Remdesivir

What is Remdesivir

Remdesivir is an investigational antiviral medication with a broad spectrum of in vitro activity against RNA viruses belonging to Filoviridae, Paramyxoviridae, Pneumoviridae, and Orthocoronavirinae families.

Although not FDA-approved, the FDA has issued an Emergency Use Authorization (EUA) allowing intravenous remdesivir to be used in hospitalized COVID-19 patients with severe disease, defined as a SpO₂ of 94% or less on room air, requiring supplemental oxygen, mechanical ventilation, or extracorporeal membrane oxygenation (ECMO).

Indications

• coronavirus disease 2019 (COVID-19)
• severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
• severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection

This drug may also have activity against the following microorganisms: severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

Side Effects

1. atrial fibrillation
2. constipation
3. delirium
4. diaphoresis
5. diarrhea
6. ecchymosis
7. elevated hepatic enzymes
8. headache
9. hematuria
10. hypernatremia
11. hypotension
12. infusion-related reactions
13. nausea
14. phlebitis
15. rash
16. shivering
17. vomiting

Monitoring Parameters

• CBC with differential
• LFTs
• serum creatinine/BUN
• serum electrolytes

Contraindications

• breast-feeding
• dialysis
• hepatic disease
• infusion-related reactions
• pregnancy
• renal failure
• renal impairment

Interactions

• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Carbamazepine
• Dexamethasone
• Eslicarbazepine
• Fosphenytoin
• Isoniazid, INH; Pyrazinamide, PZA; Rifampin
• Isoniazid, INH; Rifampin
• Omeprazole; Amoxicillin; Rifabutin
• Oxcarbazepine
• Phenobarbital
• Phenytoin
• Primidone
• Rifabutin
• Rifampin
• Rifapentine
• Rufinamide
• St. John’s Wort, Hypericum perforatum