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Overview of Remdesivir

Remdesivir is an antiviral nucleotide with broad antiviral activity. The active form of remdesivir acts as a nucleoside (adenosine triphosphate) analog and inhibits the RNA polymerase of coronaviruses including SARS-CoV-2. Remdesivir is incorporated by RNA polymerase into the growing RNA molecule and allows the addition of three more nucleotides before RNA synthesis is inhibited.

Remdesivir is a phosphoramidate prodrug that must be metabolized within host cells to its triphosphate active metabolite to effectively compete with ATP for incorporation into newly synthesized viral RNA. Due to much higher selectivity of mammalian DNA and RNA polymerases, including human mitochondrial RNA polymerase, for ATP over remdesivir triphosphate, remdesivir is not a significant inhibitor of these enzymes, which accounts for its overall tolerability and safety profile.

The results of clinical trials suggest that IV administration of remdesivir may shorten the time to recovery from COVID-19 and may reduce mortality. The duration of action is moderate, as it is given once daily.

Side effects include:

• Severe headache
• Irregular heartbeats
• Light-headedness
• Fever or chills
• Wheezing
• Nausea
• Itching, sweating

Remdesivir was authorized with conditions in Canada on July 27, 2020. It was authorized for the treatment of severe COVID-19 in adults and youth aged 12 years and over and weighing at least 40 kg with pneumonia requiring supplemental oxygen. It was the first medication authorized specifically for the treatment of COVID-19 and remains one of the few approved therapies in Canada.

Manufacturer:

Gilead Sciences Canada Inc.

Availability in Canada:

100 mg / 20 mL remdesivir solution, single-dose vial, intravenous administration
100 mg / vial remdesivir powder for injection, single-dose vial, intravenous administration

Prescription status:

Remdesivir (Veklury) is available by prescription only.

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