • mebendazole
  • levoleucovorin
  • flaxseed
  • germanium
  • glutathione
  • lycopene
  • pygeum
  • horseradish
  • ziv-aflibercept
  • micafungin
  • trofinetide
  • taliglucerase alfa
  • tildrakizumab
  • sulopenem (Pending FDA Approval)
  • thyrotropin alfa
  • birch
  • thrombin, topical
  • tivozanib
  • tafluprost
  • methohexital
  • urea and hydrocortisone
  • unoprostone ophthalmic
  • trihexyphenidyl
  • ezetimibe
  • evolocumab
  • trifluridine and tipiracil
  • methenamine
  • misoprostol
  • miltefosine
  • rimantadine
  • maralixibat
  • coenzyme Q10
  • chlorella
  • garlic
  • forskolin
  • zavegepant
  • menotropins
  • margetuximab
  • meprobamate
  • melarsoprol
  • evening primrose oil
  • lemongrass
  • molindone
  • fenugreek
  • phytosterols
  • red yeast rice
  • uridine triacetate
  • tropicamide
  • incobotulinumtoxinA
  • Grape Seed Extract
  • carbachol ophthalmic
  • cosyntropin
  • cyclopentolate and phenylephrine
  • carteolol ophthalmic
  • pentazocine/naloxone
  • pentazocine/acetaminophen
  • casimersen
  • carisoprodol, aspirin, and codeine
  • carisoprodol
  • carboprost tromethamine
  • flurandrenolide
  • brinzolamide/brimonidine
  • betamethasone topical
  • omaveloxolone
  • bardoxolone
  • allogeneic processed thymus tissue
  • fluocinolone topical
  • tacrolimus topical
  • ruxolitinib topical
  • pimecrolimus topical
  • sofosbuvir, velpatasvir and voxilaprevir
  • sofosbuvir/velpatasvir
  • mitotane
  • elbasvir/​grazoprevir
  • wheat dextrin
  • vanadium
  • iron/folic acid/vitamin/mineral
  • molybdenum
  • sparsentan
  • velmanase alfa-tycv
  • pegcetacoplan
  • ferrous sulfate
  • cyclosporine ophthalmic
  • ferric pyrophosphate
  • ammonium lactate
  • etelcalcetide
  • iodoquinol
  • sucroferric oxyhydroxide
  • doxercalciferol
  • terconazole vaginal
  • cortisone
  • pyronaridine
  • tetrahydrozoline, ophthalmic
  • tenapanor
  • tesamorelin
  • benazepril/hydrochlorothiazide
  • nadolol and bendroflumethiazide
  • spironolactone and hydrochlorothiazide
  • COVID-19 Vaccine, mRNA
  • atosiban
  • bisoprolol and hydrochlorothiazide
  • ephedrine/guaifenesin
  • clonidine/chlorthalidone
  • captopril/hydrochlorothiazide
  • amlodipine/valsartan/hydrochlorothiazide
  • hydrochlorothiazide and irbesartan
  • candesartan/hydrochlorothiazide
  • ciclesonide intranasal
  • cromolyn sodium ophthalmic
  • methyldopa/hydrochlorothiazide
  • valsartan/hydrochlorothiazide
  • hydrochlorothiazide and triamterene
  • moexipril/hydrochlorothiazide
  • mometasone/intranasal
  • ofloxacin ophthalmic
  • cysteamine
  • metoprolol/hydrochlorothiazide
  • amlodipine/olmesartan
  • eprosartan/hydrochlorothiazide
  • amlodipine/telmisartan
  • hydrochlorothiazide/aliskiren
  • betamethasone/clotrimazole
  • telmisartan/hydrochlorothiazide
  • benazepril/amlodipine
  • bezlotoxumab
  • propranolol/hydrochlorothiazide
  • bupropion/naltrexone
  • burosumab
  • acetylcholine chloride intraocular solution
  • bupivacaine and meloxicam
  • budesonide and formoterol (inhalation)
  • valerian
  • entacapone/levodopa/carbidopa
  • carbidopa/levodopa
