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 microorganismssevere 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
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