How well does Veklury (remdesivir) work?

Veklury (remdesivir) works pretty well to treat COVID-19. In studies with certain people who weren't hospitalized, Veklury (remdesivir) lowered the risk of hospitalization or death by about [87%](https://www.covid19treatmentguidelines.nih.gov/management/clinical-management-of-adults/nonhospitalized-adults--therapeutic-management/). But for people who are hospitalized, the information is a lot [more variable](https://www.covid19treatmentguidelines.nih.gov/management/clinical-management-of-adults/hospitalized-adults--therapeutic-management/).

Does Veklury (remdesivir) work well against the different COVID-19 variants?

There's a chance Veklury (remdesivir) won't work against all COVID-19 variants (different versions of the virus due to changes in its genetic material). But the way in which it works can make it [more likely](https://www.gilead.com/news-and-press/press-room/press-releases/2022/2/veklury-remdesivir-retains-antiviral-activity-against-omicron-delta-and-other-emergent-sarscov2-variants-in-multiple-in-vitro-studies) to be active against certain COVID-19 variants. In a [study](https://www.gilead.com/news-and-press/press-room/press-releases/2022/2/veklury-remdesivir-retains-antiviral-activity-against-omicron-delta-and-other-emergent-sarscov2-variants-in-multiple-in-vitro-studies), Veklury (remdesivir) worked well against the Delta and Omicron variants in particular. It's also [expected to work](https://www.covid19treatmentguidelines.nih.gov/therapies/antiviral-therapy/remdesivir/) against the Omicron BA.2 subvariant.

Veklury

remdesivir

Used for COVID-19

Veklury (remdesivir) is an intravenous (IV) medication used to treat coronavirus disease 2019 (COVID-19) in certain people. It was FDA-approved in October 2020 during the coronavirus pandemic. While the medication was originally only approved for people aged 12 years and older, Veklury (remdesivir) can now be used for people as young as 28 days old. Veklury (remdesivir) is only given in a hospital or a clinic.

Reviewed by:

Ashley Wong, PharmD

Daisy Chau, PharmD

Last reviewed on August 24, 2022

What is Veklury (remdesivir)?

What is Veklury (remdesivir) used for?

Treatment of COVID-19 infection in people aged 28 days or older and weigh at least 3 kg (6.6 lbs), and are either: - Hospitalized or - Not hospitalized but have mild-to-moderate COVID-19 and are at high risk of developing severe COVID-19

How Veklury (remdesivir) works

Veklury (remdesivir) is a SARS-CoV-2 nucleotide analog RNA polymerase inhibitor. It blocks a protein that the COVID-19 virus needs to make copies of itself and grow.

More specifically, Veklury (remdesivir) looks like one of the building blocks of RNA. RNA is the genetic material of SARS-CoV-2 (the virus that causes COVID-19). When Veklury (remdesivir) is present, it can get pulled into the virus’ RNA when it tries to replicate and spread. This prevents the COVID-19 virus from spreading because it used the wrong building material.

Drug facts

Common Brands	Veklury
Drug Class	Antiviral
Controlled Substance Classification	Not a controlled medication
Generic Status	No lower-cost generic available
Availability	Prescription only

Common Brands

Veklury

Drug Class

Antiviral

Controlled Substance Classification

Not a controlled medication

Generic Status

No lower-cost generic available

Availability

Prescription only

Side effects of Veklury (remdesivir)

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Nausea
Changes in liver blood tests

Less Common Side Effects

Allergic reactions: rash, sweating, fever, changes in heart rate

Veklury (remdesivir) serious side effects

Contact your healthcare provider immediately if you experience any of the following.

Serious allergic reactions: shortness of breath, changes in heart rate, rash, swelling of your lips, face, tongue, or throat
Liver problems: nausea, vomiting, dark urine, yellowing of your eyes or skin (jaundice), poor appetite, pain in the upper right side of your stomach
Seizure

Source: DailyMed

More on Veklury (remdesivir) side effects

Patient in hospital chair undergoing an infusion.
Edwin Tan/E+ via Getty Images

What Are the Side Effects of Remdesivir?

