Remdesivir
VEKLURY
Pronunciation: rem-DE-si-veer (VEK-ler-ee)
What it isNucleotide analog inhibiting viral RNA polymerase; COVID-19.
Why this oneIt shortens recovery in hospitalized patients and is the IV option when oral antivirals are unsuitable.
What limits itIV only, over several days. Transaminase rise; benefit is greatest early and modest in late severe disease.
FDA-approved for
- COVID-19 (2020)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| COVID-19 | Adults & peds >=40 kg | 200 mg IV loading dose day 1 | 100 mg IV QD from day 2 | 100 mg/day maintenance |
| COVID-19 | Peds 1.5 to <40 kg | Weight-based (Table 1) | Weight-based maintenance | Per weight |
Renal No adjustment needed (any degree, including dialysis)
Hepatic Monitor LFTs; consider discontinuing if ALT >10x ULN or with signs of liver injury
Total duration 5-10 days by severity
Instructions
- Give by IV infusion (may slow to up to 120 min if hypersensitivity risk)
- Perform hepatic labs and prothrombin time before and during treatment
- Duration 5 days (not ventilated) or 10 days (invasive mechanical ventilation/ECMO)
- Initiate as soon as possible after diagnosis
Available strengths
- inj 100 mg
Cautions
- Hypersensitivity including infusion-related and anaphylactic reactions
- Increased risk of transaminase elevations — monitor LFTs
Adverse reactions
- Nausea
- ALT increased
- AST increased
Pregnancy No drug-associated risk identified (2nd/3rd trimester); no dose adjustment in pregnancy
Lactation Detected in human milk; no adverse effects reported in breastfed infants (limited data)
Cost
| Strength | #/mo | generic $/unit | CostPlus | |
|---|---|---|---|---|
| 100 mg | inj | per unit | not offered |
Generic entry2041 est.
NO BOXED WARNINGS
Principal riskIV only; transaminase rise
Classes and tags
Clinical profile
Legacy pregnancy categoryNot assigned — PLLR-era drug
Defining liabilityAgent-specific renal, hepatic, hematologic, metabolic and drug-interaction toxicity.