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Yupelri

revefenacin
Used for COPD
Used for COPD

Yupelri (revefenacin) is an inhalation solution that's used to treat adults with chronic obstructive pulmonary disease (COPD). It belongs to the drug class called long-acting muscarinic antagonists, or LAMAs. Yupelri (revefenacin) is inhaled through the mouth once a day using a nebulizer machine. Some possible side effects include headache and cough. Yupelri (revefenacin) is a brand-name medication; there's currently no generic version available.

Reviewed by:
reviewer
Cydnee Ng, PharmD
reviewer
Allison Gourley, PharmD
Last reviewed on October 28, 2024
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageCostAlternativesReferencesPricesMedicare
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What is Yupelri (revefenacin)?

What is Yupelri (revefenacin) used for?

How Yupelri (revefenacin) works

Yupelri (revefenacin) is a long-acting muscarinic antagonist or LAMA.

When inhaled, the medication blocks the muscarinic receptors in your lungs. This helps open up the airways in your lungs, which helps you breathe easier.

Drug Facts

Common BrandsYupelri
Drug ClassLAMA
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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What are the side effects of Yupelri (revefenacin)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Other Side Effects

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Sudden trouble breathing or shortness of breath
  • Allergic reaction: rash; hives; swelling of the face, mouth, or throat

Source: DailyMed

The following side effects have also been reported

Side effects that you should report to your care team as soon as possible:

  • Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
  • Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss
  • Trouble passing urine
  • Wheezing or trouble breathing that is worse after use

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

pros-and-cons

Pros and cons of Yupelri (revefenacin)

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Pros

Only taken once a day

Works quickly (within 5 minutes) and lasts the whole day

Easy to breathe in; there isn't as much timing and technique needed like for COPD inhalers

thumbs-down

Cons

Must set up the nebulizer machine before each dose

Takes about 8 minutes to take a full dose

Not a good option for people with liver damage because of higher risk of side effects

pharmacist-tips

Pharmacist tips for Yupelri (revefenacin)

pharmacist

  • Take Yupelri (revefenacin) only once at the same time every day. Don’t use Yupelri (revefenacin) to relieve any worsened, life-threatening, or sudden COPD symptoms. It’s important to keep your rescue inhaler, such as albuterol (Ventolin), by you so you can easily get to it and use it to relieve any sudden episodes of trouble breathing.

    • Let your prescriber know if you notice that Yupelri (revefenacin) isn't helping your COPD symptoms anymore even though you've been taking it once every day. Also talk to your prescriber if you need to use your rescue inhaler more often than usual. This might mean that your COPD has gotten worse and you might need a different medication to manage your lung condition.

      • Don’t stop taking Yupelri (revefenacin) without talking to your prescriber first. Otherwise, your COPD symptoms, such as shortness of breath and wheezing, can come back.

        • Keep each vial of Yupelri (revefenacin) in their original foil pouch until you’re ready to use it. This helps protect the medication from light.

          How to use Yupelri (revefenacin):

          • Carefully review the instructions for use for Yupelri (revefenacin). You must use a standard jet nebulizer machine with Yupelri (revefenacin). Ask your prescriber or pharmacist if you have questions about how to take the medication using your nebulizer machine.

            • Don’t inject or swallow the inhalation solution. Also don’t mix other medications with Yupelri (revefenacin) in the nebulizer.

              • How to set up your nebulizer: Open the foil pouch containing the Yupelri (revefenacin) vial, carefully twist open the vial, and then use it right away. Check that the solution in the vial is clear and colorless. Squeeze all of the solution in the vial into the nebulizer cup. Then, connect the mouthpiece to the nebulizer cup with the valve facing up. Next, connect the nebulizer cup to the compressor using the tubing.

                • How to take your Yupelri (revefenacin) dose: Make sure you’re sitting straight in a comfortable position. Place the mouthpiece in your mouth, and then turn on the compressor to start your dose. Breathe through your mouth calmly, deeply, and evenly until you don’t see any more mist in the nebulizer cup. It usually takes about 8 minutes to take a full dose. Once done, turn off the compressor.

