Remdesivir

Antiviral, Systemic · Antiviral

Indications

COVID-19 in patients with pneumonia requiring supplemental oxygen, or patients =18 years not requiring supplemental oxygen who are at increased risk of progressing to severe COVID-19.

Dosage

IV: Adults and Children =40 kg: Single loading dose of 200 mg on Day 1. Maint: 100 mg from Day 2. Children 3.5 kg-40 kg: Only use Remdesivir for inj, 100 mg, lyophilized powd. Single loading dose of 5 mg/kg on Day 1 followed by 2.5 mg/kg once daily from Day 2. For patients requiring invasive mechanical ventilation and/or extracorporeal membrane oxygenation (ECMO), the recommended total duration is 10 days. For patients not requiring invasive mechanical ventilation and/or ECMO, the recommended total treatment duration is 5 days. If a patient does not show clinical improvement, treatment may be extended for up to 5 more days for a total treatment duration of up to 10 days.

Administration

Administer via IV infusion over 30-120 mins. After inf is complete, flush with 0.9% NaCl. Discard any remaining soln. Reconstitution: Remdesivir for Inj, 100 mg: Reconstitute remdesivir for inj lyophilized powd with 19 mL of SWFI and further dilute in 0.9% NaCl inf bag prior to adm. Remdesivir Inj, 100 mg/20 mL (5 mg/mL): Dilute remdesivir inj conc soln in 0.9% NaCl inf bag prior to adm. Prepare soln for inf on same day as adm. Compatibility: SWFI, NS. Stability: Store diluted remdesivir soln for inf up to 4 hrs at room temp (20°C-25°C) or 24 hrs at refrigerated temp (2°C-8°C).

Adverse Effects

Headache, nausea, increased transaminases, rash, PT time prolonged.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Positive evidence of risk: Use only when no safer alternative exists for a serious problem. Lactation: Caution advised or effect undetermined. Contraindications: Patients with eGFR < 30 mL/min or in full term neonates (at least 7 days to =28 days old) with serum creatinine =1 mg/dL unless the potential benefit outweighs the potential risk. Patients with ALT = 5 times the ULN (upper limit of normal) at baseline. Precautions: Hepatic lab testing should be performed in all patients prior to starting remdesivir and daily while receiving treatment. Monitor for hypersensitivity reactions. Immunocompromised patients.

Interactions

Chloroquine phosphate, hydroxychloroquine sulphate (avoid). Strong inducers of plasma/tissue esterases or CYP2C8, CYP2D6 or CYP3A4. Substrates of CYP3A4, OATP1B1 or OATP1B3.

Pharmacokinetics

Metabolism: Metabolized to a triphosphate metabolite. Half-life elimination: Nucleoside triphosphate metabolite: Approx. 20 hrs. Excretion: Urine (74%). Faeces (18%).

Compiled by Healify Pharmacy from published drug references. How we compile it →

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