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ArticleCOVID-19

What is the role of the antiviral drug remdesivir in the treatment of COVID-19?

Remdesivir was the first drug approved by the FDA for treating the SARS-CoV-2 virus. It is indicated for treatment of COVID-19 disease in hospitalized adults and children aged 12 years and older who weigh at least 40 kg. The broad-spectrum antiviral is a nucleotide analog prodrug. 

Dosage:

  • Day 1 loading dose: 200 mg IV infused over 30-120 min, THEN
  • Day 2 to 5: 100 mg IV qDay

Adverse Effects:

  • >10% eGFR decreased* (18%)
  • Decreased CrCl* (calculated by Cockcroft-Gault) (10-18%)
  • Creatinine increased* (5-15%)
  • Hemoglobin decreased* (6-15%)
  • Glucose increased* (11-12%)
  • Lymphocytes decreased* (11%)
  • 1-10%
  • Prothrombin time increased (9%)
  • ALT increased* (3-8%)
  • AST increased* (6-7%)
  • Nausea (3-5%)
  • Bilirubin increased* (2%)
  • Hypersensitivity reactions (<2%)
  • Generalized seizure (<2%)
  • Rash (<2%)

Storage:

Lyophilized powder

  • Unopened vial: Store <30ºC (<86ºF)
  • Reconstituted vial: Use reconstituted product immediately to prepare diluted solution
  • Diluted solution: Stable for 24 hr at 20-25ºC (68-77ºF) or 48 hr refrigerated at temperature 2-8ºC (36-46ºF)

Solution for injection:

  • Unopened vial: Refrigerate at 2-8ºC (36-46ºF); may store at room temperature up to 12 hr before dilution.
  • Diluted solution: Stable for 24 hr at 20-25ºC (68-77ºF) or 48 hr refrigerated at temperature 2-8ºC (36-46ºF)

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