Written by Joshua Murdock, PharmD

The following Veklury (remdesivir) side effects have also been reported

Side effects that you should report to your care team as soon as possible:

Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
Infusion reactions—chest pain, shortness of breath or trouble breathing, feeling faint or lightheaded
Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

Nausea

Pros and cons of Veklury (remdesivir)

Pros

Second-choice option for certain people who aren't hospitalized at risk of severe COVID-19
Expected to work against the Omicron variant and the BA.2 subvariant
Can be used for people who are hospitalized and certain people who aren't hospitalized

Cons

If the medication is received at a clinic, requires travel to the clinic on 3 back-to-back days
Given through an IV infusion
Can cause serious allergic reactions

Pharmacist tips for Veklury (remdesivir)

Veklury (remdesivir) is given by a healthcare provider at the hospital or clinic. Your provider will monitor you for any side effects while you receive the medication and for at least 1 hour afterwards in case of an allergic reaction .
Veklury (remdesivir) is given through an infusion into your veins. The infusion can take 30 to 120 minutes. Your provider will decide how long your infusion will take. The length of your infusion depends on whether you're at risk of a potential allergic reaction.
The total duration of your Veklury (remdesivir) treatment depends on the how severe your condition is and if you're hospitalized or not. If you're not hospitalized, you'll need to travel to the clinic to receive the medication on 3 back-to-back days.
It's important that you practice CDC-recommended safety measures to protect yourself and others from either getting or spreading the COVID-19 virus.
Veklury (remdesivir) can cause serious allergic reactions. Let your provider know if you experience a rash, shortness of breath, changes in your heart rate, or swelling of your lips, face, tongue, or throat.

Common questions about Veklury

The sooner you receive Veklury the better. In order for it to work properly, the medication needs to be given within the first 7 days after your symptoms start.

Veklury works pretty well to treat COVID-19. In studies with certain people who weren't hospitalized, Veklury lowered the risk of hospitalization or death by about 87%. But for people who are hospitalized, the information is a lot more variable.

There's a chance Veklury won't work against all COVID-19 variants (different versions of the virus due to changes in its genetic material). But the way in which it works can make it more likely to be active against certain COVID-19 variants. In a study, Veklury worked well against the Delta and Omicron variants in particular. It's also expected to work against the Omicron BA.2 subvariant.

It's not known if Veklury is safe to use during pregnancy. If you're pregnant, talk to your provider to see if this medication is right for you. If you use Veklury during your pregnancy, there is a registry available that will collect information about your health and the health of your baby. You or your provider can call 1-800-616-3791 or go to https://covid-pr.pregistry.com to enroll.

It's not known whether Veklury can pass into your breast milk or if it'll affect your milk supply. If you're breastfeeding, speak with your provider. Make sure you follow CDC-recommended practices to avoid exposing your baby to COVID-19.

Risks and warnings for Veklury (remdesivir)

Veklury (remdesivir) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

Serious allergic reactions

Veklury (remdesivir) can cause serious allergic reactions, such as changes in blood pressure or heart rate, low oxygen levels, trouble breathing, wheezing, sweating, rash, and swelling of your face, lips, tongue, or throat. Most of these reactions have occurred within one hour of receiving the medication. Depending on your risk for these reactions, you might need to receive your Veklury (remdesivir) infusions for a longer period of time. Your provider will monitor you for signs and symptoms during and after your treatment for at least one hour.

Liver damage

Veklury (remdesivir) can cause changes in your liver tests, which can be a sign of liver problems. Because of this risk, your provider will likely have you do blood work to monitor your liver before and during your treatment. If you develop any symptoms of liver damage, such as dark urine, pain in the upper right area of your stomach, jaundice, or loss of appetite, let your provider know right away.

Interactions with other medications

Veklury (remdesivir) can interact with other medications, including chloroquine and hydroxychloroquine (Plaquenil). Taking these medications with Veklury (remdesivir) can affect how well the drug works against the COVID-19 virus. Be sure your provider knows all of the medications you are taking, including vitamins and herbal supplements, before you receive Veklury (remdesivir).

Veklury (remdesivir) dosage

Typical dosage for Veklury (remdesivir)

Veklury (remdesivir) is given by a healthcare provider in the hospital or clinic.

People who weigh 40 kg (88 lbs) and above: The typical dose is a one-time dose (loading dose) of 200 mg infused through your veins (IV) on day 1. On day 2 and each day after, you'll receive 100 mg infused through your veins.
Children who weigh 3 kg (6.6 lbs) to less than 40 kg (88 lbs): The dose will depend on your child's weight. The typical dose is a one-time dose of 5 mg/kg infused through their veins (IV) on day 1. On day 2 and each day after, they will receive 2.5 mg/kg infused through their veins.

The total number of days you receive treatment will depend on if you're in the hospital or clinic, and how severe your condition is.