                  • Throw each plastic vial away right after you pour the solution into the nebulizer cup, even if there's still some medication left in the vial. Young children are at risk of choking if they accidentally put the small vials into their mouth.

                    • Clean and store your nebulizer by following the manufacturer's instructions.

                      faqs

                      Frequently asked questions about Yupelri (revefenacin)

                      How long does Yupelri (revefenacin) take to work?
                      Yupelri (revefenacin) starts to work in as quickly as 5 minutes after you inhale the medication. The greatest effect of Yupelri (revefenacin) on your lung function from a single dose typically happens within 2 hours of taking the medication. Keep in mind that Yupelri (revefenacin) is a maintenance medication, meaning that you should take it every day to prevent your COPD symptoms from worsening in the long run. Don't use Yupelri (revefenacin) to treat or relieve sudden or severe breathing problems; use a rescue inhaler in this situation instead.
                      Is Yupelri (revefenacin) an inhaler?
                      No, Yupelri (revefenacin) doesn't come as an inhaler. Instead, it’s a solution that gets turned into a mist using a nebulizer machine. By using the nebulizer, you can breathe the medication through your mouth using a mouthpiece. You don't need as much technique to use a nebulizer properly as you would with inhalers.
                      Is there a generic for Yupelri (revefenacin)?
                      No, there's currently no generic available for Yupelri (revefenacin). It's only available as a brand-name medication at this time.
                      Is Yupelri (revefenacin) a steroid?
                      No, Yupelri (revefenacin) isn't a steroid. This medication is a long-acting muscarinic antagonist (or LAMA). Steroids and LAMAs work differently to manage COPD. Steroids lessen inflammation (swelling) in the airways of your lungs. On the other hand, LAMAs like Yupelri (revefenacin) open up your airways so you can breathe easier.
                      What's the difference between Yupelri (revefenacin) and albuterol?
                      Yupelri (revefenacin) and albuterol are both medications that are used to manage COPD. The two medications open your airways to help you breathe better. But they're used for different reasons and so it's possible that you might need to use both during treatment. Yupelri (revefenacin) is a maintenance medication that's used once a day every day to help manage COPD in the long run. It's inhaled through the mouth using a nebulizer. On the other hand, albuterol is used on an as-needed basis as a rescue medication to relieve sudden symptoms of COPD. You can typically use albuterol as often as every 4 to 6 hours. Albuterol comes as inhalers as well as inhalation solutions used with a nebulizer. Talk with your prescriber about comparing the two medications.
                      Can you take Yupelri (revefenacin) and ipratropium together?
                      No. Yupelri (revefenacin) and ipratropium are both treatment options for COPD. They both work as muscarinic antagonists to help open your airways. Yupelri (revefenacin) is longer acting and is taken just once a day every day. On the other hand, ipratropium is shorter acting and must be taken 3 to 4 times a day. In addition, Yupelri (revefenacin) is inhaled through the mouth using a nebulizer. Ipratropium comes as an inhaler as well as inhalation solution that's used with a nebulizer. Since the two medications belong to the same drug class, you can't take them at the same time because it raises your risk for side effects. You can compare these medications and ask your prescriber about which option is best for you.
                      What's the difference between Yupelri (revefenacin) and arformoterol (Brovana)?
                      Yupelri (revefenacin) and arformoterol (Brovana) are maintenance treatment options for COPD that are inhaled through the mouth using a nebulizer. But they work in different ways to help you breathe easier. Yupelri (revefenacin) is a long-acting muscarinic antagonist (LAMA), and arformoterol (Brovana) is a long-acting beta agonist (LABA). In addition, you only need to take Yupelri (revefenacin) once a day, but you need to take arformoterol (Brovana) twice a day. Some people might need a LAMA/LABA combination to manage their COPD, so it's possible to take these two medications together for COPD. But they can't be mixed together in the nebulizer cup and inhaled at exactly the same time. Ask your prescriber to learn more about comparing the two medications.
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                      What are the risks and warnings for Yupelri (revefenacin)?

