In this section : Covid-19
Molnupiravir
Sotrovimab
Conscious Proning
Covid-19 Basics
Remdesivir
Thromboprophylaxis
Identifying Patients in the Highest Risk Groups
Steroids for Patients with Covid-19 Infection
IL-6 Inhibitors – Tocilizumab or Sarilumab
Baricitinib
Paxlovid (Nirmatrelvir/Ritonavir)
Covid-19 Sick Day Rules for Patients with Primary Adrenal Insufficiency
Remdesivir
Last updated 18th July 2024
Please ensure you have read the information on the Covid-19 Basics page before proceeding.
Remdesivir
- Suitable for hospital inpatients in the following circumstances:
- Adults over 40kg who have a high risk of developing serious illness See Identifying Patients in the Highest Risk Groups for more information
Patients Who do not Have an Oxygen Requirement
- Nirmatrelvir/ritonavir is our first line choice.
- Sotrovimab is second line, but remdesivir may be a more appropriate second line for patients who are immunocompromised or have B cell depletion.
- Weight must be >40kg
- ALT < 5x upper limit of normal (ULN).
- Only licensed if eGFR >30ml/min but there is now some evidence for use in patients with poor renal function
- Dose 200mg IV stat, then 100mg daily for 2 days. The treatment course can be extended if patient becomes more unwell.
- Check LFTs daily. Stop if ALT becomes > 5 x ULN or any ALT rise accompanied by concerns of liver inflammation.
Patients With an Oxygen Requirement
- Weight must be >40kg
- ALT < 5x upper limit of normal.
- Only licensed if eGFR >30ml/min but there is now some evidence for use in patients with poor renal function
- Dose 200mg IV stat, then 100mg daily for 4 days.
- Review daily. The treatment course can stop after 3 days if the patient has clinically improved and is off oxygen. The treatment course can be extended up to 10 days if the patient is immunocompromised.
- Check LFTs daily. Stop if ALT becomes > 5 x ULN or any ALT rise accompanied by concerns of liver inflammation.
Links
- NICE COVID-19 rapid guideline: Managing COVID-19
- NICE TA971 Remdesivir and tixagevimab plus cilgavimab for treating COVID-19
- Electronic Medicines Compendium SPC
Content by Alison Moore