Yupelri (Revefenacin) - Inhalation

Warning:

What Is Yupelri?

Yupelri (revefenacin) is a long-term prescription treatment option for chronic obstructive pulmonary disease (COPD). COPD is a respiratory (lung) condition.

Yupelri is considered a long-acting anticholinergic or long-acting muscarinic antagonist (LAMA). It works by relaxing the airways in your lungs. Yupelri is available as a prescription inhalation solution. You will need to use this medication with a nebulizer machine.

Drug Facts

Generic Name: Revefenacin

Brand Name: Yupelri

Drug Availability: Prescription

Therapeutic Classification: Anticholinergic; Long-acting muscarinic antagonist (LAMA)

Available Generically: No

Controlled Substance: N/A

Administration Route: Oral (by mouth) inhalation route

Active Ingredient: Revefenacin

Dosage Form: Oral inhalation solution

What Is Yupelri Used For?

The Food and Drug Administration (FDA) approved Yupelri as a long-term treatment option for COPD.

Millions of people in the United States live with COPD. People with COPD have difficulties moving air in and out of their lung airways. Symptoms of the disease may include wheezing, coughing, and breathing troubles.

How to Use Yupelri

Since directions might vary for different inhalation solutions and nebulizer machines, carefully read the directions and packaging label on the container.

In general, however, a 175 microgram (mcg) or 3 milliliter (mL) Yupelri dose is used once daily with a nebulizer machine. You will need to inhale this medication through a nebulizer. Don't swallow the Yupelri solution, and don't combine Yupelri with other medications in your nebulizer. The following are additional steps for using Yupelri.

  1. Remove a Yupelri vial from the foil pouch. Only open the pouch when you are ready to use Yupelri.
  2. Before using Yupelri, inspect the vial. The solution should be clear and colorless. If it's not, throw the vial away.
  3. To open the Yupelri vial, twist the top of the vial.
  4. Squeeze the Yupelri vial to transfer all of the medication into the nebulizer cup (reservoir).
  5. Attach the mouthpiece to the nebulizer cup. Make sure that the expiratory valve is facing up.
  6. Use tubing to connect the bottom of the nebulizer cup to the compressor.
  7. Sit in a comfortable and upright position.
  8. Seal your lips around the mouthpiece.
  9. Turn on the compressor to begin receiving your Yupelri treatment.
  10. Take calm, deep, and even breaths until no mist remains in the nebulizer cup. This should take approximately eight minutes.
  11. With no more mist in the nebulizer cup, your breathing treatment is complete. Turn off the compressor.
  12. Clean your nebulizer following your device's cleaning instructions.

Storage

Once you receive Yupelri from the pharmacy, store this medication at room temperature between 68 degrees to 77 degrees Fahrenheit (F)—with a safety range of 59 degrees to 86 degrees F. Also, keep the Yupelri vials in their foil pouches. Don't open the pouch until you're ready to use Yupelri. Protect this medication from exposure to the sun and excessive heat. Keep out of reach of children and pets.

If you plan to travel with Yupelri, familiarize yourself with the regulations of your final destination. In general, however, make a copy of your Yupelri prescription. Also, have the medicine in its original packaging or container from the pharmacy, with your name on it.

How Long Does Yupelri Take to Work?

You might notice some symptom improvment within two hours of using Yupelri. Yupelri, however, might take up to seven days to reach steady levels in your body for maximum effectiveness.

What Are the Side Effects of Yupelri?

This is not a complete list of side effects, and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Common side effects with Yupelri include:

  • Back pain
  • Cough
  • Headache
  • Runny nose
  • Upper respiratory tract infection (URTI)

Severe Side Effects

Severe side effects are possible with Yupelri. Get medical help right away if you experience the following serious side effects:

  • Severe allergic reaction: If you have a severe allergic reaction to Yupelri, you may experience symptoms of rash, itchiness, swelling, and breathing difficulties.
  • Tightening airways: In some people, Yupelri might cause sudden breathing problems.
  • Glaucoma: Glaucoma is a medical condition of high pressure in the eye. If you're experiencing glaucoma with Yupelri, symptoms may include blurred vision, red or painful eyes, nausea and vomiting. You might also notice halos or bright colors around lights.
  • Urinary retention: If you have urinary retention with Yupelri, you might have trouble urinating (peeing), frequent urination, or painful urination. You may also notice a weak stream.

Long-Term Side Effects

Long-term side effects with Yupelri are similar to the medication's short-term side effects.