                      Yupelri (revefenacin) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                      risk-warning

                      Sudden trouble breathing

                      Many inhaled medications, including Yupelri (revefenacin), can suddenly worsen your breathing problems and cause more wheezing. This can be life-threatening. Be sure to have a rescue inhaler handy to treat and relieve sudden worsened breathing; don't use Yupelri (revefenacin) in this situation.

                      risk-warning

                      Eye problems

                      • Risk factors: Narrow-angle glaucoma

                        Yupelri (revefenacin) can raise the pressure in your eyes. This can cause new or worsening narrow-angle glaucoma, which is serious and needs medical attention. Contact a healthcare professional or your optometrist if you have any symptoms like eye pain or discomfort, blurry vision, seeing bright colors or halos around lights, or eye redness.

                        risk-warning

                        Problems with urination

                        • Risk factors: Urinary retention (can't urinate) | Enlarged prostate | Bladder-neck blockage

                          Yupelri (revefenacin) can make you have trouble urinating or have pain while urinating. This medication can worsen these symptoms if you have an enlarged prostate or other medical conditions that make you have trouble urinating. Talk with your prescriber right away if you notice that you have any new or worsening problems with urination while you're taking Yupelri (revefenacin).

                          risk-warning

                          Allergic reactions

                          It's possible to have a serious allergic reaction right after you take your Yupelri (revefenacin) dose. Stop taking this medication and get emergency care right away if you have trouble breathing; rash; hives; or swelling of your face, mouth, or throat. You'll probably need to switch to a different COPD maintenance medication.

                          dosage

                          Yupelri (revefenacin) dosage forms

                          The average cost for 1 carton of 30 vials of 175mcg/3ml of Yupelri (revefenacin) is $1317.40 with a free GoodRx coupon. This is 31.23% off the average retail price of $1915.53.
                          carton
                          Carton
                          DosageQuantityPrice as low asPrice per unit
                          30 vials of 175mcg/3ml1 carton$1317.40$1317.40
                          vial
                          Vial
                          DosageQuantityPrice as low asPrice per unit
                          175mcg/3ml30 vials$1576.28$52.54

                          Typical dosing for Yupelri (revefenacin)

                          The typical dose is 175 mcg (1 vial) inhaled into the lungs once a day using a nebulizer. The nebulizer helps turn the medication into a mist that you inhale through your mouth and into your lungs.

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                          alternatives

                          What are alternatives to Yupelri (revefenacin)?

                          There are a number of medications that your doctor can prescribe in place of Yupelri (revefenacin). Compare a few possible alternatives below.
                          Yupelri (revefenacin)
                          Used for:
                          $1317.40 Lowest GoodRx priceView Prices
                          Incruse Ellipta (umeclidinium)
                          Used for:
                          $358.60 Lowest GoodRx priceView Prices
                          Spiriva (tiotropium)
                          Used for:

                          • Chronic obstructive pulmonary disease (COPD)

                          • Asthma in people age 6 years and older - Spiriva Respimat only

                          $126.32 Lowest GoodRx priceView Prices

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                          References

                          Best studies we found

                          American Thoracic Society. (2020). Nebulizer breathing treatments at home. American Journal of Respiratory and Critical Care Medicine.

                          Buels, K. S., et al. (2012). Muscarinic receptor antagonists: Effects on pulmonary function. Handbook of Experimental Pharmacology.

                          Global Initiative for Chronic Obstructive Lung Disease. (2024). Pocket guide to COPD diagnosis, management, and prevention: A guide for health care prevention.

                          View All References (5)

                          Maqsood, M. H., et al. (2019). The role of revefenacin in chronic obstructive pulmonary disease. Cureus.

                          Mylan Specialty L.P. (2022). Yupelri- revefenacin solution [package insert]. DailyMed.

                          National Heart, Lung, and Blood Institute. (2021). How to use a nebulizer fact sheet.

                          National Institute of Diabetes and Digestive and Kidney Diseases. (2019). Symptoms & causes of urinary retention.

                          ScienceDirect. (2011). Maintenance pharmacotherapy of mild and moderate COPD: What is the evidence? Respiratory Medicine.

                          GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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