  • calaspargase pegol
  • cabotegravir
  • cefixime
  • calfactant
  • brinzolamide
  • daprodustat
  • brimonidine and timolol
  • brodalumab
  • buprenorphine and naloxone
  • hydrocortisone acetic acid otic
  • butorphanol
  • butoconazole
  • adapalene and benzoyl peroxide
  • acrivastine and pseudoephedrine
  • neomycin/polymyxin B/bacitracin topical
  • midodrine
  • baloxavir marboxil
  • bacitracin, neomycin, polymyxin B, and hydrocortisone topical
  • avatrombopag
  • glucagon
  • atenolol/chlorthalidone
  • adefovir
  • activated charcoal
  • avalglucosidase alfa
  • aclidinium and formoterol
  • iclaprim (Pending FDA Approval)
  • ampicillin/sulbactam
  • quinupristin/dalfopristin
  • lamivudine/zidovudine/abacavir
  • acetaminophen and caffeine
  • acetaminophen/pamabrom
  • abacavir and lamivudine
  • anifrolumab
  • elacestrant
  • anidulafungin
  • acetohydroxamic acid
  • alogliptin/pioglitazone
  • anthralin
  • pirtobrutinib
  • gabapentin
  • galsulfase
  • gadoterate meglumine
  • ferric gluconate
  • ferric derisomaltose
  • ethanolamine oleate
  • eteplirsen
  • vasopressin
  • desmopressin
  • meropenem/vaborbactam
  • ecallantide
  • econazole topical
  • dornase alfa
  • aspirin/dipyridamole
  • dipyridamole
  • difenoxin and atropine
  • diflorasone
  • difluprednate ophthalmic
  • eptinezumab
  • diethylpropion
  • dexchlorpheniramine
  • dexmethylphenidate
  • serdexmethylphenidate/​dexmethylphenidate
  • bexagliflozin
  • galcanezumab
  • fremanezumab
  • tapinarof topical
  • darifenacin
  • dalbavancin
  • darbepoetin alfa
  • azilsartan
  • colestipol
  • corticorelin
  • crotamiton
  • crofelemer
  • allogeneic cultured keratinocytes/fibroblasts in bovine collagen
  • tapentadol
  • cyclopentolate
  • polymyxin B/bacitracin topical
  • tavaborole
  • tagraxofusp
  • crisaborole
  • crizanlizumab
  • satralizumab
  • spinosad
  • sacubitril/valsartan
  • sargramostim
  • sebelipase alfa
  • regadenoson
  • ribociclib/letrozole
  • ragweed allergen extract
  • radium-223 dichloride
  • secnidazole
  • setmelanotide
  • polycarbophil
  • plecanatide
  • sacituzumab govitecan
  • pertuzumab
  • pertuzumab/trastuzumab/hyaluronidase
  • pamidronate
  • halcinonide
  • glecaprevir/​pibrentasvir
  • glucarpidase
  • golodirsen
  • dextrose (antidote)
  • hexaminolevulinate
  • iohexol
  • ferric citrate
  • elapegademase
  • emicizumab
  • erenumab
  • danaparoid
  • dantrolene
  • eflapegrastim
  • edaravone
  • amcinonide
  • carglumic acid
  • alcaftadine ophthalmic
  • agalsidase beta
  • afamelanotide
  • fosdenopterin
  • lidocaine and chlorhexidine
  • levorphanol
  • calcifediol
  • factor VIIa, recombinant
  • triheptanoin
  • peanut oral allergen powder
  • teprotumumab
  • poly-L-lactic acid/carboxymethylcellulose/mannitol
  • xenon Xe 129 hyperpolarized
  • ublituximab
  • anacaulase
  • glatiramer
  • peginterferon beta-1a
  • interferon beta-1a
  • onabotulinumtoxinA
  • cycloserine
  • ethionamide
  • cabotegravir and rilpivirine
  • vericiguat
  • omidenepag isopropyl
  • azelastine/fluticasone intranasal
revefenacin + 

