Indications
Revefenacin is used as a long-term, once-daily maintenance treatment for chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. It helps keep the airways open and reduces breathlessness. It is not a rescue medicine and should not be used to treat sudden breathing attacks.
How It Works
Revefenacin is a long-acting muscarinic antagonist (LAMA), also called an anticholinergic bronchodilator. It blocks the action of acetylcholine, a chemical messenger that makes the muscles around the airways tighten. By relaxing these muscles, it widens the airways and makes breathing easier for about 24 hours.
Dosage and Administration
The usual adult dose is 175 micrograms (one unit-dose vial) inhaled once a day through a standard jet nebuliser with a mouthpiece, at about the same time each day. Do not swallow the solution or inject it. Do not take more than one dose in 24 hours. Use it every day even when you feel well, and keep a separate fast-acting reliever inhaler for sudden symptoms.
Interactions
Avoid using it with other anticholinergic medicines such as Tiotropium, Ipratropium, Glycopyrronium or Umeclidinium, as side effects can add up. Medicines that block the liver transporter OATP1B, such as Rifampicin or Ciclosporin, may raise levels of its active breakdown product and are best avoided together. Tell your doctor about all medicines you use.
Contraindications
Do not use if you are allergic to Revefenacin or any part of the solution. It is not recommended for people with moderate or severe liver disease.
Side Effects
Common effects include cough, runny or blocked nose, sore throat, upper respiratory infection, headache and back pain. Anticholinergic effects such as dry mouth, constipation or difficulty passing urine can occur.
Get urgent medical help if breathing suddenly gets worse or you start wheezing right after a dose (paradoxical bronchospasm), if you have eye pain, blurred vision, halos around lights or red eyes (signs of acute glaucoma), if you cannot pass urine, or if you have swelling of the face or throat or a severe rash.
Pregnancy and Lactation
There is little information on use in pregnancy. It should be used only if the doctor thinks the benefit is greater than any possible risk. It is not known whether it passes into breast milk; discuss with your doctor before breastfeeding.
Precautions and Warnings
Tell your doctor if you have narrow-angle glaucoma, an enlarged prostate, bladder neck blockage or liver problems. Keep the nebulised mist away from your eyes. Do not use it to relieve sudden breathlessness. Contact your doctor if your COPD gets worse or you need your reliever inhaler more often.
Overdose
Too much may cause marked anticholinergic effects such as dry mouth, blurred vision, fast heartbeat, constipation or urine retention. Seek medical advice; treatment is supportive.
Therapeutic Class
Long-acting muscarinic antagonist (inhaled anticholinergic bronchodilator)
Storage
Store below 30°C in the original foil pouch to protect from light, and keep out of the reach of children. Use each vial right after opening and discard any leftover solution.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.