Report Side Effects

Yupelri may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or call the FDA by phone (800-332-1088).

Dosage: How Much Yupelri Should I Use?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For inhalation dosage form (solution):
    • For maintenance treatment of COPD:
      • Adults—1 vial by oral inhalation once a day. Each vial contains 175 micrograms (mcg) per 3 milliliters (mL) solution.
      • Children—Use is not recommended.

Modifications

Your healthcare provider might slightly change your Yupelri treatment under the following situations:

Pregnant parents: We don't know enough about the effectiveness and safety data about Yupelri in pregnant parents. If you're pregnant or you suspect that you're pregnant, tell your healthcare provider right away. They may help you weigh the benefits and risks of using Yupelri while pregnant.

Nursing parents: We don't know enough about the safety of Yupelri exposure in nursing babies. With only a small amount of the medication being absorbed into your body, it's unlikely to have negative effects on your nursing baby. Long-term Yupelri use, however, might lower milk production. Therefore, closely monitor your baby for symptoms of hunger or weight gain problems.

Missed Dose

If you accidentally forgot your Yupelri dose, inhale a dose as soon as you remember. If it's already close to your next scheduled dose, however, then skip the missed dose and inhale the following dose at your next scheduled time. Don't try to double up to make up for the missed dose.

Try to find ways to remember to take your medication. Missing too many Yupelri doses may lead to worsening COPD control.

Overdose: What Happens If I Use Too Much Yupelri?

In human studies, people with COPD tolerated high doses of up to 700 micrograms Yupelri daily for seven days. If you use too much Yupelri, however, you might experience the following symptoms:

  • Constipation
  • Dizziness
  • Lightheadedness
  • Nausea
  • Vomiting
  • Vision changes

If you suspect that you're experiencing life-threatening side effects, seek immediate medical attention.

What Happens If I Overdose on Yupelri?

If you think you or someone else may have overdosed on Yupelri, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Yupelri, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects.

Tell your doctor if you are also using other medicines for your COPD. Your doctor may want you to stop using the other medicine and use it only during a severe COPD attack. Follow your doctor's instructions on how you should take your medicine.

This medicine should not be used if you are having a severe COPD attack, or if symptoms of COPD attack have already started. Your doctor may prescribe another medicine for you to use in case of an acute COPD attack. If the other medicine does not work as well, tell your doctor right away.

Talk to your doctor or get medical care right away if your symptoms do not improve after using this medicine within a few days or if they become worse, or your short-acting inhaler does not seem to be working as well as usual and you need to use it more often.

This medicine may cause paradoxical bronchospasm, which means your breathing or wheezing will get worse. Paradoxical bronchospasm may be life-threatening. Check with your doctor right away if you are having a cough, difficulty with breathing, shortness of breath, or wheezing after using this medicine.

If you develop a skin rash, hives, swelling of the tongue, lips, or face, or any allergic reaction to this medicine, check with your doctor right away.

Check with your doctor right away if blurred vision, difficulty in reading, seeing halos around lights, or any other change in vision occurs during or after treatment. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn't Use Yupelri?

Before using Yupelri, talk with your healthcare provider if the following applies to you.

  • Severe allergic reaction: If you have a severe allergy to Yupelri or any of its components (ingredients), avoid this medication.
  • Pregnant parents: There is limited effectiveness and safety data about Yupelri in pregnant parents. If you're pregnant or you suspect that you're pregnant, have a conversation with your healthcare provider. They can help you weigh the benefits and risks of using Yupelri during your pregnancy.
  • Nursing parents: There is no effectiveness or safety information about Yupelri on nursing babies. Since very little Yupelri is absorbed into the body, the medication is unlikely to have negative effects on the nursing baby. Yupelri, however, might lower milk production. Therefore, closely monitor your baby for symptoms of hunger and poor weight gain.
  • Children: There are no clinical studies of Yupelri in children.
  • Older adults: Based on currently available effectiveness and safety data on Yupelri, there are no differences between younger adults and older adults—people over 65 years of age. Some older adults, however, may have a higher risk for side effects.
  • Liver problems: There are no clinical studies for Yupelri in people with liver problems. Therefore, Yupelri isn't recommended for people with any degree of liver impairment.

What Other Medications Interact With Yupelri?

Yupelri is an anticholinergic (stops the brain chemical acetylcholine from functioning). Therefore, avoid combining Yupelri with other anticholinergic medications—like Vesicare (solifenacin) for overactive bladder. Taking multiple anticholinergics can raise the likelihood of side effects.

