Remdesivir – The drug killing hospitalised Covid-19 patients

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Antiviral Drugs That Are Approved or Under Evaluation for the Treatment of COVID-19
Last Updated: July 8, 2021
https://www.covid19treatmentguidelines.nih.gov/therapies/antiviral-therapy/summary-recommendations/

Remdesivir
See Therapeutic Management of Hospitalized Adults with COVID-19 for recommendations on using remdesivir with or without dexamethasone.

Last Updated: April 21, 2021

Remdesivir is an intravenous nucleotide prodrug of an adenosine analog. Remdesivir binds to the viral RNA-dependent RNA polymerase and inhibits viral replication through premature termination of RNA transcription. It has demonstrated in vitro activity against SARS-CoV-2.1 In a rhesus macaque model of SARS-CoV-2 infection, remdesivir treatment was initiated soon after inoculation; the remdesivir-treated animals had lower virus levels in the lungs and less lung damage than the control animals.2

Remdesivir is approved by the Food and Drug Administration (FDA) for the treatment of COVID-19 in hospitalized adult and pediatric patients (aged ≥12 years and weighing ≥40 kg). It is also available through an FDA Emergency Use Authorization (EUA) for the treatment of COVID-19 in hospitalized pediatric patients weighing 3.5 kg to <40 kg or aged <12 years and weighing ≥3.5 kg. Remdesivir should be administered in a hospital or a health care setting that can provide a similar level of care to an inpatient hospital.

Remdesivir has been studied in several clinical trials for the treatment of COVID-19. The recommendations from the COVID-19 Treatment Guidelines Panel (the Panel) are based on the results of these studies. See Table 2a for more information.

The safety and efficacy of combination therapy of remdesivir with corticosteroids have not been rigorously studied in clinical trials; however, there are theoretical reasons that combination therapy may be beneficial in some patients with severe COVID-19. For the Panel’s recommendations on using remdesivir with or without dexamethasone in certain hospitalized patients, see Therapeutic Management of Hospitalized Adults with COVID-19.

Monitoring and Adverse Effects
Remdesivir can cause gastrointestinal symptoms (e.g., nausea), elevated transaminase levels, an increase in prothrombin time (without a change in the international normalized ratio), and hypersensitivity reactions.

Liver function tests and prothrombin time should be obtained in all patients before remdesivir is administered and during treatment as clinically indicated. Remdesivir may need to be discontinued if alanine transaminase (ALT) levels increase to >10 times the upper limit of normal and should be discontinued if an increase in ALT level and signs or symptoms of liver inflammation are observed.

Remdesivir is not recommended for patients with an eGFR <30 mL/min due to lack of data.5 Renal function should be monitored before and during remdesivir treatment as clinically indicated.

Drug-Drug Interactions
Clinical drug-drug interaction studies of remdesivir have not been conducted.

Minimal to no reduction in remdesivir exposure is expected when remdesivir is coadministered with dexamethasone, according to information provided by Gilead Sciences (written communication, July 2020). Chloroquine or hydroxychloroquine may decrease the antiviral activity of remdesivir; coadministration of these drugs is not recommended.

Source: https://www.covid19treatmentguidelines.nih.gov/therapies/antiviral-therapy/remdesivir/

Ivermectin (https://www.covid19treatmentguidelines.nih.gov/therapies/antiviral-therapy/ivermectin/)

And then on the same website, Ivermectin which has been shown to work for Covid-19 viral infection, the following disinformation is provided.

There is insufficient evidence for the COVID-19 Treatment Guidelines Panel (the Panel) to recommend either for or against the use of ivermectin for the treatment of COVID-19. Results from adequately powered, well-designed, and well-conducted clinical trials are needed to provide more specific, evidence-based guidance on the role of ivermectin in the treatment of COVID-19.

For more information on ivermectin and its use, go here.

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