Antimicrobials
Remdesivir

Remdesivir

Restricted

N/A
N/A

Spectrum of Activity

General Information

Renal Function:

  • (Non-HD) Estimated CrCl (or eGFR) <30 is a relative contraindication
    • A 5-day treatment course may be considered with appropriate risk-benefit evaluation
    • Extended use (beyond 5 days) should be avoided due to accumulation of the cyclodextrin component
  • (HD) Cyclodextrin is dialyzable and remdesivir at standard doses may be used in ESRD patients who continue to receive regular dialysis

Hold therapy for any of the following:

  • ALT ≥ 10 times the upper limit of normal
  • ALT elevation accompanied by clinical symptoms or coagulopathies
  • Transaminase elevations

  • Contains cyclodextrin vehicle, caution in CrCl <30

Remdesivir is an inhibitor of the SARS-CoV-2 RNA-dependent RNA polymerase, which is essential for viral replication.

Remdesivir is an adenosine nucleotide prodrug that is metabolized to pharmacologically active nucleoside triphosphate metabolite. Remdesivir triphosphate (RDV-TP) acts as an analog of adenosine triphosphate (ATP) and competes with high selectivity (3.65-fold) over the natural ATP substrate for incorporation into nascent RNA chains by the SARS-CoV-2 RNA polymerase, which results in delayed chain termination during replication of the viral RNA.