Remdesivir belongs to a group of antiviral drugs. In our awareness, it only began to exist at the time of the COVID-19 epidemic, although the drug was created much earlier to treat a completely different disease.

Remdesivir operation

Remdesivir is an adenosine nucleotide prodrug that is metabolized in the host cells to a pharmacologically active metabolite. Remdesivir triphosphate acts primarily as an adenosine triphosphate (ATP) analogue and competes with the natural ATP substrate for inclusion in nascent RNA chains via SARS CoV-2 RNA dependent RNA polymerase, resulting in delayed chain termination during viral RNA replication.

Indications for the use of remdesivir

Remdesivir is approved for the treatment of COVID-19 disease (coronavirus disease 2022) in adults and adolescents (12 to less than 18 years of age and weighing 40 kg or more) with pneumonia. for whom oxygen administration is required (use of low or high flow oxygen or other types of non-invasive ventilation at the start of treatment).

Contraindications to the use of remdesivir

The main contraindication is hypersensitivity to the active substance.

The drug with this composition contains as an excipient beta-cyclodextrin sulfobutyl ether sodium, which is excreted by the kidneys and accumulates in patients with impaired renal function. Therefore, it should not be used in patients with eGFR<30 ml/min.

Available preparations

Remdesivir is currently only available as a powder for concentrate for solution for infusion (powder for concentrate).

Remdesivir dosage

The drug is used only in hospital treatment settings, i.e. where patients can be closely monitored.

Remdesivir is intended for intravenous infusion after reconstitution and further dilution.

Side effects

The most frequently reported side effect is increased levels of transaminases. Hypersensitivity reactions are possible. Symptoms may include:

  • hypotension,
  • hypertension,
  • tachycardia,
  • bradycardia,
  • hypoxia,
  • fever,
  • shortness of breath,
  • wheezing,
  • angioedema,
  • rash,
  • nausea,
  • vomiting,
  • profuse sweating
  • and chills.

Interaction with other drugs

No clinical drug interaction studies have been performed with remdesivir. The total interaction potential is currently unknown. Patients should be closely monitored on the days of remdesivir administration.

The concomitant use of remdesivir with chloroquine phosphate or hydroxychloroquine sulfate is definitely not recommended.

Strong inducers (e.g. rifampicin) may reduce the plasma concentration of remdesivir and their use is not recommended. Strong inhibitors may result in increased exposure to remdesivir.

Pregnancy and breastfeeding

There is limited amount of data from the use of remdesivir in pregnant women. Therefore, remdesivir should not be used during pregnancy unless the clinical condition of the woman requires treatment.

It is also unknown whether remdesivir is excreted in human milk, and its effects on a breastfed infant or milk production are not known.

Effects on the ability to drive and use machines

Remdesivir has no or negligible influence on the ability to drive and use machines.

Storage

Diluted remdesivir infusion solution should be stored for up to 24 hours below 25 ° C or 48 hours in a refrigerator (2 ° C-8 ° C).

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