Remdesivir, sold under the brand name Veklury, is a broad-spectrum antiviral medication developed by the biopharmaceutical company Gilead Sciences. It is administered via injection into a vein. During the COVID‑19 pandemic, remdesivir was approved or authorized for emergency use to treat COVID‑19 in numerous countries.
Remdesivir was originally developed to treat hepatitis C, and was subsequently investigated for Ebola virus disease and Marburg virus infections before being studied as a post-infection treatment for COVID‑19.
Remdesivir is a prodrug that is intended to allow intracellular delivery of GS-441524 monophosphate and subsequent biotransformation into GS-441524 triphosphate, a ribonucleotide analogue inhibitor of viral RNA polymerase.
The most common side effect in healthy volunteers is raised blood levels of liver enzymes. The most common side effect in people with COVID‑19 is nausea. Side effects may include liver inflammation and an infusion-related reaction with nausea, low blood pressure, and sweating.
The US Food and Drug Administration (FDA) considers it to be a first-in-class medication.
Medical uses
In the European Union, remdesivir is indicated for the treatment of COVID‑19 in adults and adolescents (aged twelve years and older with body weight at least 40 kilograms (88 lb)) with pneumonia requiring supplemental oxygen and for adults who do not require supplemental oxygen and who are at increased risk of progressing to severe COVID‑19.
In the United States, remdesivir is indicated for the treatment of COVID‑19 in people 28 days of age and older and weighing at least 3 kilograms (6.6 lb) who are hospitalized; or not hospitalized and have mild-to-moderate COVID‑19, and are at high risk for progression to severe COVID‑19, including hospitalization or death.
In November 2020, the FDA issued an emergency use authorization (EUA) for the combination of baricitinib with remdesivir, for the treatment of suspected or laboratory confirmed COVID‑19 in hospitalized people two years of age or older requiring supplemental oxygen, invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO).
In Australia, it is approved for those aged four weeks of age and older with a body weight at least 3 kilograms (6.6 lb) with pneumonia requiring supplemental oxygen or those aged four weeks of age and older with body weight at least 40 kilograms (88 lb) who do not require supplemental oxygen and who are at high risk of progressing to severe COVID‑19.
In 2024, a retrospective study found treatment with the antiviral remdesivir plus dexamethasone was associated with fewer deaths in hospitalized COVID-19 patients compared to dexamethasone alone. The combination led to a 26% reduction in mortality at 14 days and a 24% reduction at 28 days.