Use of Remdesivir in COVID Patients

COVID -19

According to the WHO, COVID -19 is a disease which causes mild to moderate respiratory illness caused by novel Corona virus. The common symptoms may include fever, dry cough with serious symptoms of shortness of breath, chest pain.

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REMDESIVIR

Remdesivir belongs to the antiviral class of drugs. It is available in lyophilized powder for reconstitution form (1000mg/vial) and also in concentrated solution for injection (5mg/ml). Remedsivir is a monophosphate prodrug version of GS-441524. Remdesivir has shown effect against many viruses like EBOV, respiratory syncytial virus, HCV, paramyxoviruses. There were cell-based proven positive results for the SARS-Cov, Mers-Cov which belongs to the same family (coronaviridae) of coronavirus and this is the main lead to use remdesivir in the treatment of COVID-19.

Mechanism Of Action:

As remdsivir is a nucleoside analogue prodrug this drug undergoes conversion into its active metabolite remdesivir Triphosphate intracellularly and it competes with the endogenous nucleoside pools for incorporation into replicating viral RNA. It mimics the physiological properties of the virus and inhibits the viral replication of the RNA genome.

As mentioned remdesivir has shown a positive effect in a family of coronavirus. Coronaviridae family  (SARS-Cov and Mers-Cov) remdesivir triphosphate interferes with the nonstructural protein12 polymerase (multisubunit RNA synthesis complex) produced cleavage products of viral polyproteins.

REMDESIVIR in COVID-19

On May 1, 2020, FDA has approved remedsivir in the treatment regimen of corona infection for patients of age above 12 years and weight of above 40kgs.

The dose of remdesivir indicated was for patients above 40 kgs and 12 years of age. The loading dose (day 1) is 200 mg IV infused over 30-120 and then the maintenance dose is 100 mg IV four times a day. 

Remdesivir drug has removed from the COVID treatment as many studies have shown that this drug has no effect on coronavirus infection.

On 20 November 2020, Dr Soumya Swaminathan, the chief secretariat of WHO (World Health Organization) said that the use of remedsivir as an antiviral drug has removed from the prequalification list of coronavirus treatment as there were many negative suggestions.

References:

  1. https://www.who.int/health-topics/coronavirus#tab=tab_1
  2. https://images.app.goo.gl/vrC71SnC1284jNUg6
  3. https://cmr.asm.org/content/34/1/e00162-20#sec-6
  4. https://go.drugbank.com/drugs/DB14761
  5. https://reference.medscape.com/drug/veklury-remdesivir-4000090
  6. https://indianexpress.com/article/india/who-suspends-remdesivir-from-list-of-medicines-7059515/

Article Written by

B.Akhila Sai, Pharma D, Clinosol Student, ID: CSRPL_INT_ONL_WKD_071/0221

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