secretin 

may decrease the therapeutic effect of Anticholinergic Agents

trofinetide 

may enhance the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates

agmatine

revefenacin: they may increase the bradycardic effect of Bradycardia-Causing Agents

mibefradil

revefenacin: they may increase the bradycardic effect of Bradycardia-Causing Agents

donepezil

revefenacin: they may increase the bradycardic effect of Bradycardia-Causing Agents

rivastigmine

revefenacin: they may increase the bradycardic effect of Bradycardia-Causing Agents

labetalol 

revefenacin: they may increase the bradycardic effect of Bradycardia-Causing Agents

bempedoic acid

OATP1B1/1B3 inhibitors increase the concentration of active metabolites of revefenacin in the serum

darolutamide

OATP1B1/1B3 inhibitors increase the concentration of active metabolites of revefenacin in the serum

sotagliflozin

OATP1B1/1B3 inhibitors increase the concentration of active metabolites of revefenacin in the serum

ubrogepant

OATP1B1/1B3 inhibitors increase the concentration of active metabolites of revefenacin in the serum

clarithromycin

OATP1B1/1B3 inhibitors increase the concentration of active metabolites of revefenacin in the serum

aclidinium 

may increase the anticholinergic effect of Anticholinergic Agents

neostigmine

may increase the anticholinergic effect of each other when combined

isoflurophate

may increase the anticholinergic effect of each other when combined

memantine/donepezil

may increase the anticholinergic effect of each other when combined

donepezil (Rx)

may increase the anticholinergic effect of each other when combined

donepezil transdermal

may increase the anticholinergic effect of each other when combined

methacholine 

may decrease the therapeutic effect of Long-acting muscarinic antagonists

tiotropium 

may increase the anticholinergic effect of Anticholinergic Agents

umeclidinium 

may increase the anticholinergic effect of Anticholinergic Agents

caspofungin

BCRP/ABCG2 inhibitors increase the concentration of pazobanib in the serum

lonafarnib

BCRP/ABCG2 inhibitors increase the concentration of pazobanib in the serum

hydroxyzine

revefenacin: they may decrease the therapeutic effect of antihistamines

levocabastine

revefenacin: they may decrease the therapeutic effect of antihistamines

mepyramine

revefenacin: they may decrease the therapeutic effect of antihistamines

acrivastine

revefenacin: they may decrease the therapeutic effect of antihistamines

alimemazine

revefenacin: they may decrease the therapeutic effect of antihistamines

cyclopentolate

it increases the effect of anticholinergic agents

pancuronium

it increases the effect of anticholinergic agents

botulinum toxin

it increases the effect of anticholinergic agents

atropine

it increases the effect of anticholinergic agents

abobotulinumtoxinA

it increases the effect of anticholinergic agents

diphenoxylate/atropine

revefenacin: they may increase the CNS depressant effect of CNS Depressants

phenobarbital

revefenacin: they may increase the CNS depressant effect of CNS Depressants

clorazepic acid

revefenacin: they may increase the CNS depressant effect of CNS Depressants

isoflurane

revefenacin: they may increase the CNS depressant effect of CNS Depressants

promazine

revefenacin: they may increase the CNS depressant effect of CNS Depressants

aclidinium and formoterol 

may increase the anticholinergic effect of anticholinergic agents

simeprevir 

may enhance the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Inhibitors

elbasvir/​grazoprevir 

may enhance the serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Inhibitors

carbinoxamine 

may increase the anticholinergic effect of anticholinergic agents

atropine 

may increase the anticholinergic effect of anticholinergic agents

molindone 

may increase the anticholinergic effect of Anticholinergic Agents

atropine/pralidoxime 

may increase the anticholinergic effect of Anticholinergic Agents

acetaminophen/doxylamine/dextromethorphan 

may increase the anticholinergic effect of Anticholinergic Agents

taurursodiol 

may enhance the concentration of serum when combined with OAT1/3 substrates

donepezil (Rx)

may decrease the therapeutic effect of Anticholinergic Agents

prabotulinumtoxinA

may decrease the therapeutic effect of Anticholinergic Agents

itopride 

may decrease the therapeutic effect of Anticholinergic Agents

mirabegron 

may increase the adverse effect of Anticholinergic Agents

hydrochlorothiazide

may enhance the serum concentration of Anticholinergic Agents

metolazone

may enhance the serum concentration of Anticholinergic Agents

quinethazone

may enhance the serum concentration of Anticholinergic Agents

trichlormethiazide

may enhance the serum concentration of Anticholinergic Agents

topiramate 

may increase the adverse effect of Anticholinergic Agents

abediterol

revefenacin: they may increase the hypertensive effect of sympathomimetics

noradrenaline

revefenacin: they may increase the hypertensive effect of sympathomimetics

dextroamphetamine

revefenacin: they may increase the hypertensive effect of sympathomimetics

tetrahydrozoline nasal

revefenacin: they may increase the hypertensive effect of sympathomimetics

oxymetazoline

revefenacin: they may increase the hypertensive effect of sympathomimetics

maralixibat

revefenacin: they may enhance the serum concentration of CYP3A4 Inhibitors

lenacapavir

revefenacin: they may enhance the serum concentration of CYP3A4 Inhibitors

curcumin

revefenacin: they may enhance the serum concentration of CYP3A4 Inhibitors

glecaprevir

revefenacin: they may enhance the serum concentration of CYP3A4 Inhibitors

caspofungin

revefenacin: they may enhance the serum concentration of CYP3A4 Inhibitors

aminohippuric acid 

aminohippuric acid may result in a decreased excretion rate of revefenacin, potentially causing elevated serum levels

