remdesivir

remdesivir, antiviral drug that is active against SARS-CoV-2, the cause of coronavirus disease 2019 (COVID-19). Remdesivir is administered by intravenous infusion in patients who are hospitalized or who are at high risk of severe COVID-19, including adults and adolescents as well as children age 28 days or older. The drug may be formulated as a liquid or as a powder to be mixed with a liquid. Infusions usually are repeated daily for five days; however, treatment may be prolonged in severe cases or shortened in mild cases.

Remdesivir acts by halting viral RNA production. It does so by functioning as a prodrug nucleotide analog, meaning that it is inactive until metabolized by the body, at which point the prodrug is converted into a compound that mimics one of the nucleotide building blocks of DNA and RNA. The nucleotide analog binds to an enzyme known as RNA-dependent RNA polymerase, thereby preventing viral replication and effectively reducing viral RNA levels.

Common side effects of remdesivir include nausea and reactions associated with infusion, such as pain, bleeding, bruising, soreness, and swelling at the injection site. Remdesivir typically also causes elevations in the liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST), which in rare instances can result in jaundice. Treatment may also affect kidney function; prior to receiving remdesivir, patients typically undergo testing for kidney function, primarily estimated glomerular filtration rate, which measures the amount of blood filtered by the kidneys per minute. Levels of ALT and AST may also be assessed prior to initiating treatment.