Remdesivir : Therapeutic uses, Clinical uses, Indications, Dosage, Side Effects, Warnings, Interactions, Precautions, Contraindications & Brand names
Updated on 22nd April 2020. These materials are regularly updated based on new scientific findings & trials as the pandemic evolves.
Remdesivir (RDV), a nucleotide analog, is an antiviral medication developed by the Gilead Sciences. It is currently an investigational drug and not approved in any country for any use. It was originally developed for Ebola Virus Disease And now being studied for Coronavirus Disease 2019 (COVID-19).
Dose : 100-200 mg
Route : Intravenous
Onset of action : N/A
Plasma half-life : N/A
Duration of action : N/A
Bioavailability : N/A
Plasma protein binding : N/A
Metabolism : N/A
Pregnancy risk category : N/A
Chemical formula : C27H35N6O8P
IUPAC name : (2S)-2-{(2R,3S,4R,5R)-[5-(4-Aminopyrrolo[2,1-f] [1,2,4]triazin-7-yl)-5-cyano-3,4-dihydroxy-tetrahydro-furan-2-ylmethoxy]phenoxy-(S)-phosphorylamino}propionic acid 2-ethyl-butyl ester
Trade name : N/A
Therapeutic uses : Remdesivir is currently an investigational drug and not approved in any country for any use.
- Off Label Uses: Coronavirus Disease 2019 (COVID-19)
Access
- On 17 March 2020, the drug was provisionally approved for use for COVID-19 patients in a serious condition as a result of the outbreak in the Czech Republic.
- On 20 March 2020, United States president Donald Trump announced that remdesivir was available for “compassionate use” by people with COVID-19; FDA Commissioner Stephen Hahn confirmed the statement at the same press conference.
- On 23 March 2020, Gilead voluntarily suspended access for compassionate use (excepting cases of critically ill children and pregnant women), for reasons related to supply, citing the need to continue to provide the agent for testing in clinical trials.
- As of 11 April 2020, access in Canada is only to those who will be involved in a clinical trial.
Is remdesivir effective for COVID-19?
Preliminary data from two clinical trials using the antiviral drug remdesivir to treat COVID-19 patients is encouraging, researchers report.
One trial is providing the drug to patients with moderate illness and the other focuses on patients with severe illness.
A number of the patients are now recovering and have been released from the hospital. While it’s too early to tell, the researchers said there are also indications that remdesivir can possibly stave off being put on a ventilator.
“Early results are promising, and that is important right now. Much of what we are learning about COVID-19 management is centered around preventing quick deterioration. Timing is everything. I can’t say for certain they [patients] would have been intubated otherwise, but it’s encouraging,” said Katherine Perez, an infectious diseases pharmacist who is co-leading the trials.
Houston Methodist Hospital was the fifth site in the United States to join the clinical trials with remdesivir, and it began enrolling and treating patients in mid-March. Now, these Phase 3 trials will evaluate the effectiveness and safety of remdesivir. Both trials are registered with the federal government’s clinical trial registry.
The patients with moderate illness receive either five or 10 days of remdesivir treatment, while those with severe illness receive 10 days of treatment with the drug.
Quick treatment is critical, said Dr. Kevin Grimes, an infectious diseases physician and co-leader of the trials.
“If given early enough, we’re hoping that remdesivir interferes with the virus and blocks its ability to replicate in patients’ cells,” Grimes said in a Houston Methodist news release. “The goal is that it staves off the deadly inflammatory cascade that leads to respiratory failure and the need to be intubated and put on a ventilator.”
Mechanism of action
Remdesivir (prodrug) that metabolizes into its active form GS-441524 (an adenosine nucleotide analog).
GS-441524 interferes with the action of viral RNA-dependent RNA polymerase and evades proofreading by viral exoribonuclease (ExoN), causing a decrease in viral RNA production.
Side effects
In the Ebola trial, researchers detected:
- Increased liver enzyme levels that may or may not indicate liver damage.
Researchers documented similar increases in liver enzymes in three U.S. COVID-19 patients.
Typical antiviral drug side effects include:
- Nausea
- Vomiting
Drug Interactions
- There are no known significant interactions.
Precautions
Before using this medication, tell your doctor or pharmacist
- If you are allergic to it; or if you have any other allergies.
- Your medical history.
Contraindications
- Known hypersensitivity to RDV.
For detailed query or in case of uncertainty, Always consult your doctor or pharmacist.
Editor’s Note: Remdesivir is not FDA-approved. As a result, there is limited published information on this potential COVID-19 coronavirus treatment. The above article is sourced from various articles.