flavoxate 

may increase the anti-cholinergic effect

pretomanid 

may increase the serum concentration of OAT1/3 substrates

zavegepant 

may result in a significant increase in zavegepant exposure

raltegravir 

may diminish the serum concentration of each other when combined

methacholine 

long-acting muscarinic antagonists decrease the efficacy of methacholine

Actions and Spectrum: 

Mechanism of Action: 

  • Muscarinic Receptor Antagonism: revefenacin selectively antagonizes the M3 subtype of muscarinic receptors in the airway smooth muscles. By blocking these receptors, it inhibits the binding of acetylcholine, a neurotransmitter, thereby preventing its broncho-constrictive effects. 
  • Bronchodilation: By blocking the M3 receptors, revefenacin relaxes the smooth muscles surrounding the airways, leading to bronchodilation. This helps to alleviate bronchoconstriction, improve airflow, and reduce symptoms in patients with COPD. 

Spectrum of Activity: 

  • Chronic Obstructive Pulmonary Disease (COPD): revefenacin is especially prescribed for the maintenance therapy of COPD patients. It is used to prevent and treat COPD symptoms such as shortness of breath, coughing,chest tightness and wheezing. 
  • Extended Duration of Action: revefenacin is formulated as a once-daily inhaled medication, providing a sustained effect throughout the day. Its prolonged action duration helps maintain bronchodilation and symptom control, reducing the need for frequent dosing. 

Frequency defined 

1-10% 

Nasopharyngitis (4%) 

Upper respiratory tract infection (3%) 

Hypertension (1-2%) 

Oropharyngeal pain (1-2%) 

Cough (4%) 

Headache (4%) 

Back pain (2%) 

Dizziness (1-2%) 

Bronchitis (1-2%) 

Frequency not defined 

Worsening narrow-angle glaucoma 

Immediate hypersensitivity reactions 

Dry mouth 

Paradoxical bronchospasm 

Worsening urinary retention 

Contraindications/caution: 

Contraindications: 

  • Hypersensitivity: revefenacin is contraindicated in individuals with known hypersensitivity or allergic reactions to revefenacin or any of its components. Allergic reactions can range from mild skin to severe systemic reactions requiring immediate medical attention. 
  • Acute bronchospasm: revefenacin should not be used to treat acute episodes of bronchospasm or acute exacerbations of chronic obstructive pulmonary disease (COPD). It is intended for maintenance treatment and not for immediate relief of acute symptoms. 
  • Urinary Retention: Individuals with a history of urinary retention or urinary bladder obstruction should avoid revefenacin due to the potential for worsening these conditions. LAMAs, including revefenacin, can have anticholinergic effects that may exacerbate urinary retention. 
  • Severe Hypersensitivity to Milk Proteins: Some formulations of revefenacin may contain lactose, which can be derived from milk proteins. Individuals with severe hypersensitivity to milk proteins should avoid revefenacin products that contain lactose. 

Caution: 

  • Hypersensitivity Reactions: Although hypersensitivity reactions are rare, they have been reported using revefenacin. Seek immediate medical attention if you experience rash,swelling,tching,  or difficulty breathing. 
  • Cardiovascular Effects: revefenacin, like other long-acting muscarinic antagonists (LAMAs), may have potential cardiovascular effects. Caution should be exercised in patients with pre-existing cardiovascular conditions such as coronary artery disease, arrhythmias, or hypertension. Close monitoring is recommended in these patients. 

 

  • Worsening of Urinary Retention: LAMAs, including revefenacin, can have anticholinergic effects that may exacerbate urinary retention. Patients with a history of urinary retention or bladder obstruction should use revefenacin cautiously and be monitored closely. 
  • Narrow-Angle Glaucoma: revefenacin should be used cautiously in individuals with narrow-angle glaucoma. LAMAs can induce pupillary dilation, which can potentially increase intraocular pressure. Regular eye examinations are recommended for patients with glaucoma. 
  • Paradoxical Bronchospasm: Rare cases of paradoxical bronchospasm (wheezing and shortness of breath) have been reported using revefenacin. If this occurs, discontinue the medication and seek medical assistance. 
  • Drug Interactions: revefenacin has a low potential for drug interactions as it is primarily metabolized by hydrolysis rather than through the cytochrome P450 enzyme system.  
  • Pregnancy and Lactation: Limited information about using revefenacin in pregnant or lactating women is available. It should be used only during pregnancy or breastfeeding if the potential benefits outweigh the risks. 

