Home Drug Guide Remdesivir

Drug Guide

Generic Name

Remdesivir

Brand Names Veklury

Classification

Therapeutic: Antiviral

Pharmacological: Nucleoside analog prodrug

FDA Approved Indications

  • Treatment of COVID-19 in hospitalized patients requiring supplemental oxygen

Mechanism of Action

Remdesivir inhibits viral RNA-dependent RNA polymerase, thereby preventing viral replication.

Dosage and Administration

Adult: 200 mg IV on day 1, then 100 mg IV daily for 5-10 days, depending on clinical response

Pediatric: Safety and efficacy not established for pediatric patients; use with caution under clinical trial or hospital protocols

Geriatric: Adjustments not specifically required but monitor for renal and hepatic function

Renal Impairment: Use with caution; dose adjustment may be necessary for severe impairment

Hepatic Impairment: Use with caution; monitor liver function; avoid in patients with ALT levels >5 times the upper limit of normal

Pharmacokinetics

Absorption: Administered intravenously, not absorbed orally

Distribution: Wide tissue distribution, including lungs

Metabolism: Metabolized by hydrolysis and potentially cytochrome P450 enzymes

Excretion: Primarily via urine in the form of metabolites

Half Life: Approximately 11 hours in plasma

Contraindications

  • Hypersensitivity to remdesivir or any component of the formulation

Precautions

  • Liver enzyme elevation, renal impairment, pregnancy, breastfeeding

Adverse Reactions - Common

  • Elevated liver enzymes (Common)
  • Nausea (Common)
  • Headache (Common)

Adverse Reactions - Serious

  • Allergic reactions including hypersensitivity and anaphylaxis (Rare)
  • Severe renal impairment (Rare)

Drug-Drug Interactions

  • Certain oral anticoagulants may have altered effect

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor renal and hepatic function before and during therapy; assess for signs of hypersensitivity

Diagnoses:

  • Risk for hepatic injury
  • Risk for renal impairment

Implementation: Administer IV infusion with appropriate monitoring; support as needed

Evaluation: Assess for clinical improvement of COVID-19 symptoms; monitor lab values regularly

Patient/Family Teaching

  • Inform about potential side effects such as liver enzyme elevation
  • Report any allergic reactions immediately
  • Explain the importance of adherence to the prescribed duration

Special Considerations

Black Box Warnings:

  • Potential for liver injury, including hepatic failure
  • Use with caution in renal impairment

Genetic Factors: N/A

Lab Test Interference: May elevate liver function tests (ALT, AST) temporarily

Overdose Management

Signs/Symptoms: Potential hepatic toxicity, renal impairment

Treatment: Supportive care, monitor organ function, no specific antidote

Storage and Handling

Storage: Store at 2°C to 8°C (36°F to 46°F), in original container

Stability: Stable under recommended storage conditions for the duration of the beyond-use date

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.