Comprehensive medication guide to Yupelri including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0 for approximately 90% of commercially insured patients using the Viatris Savings Card; Medicare Part B patients pay ~20% coinsurance (~$0 with Medigap supplemental). Prior authorization typically required.
Estimated Cash Pricing
$1,625–$1,826 retail per 30-day supply (30 unit-dose vials) without insurance; as low as $1,439 with a GoodRx coupon. No generic version is currently available.
Medfinder Findability Score
60/100
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Yupelri (revefenacin) is a prescription inhalation solution used for the maintenance treatment of chronic obstructive pulmonary disease (COPD) in adults. It was FDA-approved on November 9, 2018, and is manufactured by Viatris Specialty LLC. Yupelri is the first and only once-daily long-acting muscarinic antagonist (LAMA) available as a nebulizer solution in the United States.
Unlike most COPD bronchodilators — which come as dry powder or pressurized metered-dose inhalers — Yupelri is delivered via a standard jet nebulizer, making it ideal for patients who have difficulty using handheld inhaler devices. This includes elderly patients, those with arthritis or cognitive impairment, and people with severe COPD who already use a home nebulizer.
Yupelri is available only as a brand-name medication. No generic version has been approved as of 2026, and generic market entry is not expected before 2031 based on current patent protections.
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Yupelri (revefenacin) belongs to the drug class called long-acting muscarinic antagonists (LAMAs). In COPD, the smooth muscles surrounding the airways are chronically overtightened, restricting airflow and causing symptoms like wheezing, shortness of breath, and cough.
Revefenacin works by blocking muscarinic M3 receptors on airway smooth muscle cells. These receptors normally receive signals from acetylcholine — a neurotransmitter that triggers muscle contraction. By blocking M3 receptors, Yupelri prevents acetylcholine from causing airway tightening. The result is bronchodilation: relaxed, widened airways that allow air to flow more freely in and out of the lungs.
Each dose of Yupelri provides approximately 24 hours of sustained bronchodilation. Steady-state therapeutic levels are reached within 7 days of starting once-daily treatment. Revefenacin has similar affinity for muscarinic receptor subtypes M1 through M5, with primary bronchodilatory effects through M3 receptor inhibition in airway smooth muscle. Systemic absorption is very low (<3% oral bioavailability), meaning the drug acts primarily locally in the lungs with minimal whole-body effects.
175 mcg/3 mL — Inhalation solution (unit-dose vial for nebulization)
One vial administered once daily via standard jet nebulizer with mouthpiece. Each foil pouch contains one pre-measured unit-dose vial. Do not mix with other nebulizer medications.
Yupelri is not listed on the FDA's official drug shortage database as of 2026. However, finding it at a retail pharmacy can be genuinely difficult. As a specialty medication with a high list price (over $1,655 per 30-day supply) and no generic alternative, most community retail pharmacies do not stock it routinely. Yupelri holds approximately 2–3% of the inhaled COPD market, making it a low-volume, high-cost inventory risk for most pharmacies.
Specialty pharmacies, mail-order pharmacies through major pharmacy benefit managers (Express Scripts, CVS Caremark, Optum Rx), and high-volume chain pharmacies near pulmonology practices are the most reliable sources. Generic entry is not expected before 2031, so limited retail stocking will likely remain a challenge for the foreseeable future. When you do find a pharmacy that stocks it, consider switching to a 90-day mail-order supply for consistent access.
If you're having trouble finding Yupelri at your local pharmacy, medfinder calls pharmacies near you to find which ones have it in stock — saving you the hassle of calling around yourself. Simply provide your medication, dosage, and zip code, and medfinder texts you the results.
Yupelri (revefenacin) is not a controlled substance and has no DEA scheduling. Any licensed healthcare provider with prescribing authority can prescribe it — there are no special DEA registration requirements beyond standard prescribing privileges. Prescriptions can be written, faxed, called in, or sent electronically.
Providers who commonly prescribe Yupelri include:
Pulmonologists (most common — lung disease specialists)
Primary care physicians (PCPs) and family medicine doctors
Internal medicine physicians
Geriatricians (specialists in elderly care)
Nurse practitioners (NPs) and physician assistants (PAs) with prescribing authority
Telehealth options for Yupelri are limited. Because it is used for moderate-to-severe COPD, most telehealth platforms require documentation of an existing COPD diagnosis and prior treatment history. Established COPD patients may be able to get Yupelri refills through primary care telehealth platforms (Teladoc, MDLive), but new diagnoses or significant medication changes require in-person pulmonology evaluation.