Pregnancy consideration: Insufficient data available 

Lactation: Excretion of the drug in human breast milk is unknown 

Pregnancy category: 

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 

<b>Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category 

Pharmacology: 

revefenacin is a long-acting muscarinic antagonist (LAMA) used as a bronchodilator for treating chronic obstructive pulmonary disease (COPD). The medication works by blocking the action of acetylcholine at muscarinic receptors in the airways, leading to the relaxation of the smooth muscle and dilation of the airways. 

Specifically, revefenacin is a selective antagonist of the M3 muscarinic receptor subtype found primarily in the airway smooth muscle. By blocking the M3 receptor, revefenacin reduces bronchoconstriction and increases airflow, making breathing easier for individuals with COPD. 

Pharmacodynamics: 

The pharmacodynamics of revefenacin are primarily related to its action as a long-acting muscarinic antagonist (LAMA). Here are the vital pharmacodynamic effects of revefenacin: 

  • Muscarinic Receptor Antagonism: revefenacin selectively blocks acetylcholine binding to the M3 subtype of muscarinic receptors in smooth airway muscles. By antagonizing these receptors, revefenacin inhibits the bronchoconstrictive effects of acetylcholine, leading to bronchodilation. 
  • Bronchodilation: The blockade of M3 muscarinic receptors in the airways by revefenacin causes relaxation of the smooth muscles surrounding the bronchioles. This results in the dilation of the airways, leading to improved airflow and reduced airway resistance. Bronchodilation helps alleviate symptoms such as coughing, wheezing, and shortness of breath in chronic obstructive pulmonary disease (COPD) patients. 
  • Decreased Mucus Secretion: revefenacin’s antagonism of M3 muscarinic receptors can also reduce mucus secretion in the airways. This can help alleviate symptoms related to excessive mucus production, such as phlegm and congestion. 
  • Reduction of Airway Inflammation: LAMAs, including revefenacin, have been shown to have anti-inflammatory effects in the airways. By inhibiting muscarinic receptor activation, revefenacin may contribute to a reduction in airway inflammation. 

Pharmacokinetics: 

Absorption 

revefenacin is administered via inhalation using a handheld inhaler device. When inhaled, the medication reaches the lungs, which are absorbed through the respiratory epithelium and into the bloodstream. The inhalation route allows for targeted lung delivery while minimizing systemic absorption.  

Distribution 

After absorption, revefenacin is distributed throughout the body. It primarily targets the muscarinic receptors in the smooth muscles of the airways, exerting bronchodilatory effects. The exact extent of distribution to other tissues and organs needs to be better characterized.  

Metabolism 

revefenacin undergoes metabolism primarily through hydrolysis, which is the breakdown of the molecule by adding water. The specific enzymes involved in the metabolism of revefenacin have yet to be fully elucidated. The metabolites formed because of hydrolysis are pharmacologically inactive.  

Elimination and Excretion 

The elimination of revefenacin and its metabolites occurs primarily through renal excretion. After metabolism, the drug and its metabolites are eliminated from the body through the urine. The exact proportion of revefenacin excreted unchanged versus as metabolites need to be better established. 

Administration: 

Oral Inhalation: 

  • Do not swallow or inject the solution. 
  • Use a standard jet nebulizer connected to an air compressor for administration. The safety and efficacy of administration via non compressor nebulizer systems have not been established. 
  • Before use, remove the unit-dose vial from the foil pouch and open it. Discard the vial and any remaining content after use. 
  • Do not mix revefenacin with other drugs in the nebulizer unless compatibility, efficacy, and safety have been established.

Storage: 

  • Store revefenacin at room temperature between 68-77°F (20-25°C). Excursions between 59-86°F (15-30°C) are permitted. 
  • Keep the medication in the foil pouch until it is ready to be administered. 
  • Protect revefenacin from direct light. 

Patient information leaflet 

Generic Name: revefenacin 

Why do we use revefenacin?