revefenacin

Absorption: 3% systemically absorbed following oral inhalation.

Distribution: Extensively distributed to tissues.

Metabolism/Excretion: Rapidly hydrolyzed to an active metabolite. Primarily eliminated in feces (88%) with less than 5% excreted in urine.

Half-Life: 22–70 hr.

Time/Action Profile ⬆ ⬇

(plasma concentrations)

ROUTE	ONSET	PEAK	DURATION
Nebulization	rapid	14–41 min	24 hr

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity;
Hepatic impairment.

Use Cautiously in:

Narrow-angle glaucoma;
Prostatic hyperplasia or bladder neck obstruction;
OB: Safety not established in pregnancy;
Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant;
Pedi: Safety and effectiveness not established in children.

Adv. Reactions/Side Effects ⬆ ⬇

Neuro: headache

Resp: cough, paradoxical bronchospasm

Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS AND ANGIOEDEMA)

Interactions ⬆ ⬇

Drug-drug:

May ↑ risk of anticholinergic effects with other anticholinergics.
Rifampin or cyclosporine may ↑ levels of active metabolite; concurrent use not recommended.

Route/Dosage ⬆ ⬇

Inhaln
(Adults ): 175 mcg via nebulization once daily.

Availability ⬆ ⬇

Solution for inhalation: 175 mcg/3 mL

Assessment ⬆ ⬇

Assess lung sounds, pulse, and BP before administration and during peak of medication. Note amount, color, and character of sputum produced. Closely monitor patients on higher dose for adverse effects.
Monitor pulmonary function tests before initiating and periodically during therapy to determine effectiveness.
Observe for paradoxical bronchospasm (wheezing, dyspnea, tightness in chest) during therapy. If condition occurs, hold medication and notify health care professional immediately.
Monitor patient for signs of hypersensitivity reactions (rash, hives, severe itching, swelling of face, mouth, and tongue, difficulty breathing or swallowing) during therapy. Discontinue therapy and consider alternative if reaction occurs.

Implementation ⬆ ⬇

Inhaln: Administer once daily by oral inhalation via a standard jet nebulizer connected to an air compressor.

Patient/Family Teaching ⬆ ⬇

Instruct patient to use medication as directed. Do not discontinue therapy without discussing with health care professional, even if feeling better. Use a rapid-acting bronchodilator if symptoms occur before next dose is due. Caution patient not to use more than once a day; may cause adverse effects, paradoxical bronchospasm, or loss of effectiveness of medication. Instruct patient to review Patient Information before starting therapy and with each Rx refill in case of changes.
Caution patient not to use medication to treat acute symptoms. Use a rapid-acting inhaled beta-adrenergic bronchodilator for relief of acute asthma attacks. Notify health care professional immediately if symptoms get worse or more inhalations than usual are needed from rescue inhaler.
Instruct patient to contact health care professional immediately if shortness of breath is not relieved by medication or nausea, vomiting, shakiness, headache, fast or irregular heartbeat, sleeplessness, or signs and symptoms of narrow angle glaucoma (eye pain or discomfort, blurred vision, visual halos or colored images, red eyes) or urinary retention (difficulty passing urine, painful urination) occur.
Advise patient to consult health care professional before taking any Rx, OTC, or herbal products or alcohol concurrently with this therapy. Caution patient also to avoid smoking and other respiratory irritants.
Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇

Pharmacokinetics ⬆ ⬇