No. Yupelri (revefenacin) is not a controlled substance. It has no DEA scheduling designation and is not subject to the additional prescription controls, quantity limits, or refill restrictions that apply to Schedule II–V medications.
Because Yupelri is not a controlled substance, it can be prescribed by any licensed healthcare provider with prescribing authority — including primary care physicians, internists, pulmonologists, nurse practitioners, and physician assistants. Prescriptions can be called in, faxed, or sent electronically without the special DEA form requirements that apply to controlled substances. Refills may be authorized as part of the original prescription per the prescriber's instructions and applicable state law.
The most common adverse reactions reported in Yupelri's Phase 3 clinical trials (occurring in ≥2% of patients and more frequently than placebo) are:
Cough
Nasopharyngitis (runny/stuffy nose, sore throat)
Upper respiratory tract infection
Headache
Back pain
Paradoxical bronchospasm: Airways tighten instead of relax — stop Yupelri, use rescue inhaler, call 911
Serious allergic reactions: Hives, swelling of face/lips/tongue/throat, difficulty breathing — emergency care required
Worsening narrow-angle glaucoma: Eye pain, blurred vision, halos around lights — contact provider immediately
Urinary retention: Difficulty urinating, especially in patients with prostatic hyperplasia — report promptly
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Tiotropium (Spiriva HandiHaler / Spiriva Respimat)
Most widely prescribed LAMA; once-daily dry powder or soft mist inhaler. Generic tiotropium respimat becoming available. Often step-therapy requirement before insurance covers Yupelri.
Umeclidinium (Incruse Ellipta)
Once-daily LAMA via Ellipta dry powder inhaler. Generic available; significantly lower cost than Yupelri. Widely stocked at most pharmacies.
Aclidinium (Tudorza Pressair)
Twice-daily LAMA via dry powder inhaler. Less convenient but effective COPD maintenance option for patients who can use DPI devices.
Ipratropium (Atrovent)
Short-acting anticholinergic available as nebulized solution or MDI. Requires 3–4 doses daily. Widely available and affordable; useful as temporary bridge if Yupelri is unavailable.
Prefer Yupelri? We can find it.
Other anticholinergics (tiotropium, umeclidinium, aclidinium, glycopyrrolate, ipratropium)
majorAdditive anticholinergic effects — increased risk of urinary retention, constipation, dry mouth, glaucoma worsening. Avoid combination.
OATP1B1/1B3 inhibitors (cyclosporine, rifampicin, ceftobiprole, enasidenib)
majorSignificantly increases systemic exposure of revefenacin's active metabolite — coadministration not recommended.
Anticholinergic antihistamines (diphenhydramine/Benadryl)
moderateAdditive anticholinergic effects; use with caution especially in elderly patients who are more sensitive to confusion and urinary retention.
Tricyclic antidepressants (amitriptyline, nortriptyline)
moderateAdditive anticholinergic effects due to inherent anticholinergic properties of tricyclics.
Acetylcholinesterase inhibitors (donepezil, rivastigmine, galantamine)
moderateMay reduce Yupelri's bronchodilatory efficacy through pharmacodynamic antagonism (increased acetylcholine levels compete with LAMA blocking).
Yupelri (revefenacin) fills a genuine clinical need as the only once-daily nebulized LAMA for COPD maintenance in the US. For patients who need nebulized therapy — whether due to physical limitations, severe COPD, or personal preference — it offers a once-daily convenience that most nebulized COPD medications cannot match.
The main challenges are access and cost. With a list price over $1,655 per 30-day supply and no generic, most patients depend on insurance coverage or manufacturer assistance programs. The Viatris Savings Card makes it accessible at $0/month for most commercially insured patients. Medicare Part B provides strong coverage, especially for patients with Medigap supplemental insurance.
Finding Yupelri in stock at a local pharmacy requires persistence — most retail pharmacies don't carry it regularly. Specialty pharmacies and mail-order services are more reliable. When you do need to search for it, medfinder can call pharmacies near you to check which ones have it in stock and can fill your prescription, delivering results directly to your phone.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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