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revefenacin

R03BB08

Forms & Strengths

Inhalation solution for nebulization, 175 µg per single-use vial
Supplied in sterile 1.5 mL vials containing 175 µg revefenacin
Administered via jet or ultrasonic nebulizer

Adult Dosing

175 µg inhaled once daily via nebulizer (delivered dose)
No dose adjustment needed for age, renal or mild‑moderate hepatic impairment
Avoid use in severe hepatic impairment (Child‑Pugh C) due to increased exposure

Pediatric Dosing

Not approved for patients <18 years; safety and efficacy not established

Indications

Maintenance treatment of airflow obstruction in chronic obstructive pulmonary disease (COPD)
Not indicated for acute bronchospasm or asthma

Mechanism of Action

Long‑acting, selective antagonist of muscarinic M3 receptors in airway smooth muscle
Blocks acetylcholine‑mediated bronchoconstriction, producing sustained bronchodilation
High lung retention with minimal systemic exposure

Contraindications

Known hypersensitivity to revefenacin or any excipient
Severe hepatic impairment (Child‑Pugh C) – contraindicated

Adverse Reactions

Cough, nasopharyngitis, upper respiratory tract infection
Dry mouth, dysphonia, oropharyngeal pain
Bronchitis, worsening COPD symptoms
Rare: urinary retention, angle‑closure glaucoma exacerbation

Drug Interactions

Additive anticholinergic effects with other muscarinic antagonists (e.g., ipratropium, tiotropium)
Strong CYP3A4 inhibitors (ketoconazole, clarithromycin) may increase systemic exposure—clinical impact minimal
No significant pharmacokinetic interaction with β2‑agonists or inhaled corticosteroids
Use caution with drugs that increase intraocular pressure or cause urinary retention

Curated Content: Needs Vetting Before Put to Clinical Use