Yupelri is also not recommended with organic anion transporter (OAT) 1B1 and 1B3-inhibiting medications. When you use Yupelri, your body breaks it down into an active substance (metabolite). This active metabolite has similar effects as Yupelri. OAT1B1 ad OAT1B3 are proteins that move medications—like the Yupelri active metabolite—around the body. Taking OAT1B1 or OAT1B3-inhibiting medications may raise active metabolite levels in the body and the likelihood of side effects. Examples of OAT1B1 and OAT1B3-inhibiting medications include rifampin—a medication used for tuberculosis (TB).

What Medications Are Similar?

There are a number of different long-term medications used to treat chronic obstructive pulmonary disease (COPD). Yupelri is one of these long-term COPD treatment options. With Yupelri also being a long-acting muscarinic antagonist (LAMA) (drugs that open the airways in your lungs), however, the following medications are most similar to Yupelri.

  • Incruse (umeclidinium)
  • Lonhala (glycopyrrolate)
  • Spiriva (tiotropium)
  • Tudorza (aclidinium)

Spiriva is considered the standard LAMA. Clinical trials suggest that all LAMAs are at least as effective as Spiriva.

All LAMAs are available as inhalers, except for Yupelri and Lonhala. Yupelri and Lonhala are the only LAMAs that are available as nebulizer solutions. If you prefer to use a nebulizer machine, then Yupelri or Lonhala are potential options for you. Compared to twice-daily Lonhala dosing, Yupelri also has a convenient once-daily dosing schedule.

Frequently Asked Questions

  • Where is Yupelri available?

    Yupelri is available via prescription from your healthcare provider. Most local retail pharmacies carry Yupelri. If necessary, the pharmacy staff can also order this medication for you.

  • How much does Yupelri cost?

    Yupelri is a brand-name medication. It isn't available as a generic product yet. Without insurance coverage, this medication can be expensive. If cost is a concern, Yupelri's manufacturer—Mylan—offers a savings card for people with commercial or no insurance. To find out if you're eligible, visit Mylan's website or call 1-866-255-9018.

  • Will I need other medications in addition to Yupelri?

    Yupelri is a long-term treatment medication for chronic obstructive pulmonary disease (COPD). Yupelri, however, shouldn't be used for active COPD flare-ups.

    So, you will need at least one more medication, which is a rescue inhaler. A rescue inhaler is a short-acting medication that works faster than long-term medications to quickly relieve active COPD flare-ups.

    Some people may also need multiple different long-term medications to control COPD and prevent flare-ups.

How Can I Stay Healthy While Using Yupelri?

Living with chronic obstructive pulmonary disease (COPD) may understandably feel challenging at times. Thankfully, there are ways to help improve your quality of life. Consider the following general tips:

  • Learn about COPD to feel in better control and share your knowledge with loved ones. As your loved ones become more aware of COPD, they can provide you with the encouragement and support that you need.
  • Stop smoking to prevent additional lung damage.
  • Avoid triggers that can worsen your COPD symptoms.
  • Manage your stress and mental health. Consider social support groups or a mental health professional to help you find coping strategies to change how you think, feel, react or respond to living with COPD.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

Was this page helpful?
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Food and Drug Administration. Yupelri label.

  2. Centers for Disease Control and Prevention. COPD: symptoms, diagnosis, and treatment.

  3. MedlinePlus. COPD.

  4. LactMed. Revefenacin.

  5. MedlinePlus. Revefenacin oral inhalation.

  6. ScienceDirect. Organic anion transporter.

  7. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease.

  8. Hvisdas C. Revefenacin, once-daily, long-acting muscainic antagonist, for nebulized maintenance therapy in patients with chronic obstructive pulmonary disease. American Journal of Health-System Pharmacy. 2021;78(13);1184-1194. doi:10.1093/ajhp/zxab154

  9. Ismaila AS, Huisman EL, Punekar YS, Karabis A. Comparative efficacy of long-acting muscarinic antagonist monotherapies in COPD: a systemic review and network meta-analysis. Int J Chronic Obstructive Pulmonary Disease. 2015;10:2495-2517. doi: 10.2147/COPD.S92412

  10. Food and Drug Administration. Tudorza label.

  11. Food and Drug Administration. Spriva label.

  12. Food and Drug Administration. Lonhala label.

  13. Food and Drug Administration. Incruse label.

  14. Food and Drug Administration. Orange book: approved drug products with therapeutic equivalence evaluations.

  15. Mylan. Yupelri.