REMDESIVIR

An RNA polymerase inhibitor that disrupts the production of viral RNA, preventing multiplication of SARS-CoV-2

Dosage Forms

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Powder for infusion

100 mg

Uses

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  • Covid-19 disease

Dose and Duration

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COVID-19 inpatients hospitalised with pneumonia and requiring low-flow supplemental oxygen(under close medical supervision)

By IV infusion

Adult: Loading dose 200mg daily for 1 dose, then maintenance 100mg once daily for up to 5 days in total, treatment should be initiated within 10 days of initial COVID-19 symptoms.

Consider stopping treatment if no improvement after 48 hours.

Course maybe repeated if readmitted with COVID-19

COVID-19 in immunocompromised patients hospitalised with pneumonia

By IV infusion

Adult: Loading dose 200mg daily for 1 dose then maintenance 100mg once daily for up to 10days in total following a multidisciplinary assessment.

Consider stopping treatment if no improvement after 48 hours,

course maybe repeated if readmitted with COVID-19

COVID-19 inpatients at increased risk of progression to severe illness

By IV infusion

Adult: Loading dose 200mg daily for 1 dose, then maintenance 100mg once daily for 3 days in total, treatment should be initiated within 7days of initial COVID-19 symptoms

Contra-indications

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  • Hepatic impairement with ALT is 5 times the upper limit of normal.
  • Renal impairement with eGFR less than 30mL/minute/1.73m²

Side Effects

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  • Hypersensitivity
  • Nausea, vomiting
  • Rash
  • Headache
  • Sinus bradycardia

Pregnancy

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  • Avoid unless potential benefit outweighs risk
  • Females of childbearing potential should use effective contraception during treatment

Breast-feeding

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  • Use with caution

⚠️ Caution

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  • Hepatic impairment —treatment should not be started if ALT is 5 times the upper limit of normal. If ALT increases during treatment, remdesivir may need to be withheld
  • Renal impairment - if eGFR less than 30mL/minute/1.73m²