Names and pronunciation
(rem-de′si-vir) Veklury
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Individual generic drug information
Extracted information for remdesivir only.
(rem-de′si-vir) Veklury
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Func. class.: Antiviral
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Chem. class.: RNA-polymerase inhibitor
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ACTION: Inhibits SARS-CoV-2 RNA– dependent RNA polymerase needed for viral replication
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USES: COVID-19
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Extracted information for remdesivir only.
CONTRAINDICATIONS: Hypersensitivity Precautions: Breastfeeding, child <12 yr, dialysis, hepatic disease, infusion-related reactions, pregnancy, renal disease
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Black Box Warning: Remdesivir is not an approved treatment for COVID-19 caused by SARS-CoV-2, but is investigational and is available under an FDA emergency use authorization (EUA) for the treatment of COVID-19 in hospitalized patients only
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SIDE EFFECTS GI: Diarrhea, constipation, increased LFTs, nausea RESP: Dyspnea, hypoxia, respiratory arrest, wheezing CNS: Fever, headache, delirium, seizures, shivering INTEG: Anaphylaxis, angioedema, infu- sion-related reactions, phlebitis, rash, ecchymosis HEMA: Anemia CV: Atrial fibrillation, bradycardia, hypo-hypertension, sinus tachycardia ENDO: Hyperbilirubinemia, hyperglyce- mia, hypernatremia, hypokalemia GU: Hematuria
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INTERACTIONS Decrease: Remdesivir effect—hydroxy- chloroquine, chloroquine, strong CYP3A4 inducers, avoid using together NURSING CONSIDERATIONS
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Extracted information for remdesivir only.
DOSAGE AND ROUTES Adult/child ≥12 yr and 40 kg: IV: Patients requiring low-flow/high-flow supplemental O2 or noninvasive ven- tilation: 200 mg (single dose) on day 1, then 100 mg daily × 4 days or until hospi- tal discharge, whichever is first; may con- tinue up to 10 days in those without improvement at day 5; may use monother- apy or with dexamethasone; patients requiring invasive mechanical venti- R lation/extracorporeal membrane oxy- genation: 200 mg (single dose) on day 1, then 100 mg daily, duration varies; total duration is 5 days or hospital discharge, whichever is first; may continue up to 10 days in those without improvement at day 5 Child ≥12 yr/adolescent <40 kg: Lyophilized powder only: IV: Loading dose: 5 mg/kg/dose on day 1, then 2.5 mg/kg/dose daily; ≥40 kg: Injection solution/lyophilized powder: IV: Loading dose: 200 mg on day 1, then 100 mg daily; in those not requiring mechanical ventilation/extracorpo- real membrane oxygenation: Use for 5 days or until hospital discharge, which- ever is first; may continue up to 10 days in those without improvement at day 5; in those requiring mechanical ventilation/ECMO: Use for 10 days or start with a 5-day course and extend to 10 days on a case-by-case basis Infant/child <12 yr: Lyophilized powder only 3.5 kg to <40 kg: IV: Loading dose: 5 mg/kg/dose on day 1, then 2.5 mg/kg/dose daily; ≥40 kg: IV: Loading dose: 200 mg on day 1, then 100 mg daily; in those not requiring mechanical ventilation/extracorpo- real membrane oxygenation: Use for 5 days or until hospital discharge, which- ever is first; may continue up to 10 days in those without improvement at day 5; in those requiring mechanical venti- lation/ECMO: Use for 10 days or start with a 5-day course and extend to 10 days on a case-by-case basis
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Available forms: IV solution (preserva- tive free) 100 mg/20 mL; IV solution reconstituted 150 mg
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Administer: Intermittent IV infusion route • Injection solution: Warm to room temperature before dilution, further di- lute in 250 mL NS; withdraw and discard the required volume of NS from the infu- sion bag (40 mL/200 mg; 20 mL/100 mg) before addition of remdesivir, trans- fer required volume of remdesivir to the infusion bag and invert to mix; do not shake. Discard unused portion of the in- jection solution vial • Lyophilized powder: Reconstitute vial/19 mL SWFI; shake for 30 sec, allow to sit for 2-3 min, repeat until contents are dissolved (5 mg/mL); further dilute in 100-250 mL NS; withdraw and discard the required volume of NS from the infu- sion bag (40 mL/200 mg; 20 mL/100 mg) before adding remdesivir; transfer needed volume of remdesivir to the infu- sion bag and invert to mix. Discard unused portion • Give over 30-120 min
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Extracted information for remdesivir only.
Assess: • COVID-19: Confirm presence of CO- VID-19 before starting treatment; obtain CBC with differential, PT, and serum elec- trolytes before and during treatment • Hepatic effects: Obtain LFTs before and during treatment; discontinue in ALT >10 × ULN; discontinue if ALT elevation with signs/symptoms of liver inflamma- tion occur • Hypersensitivity: Monitor for infusion- related reactions, anaphylaxis, angioedema, diaphoresis, dyspnea, hypo-hypertension, hypoxia, fever, rash, shivering, tachycar- dia, wheezing; slow infusion rate to max infusion time: 120 min; discontinue and provide treatment if severe • Renal disease: Obtain BUN/creatinine baseline and during treatment; monitor for hematuria; avoid use in eGFR <30 mL / min, significant toxicity with a short dura- tion of therapy 5-10 days is unlikely • CV reactions: Monitor for atrial fibril lation, hyper-hypotension, sinus tachycar- dia, bradycardia • Pregnancy/breastfeeding: Identify if pregnant or if breastfeeding
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Evaluate: • Therapeutic response: Resolution of COVID-19 without serious adverse reactions
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Patient and caregiver information: • Reason for product and expected re- sults • To report immediately to provider rash, itching, injection site reactions, trouble breathing, shivering, wheezing, rapid heartbeat • Provide “fact sheet” to patient/care- giver and review • That this product has not been ap- proved by the FDA and has been granted for emergency use only HIGH ALERT
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Extracted information for remdesivir only.
PHARMACOKINETICS Protein binding 88%-93%, half-life <1 hr, metabolites up to 27 hr
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Filter the extracted dose blocks for this individual drug.