Generic
Remdesivir
12 brands available in the market
At a glance
Remdesivir is an antiviral drug authorized for emergency use in the treatment of COVID-19. It is indicated for hospitalized adult and pediatric patients for whom use of an intravenous agent is clinically appropriate.
Description
Remdesivir is an adenosine nucleotide prodrug that distributes into cells where it is metabolized to the pharmacologically active nucleoside triphosphate metabolite. Remdesivir triphosphate acts as an analogue of ATP and competes with natural ATP substrate for incorporation into nascent RNA chains by SARS-CoV-2 RNA-dependent RNA polymerase, resulting in delayed chain termination during viral RNA replication.
Indications
- Suspected or laboratory-confirmed COVID-19 (severe disease: SpO2 <94%, requiring supplemental oxygen, mechanical ventilation, or ECMO)
Therapeutic class
Anti-viral drugs
Pharmacological class
Nucleotide Analog (RNA Polymerase Inhibitor)
Pharmacology
Remdesivir is an adenosine nucleotide analog prodrug that is metabolized to the active nucleoside triphosphate in cells. It inhibits SARS-CoV-2 RNA-dependent RNA polymerase, preventing viral RNA replication. It is a weak inhibitor of mammalian DNA and RNA polymerase with low potential for mitochondrial toxicity.
Mechanism of action
Prevents viral RNA replication by inhibiting SARS-CoV-2 RNA polymerase.
Dosage
Adult Dose (IV):
- With invasive mechanical ventilation/ECMO: Day 1: 200 mg loading; Days 2-10: 100 mg/day (total 10 days)
- Without invasive mechanical ventilation/ECMO: Day 1: 200 mg loading; Days 2-5: 100 mg/day (total 5 days); may extend up to 5 additional days if no clinical improvement (total 10 days)
Pediatric Dose (3.5-<40 kg):
- Loading: 5 mg/kg IV; Maintenance: 2.5 mg/kg/day (total 10 days)
- Without mechanical ventilation/ECMO: 5 days; may extend up to 5 additional days if no improvement
- ≥40 kg: Adult dose
Administration
- Administer as IV infusion only over 30-120 minutes, in total volume of 100-250 mL 0.9% saline
- Do not administer simultaneously with any other medication
- Administered by healthcare professional
Missed dose
If you miss a dose, consult your doctor.
Side effects
Side Effects:
- Increased liver transaminases
Precautions & warnings
- Monitor liver function tests before and daily during treatment
- Determine eGFR (adults and pediatric >28 days)
- Serious and unexpected adverse events may occur
Contraindications
- Hypersensitivity to remdesivir
Drug interactions
- Compatibility with IV solutions and medications other than saline is unknown
Food interactions
Not food-related (IV use); it is not known whether it is safe to consume alcohol.
Use in pregnancy
Use in Pregnancy: No adequate controlled studies in pregnant women; use only if potential benefit justifies potential risk.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: No information on presence in human milk; consider SARS-CoV-2 transmission and potential adverse effects of the drug.
Pediatric use
Pediatric dose based on weight; neonates <28 days require eGFR determination.
Geriatric use
Caution required in elderly patients; dose adjustment may be needed.
Renal / hepatic impairment
Renal Impairment: eGFR determination required; caution in kidney disease; dose adjustment may be needed; consult your doctor.
Hepatic Impairment: Monitor liver function; caution in liver disease; consult your doctor.
Overdose effects
No overdose information available; consult your doctor if overused.
Storage conditions
Lyophilized powder: Store at temperature not exceeding 30°C in a dry place; protect from light and moisture; After reconstitution: 4 hours at room temperature or 24 hours at 2-8°C; Diluted solution: 4 hours at room temperature or 24 hours at 2-8°C.
Chemical structure
Remdesivir