Home Drug Guide Remdesivir

Drug Guide

Generic Name

Remdesivir

Brand Names Veklury

Classification

Therapeutic: Antiviral

Pharmacological: Nucleoside analog prodrug

FDA Approved Indications

Treatment of COVID-19 in hospitalized patients requiring supplemental oxygen

Mechanism of Action

Remdesivir inhibits viral RNA-dependent RNA polymerase, thereby preventing viral replication.

Dosage and Administration

Adult: 200 mg IV on day 1, then 100 mg IV daily for 5-10 days, depending on clinical response

Pediatric: Safety and efficacy not established for pediatric patients; use with caution under clinical trial or hospital protocols

Geriatric: Adjustments not specifically required but monitor for renal and hepatic function

Renal Impairment: Use with caution; dose adjustment may be necessary for severe impairment

Hepatic Impairment: Use with caution; monitor liver function; avoid in patients with ALT levels >5 times the upper limit of normal

Pharmacokinetics

Absorption: Administered intravenously, not absorbed orally

Distribution: Wide tissue distribution, including lungs

Metabolism: Metabolized by hydrolysis and potentially cytochrome P450 enzymes

Excretion: Primarily via urine in the form of metabolites

Half Life: Approximately 11 hours in plasma

Contraindications

Hypersensitivity to remdesivir or any component of the formulation

Precautions

Liver enzyme elevation, renal impairment, pregnancy, breastfeeding

Adverse Reactions - Common

Elevated liver enzymes (Common)
Nausea (Common)
Headache (Common)

Adverse Reactions - Serious

Allergic reactions including hypersensitivity and anaphylaxis (Rare)
Severe renal impairment (Rare)

Drug-Drug Interactions

Certain oral anticoagulants may have altered effect

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor renal and hepatic function before and during therapy; assess for signs of hypersensitivity

Diagnoses:

Risk for hepatic injury
Risk for renal impairment

Implementation: Administer IV infusion with appropriate monitoring; support as needed

Evaluation: Assess for clinical improvement of COVID-19 symptoms; monitor lab values regularly

Patient/Family Teaching

Inform about potential side effects such as liver enzyme elevation
Report any allergic reactions immediately
Explain the importance of adherence to the prescribed duration

Special Considerations

Black Box Warnings:

Potential for liver injury, including hepatic failure
Use with caution in renal impairment

Genetic Factors: N/A

Lab Test Interference: May elevate liver function tests (ALT, AST) temporarily

Overdose Management

Signs/Symptoms: Potential hepatic toxicity, renal impairment

Treatment: Supportive care, monitor organ function, no specific antidote

Storage and Handling

Storage: Store at 2°C to 8°C (36°F to 46°F), in original container

Stability: Stable under recommended storage conditions for the duration of the beyond-use date