Q: Remdesivir has shown some promise in COVID-19. How its role is limited by renal impairment?
Answer: Remdesivir is one of the few drugs which have shown some promise in the treatment of COVId-19. Its use is limited by the liver and renal insufficiencies.
Liver toxicity is a direct effect but the renal effect is due to the vehicle in which it is delivered parenterally. Remdisivir needs to be prepared in a cyclodextrin vehicle, which may get accumulated at a toxic level in patients with compromised kidney function. It should be given with extreme caution to patients with creatinine clearance less than 50 mL/min.
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Reference:
Grein J, Ohmagari N, Shin D,et.al. Compassionate Use of Remdesivir for Patients with Severe Covid-19.
N Engl J Med. 2020 Apr 10. doi: 10.1056/NEJMoa2007016.
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