Amitriptyline and Revefenacin: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Amitriptyline
Revefenacin
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Both of these medicines have a drying, 'anticholinergic' effect, and taking them together can add up. Amitriptyline (Elavil) is a strong drug for this, and revefenacin (Yupelri) is an inhaled medicine for breathing that also works this way.
When you stack them, you may notice more dry mouth, blurry vision, constipation, or trouble urinating. If you have narrow-angle glaucoma, the pressure in your eye could worsen. The good news: your care team is aware of pairings like this and can watch you closely or choose a safer option. Please don't stop either drug on your own, just let your pharmacist or doctor know you take both.
Interaction: Additive antimuscarinic (anticholinergic) burden when amitriptyline is combined with revefenacin. Neither is a prodrug; this is a pharmacodynamic, not pharmacokinetic, interaction.
- Direction: Increased anticholinergic effect (additive).
- Risks: Worsening narrow-angle glaucoma, urinary retention, dry mouth, constipation, blurred vision, confusion.
- Evidence: Theoretical; labeling advises avoiding coadministration with other anticholinergics.
- Severity/onset: Major; onset unspecified.
Management: Avoid coadministration where feasible; if combined, monitor for anticholinergic toxicity, particularly in patients with glaucoma or prostatic/bladder outlet issues. Consider a non-anticholinergic alternative in consultation with the prescriber.
What happens
Increased risk of anticholinergic side effects
Interaction Deep Dive
When revefenacin is used alongside other anticholinergic agents, the combination can heighten the likelihood of additive anticholinergic effects, such as exacerbation of narrow-angle glaucoma and urinary retention. Concurrent use with medications that contain other anticholinergics should be avoided1.
Why it happens (mechanism)
Additive anticholinergic effects
How to manage this interaction
What your care team may do:
- Because both drugs have anticholinergic effects, the label recommends avoiding this combination when possible, so your team may consider an alternative.
- If both are needed, they may monitor you more closely for side effects.
- They will pay extra attention if you have glaucoma or trouble urinating.
What you can do: Keep taking both as prescribed unless told otherwise. Tell your pharmacist or prescriber that you take amitriptyline and revefenacin, and report dry mouth, blurred vision, eye pain, constipation, or difficulty urinating.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Amitriptyline and Revefenacin together?
Combining amitriptyline and revefenacin adds up their drying (anticholinergic) effects, so labeling advises avoiding this pairing; if you take both, ask your pharmacist or doctor and watch for dry mouth, blurred vision, constipation, or trouble urinating. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Amitriptyline and Revefenacin interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Amitriptyline and Revefenacin interaction managed?
What your care team may do: Because both drugs have anticholinergic effects, the label recommends avoiding this combination when possible, so your team may consider an alternative. If both are needed, they may monitor you more closely for side effects. They will pay extra attention if you have glaucoma or trouble urinating. What you can do: Keep taking both as prescribed unless told otherwise. Tel… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Amitriptyline or Revefenacin need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: YUPELRI(TM) inhalation solution, revefenacin inhalation solution. Mylan Specialty LP (per FDA), Morgantown, WV, 2018. DailyMed
Keep reading about Amitriptyline
Keep reading about Revefenacin
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Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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