Extracorporeal membrane oxygenation may decrease the plasma concentration of remdesivir in a patient with severe coronavirus disease 2019

Remdesivir is an antiviral drug that results in clinical improvement after five days of treatment and accelerates recovery by 31%. No studies have discussed the pharmacokinetic analysis of remdesivir in patients with severe COVID-19 requiring extracorporeal membrane oxygenation (ECMO). A 63-year-old...

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Autores principales: Satoshi Ide, Sho Saito, Tsubasa Akazawa, Takahito Furuya, Junichi Masuda, Maki Nagashima, Yusuke Asai, Tatsunori Ogawa, Ryohei Yamamoto, Haruhiko Ishioka, Kohei Kanda, Ayako Okuhama, Yuji Wakimoto, Tetsuya Suzuki, Yutaro Akiyama, Yusuke Miyazato, Keiji Nakamura, Takato Nakamoto, Hidetoshi Nomoto, Yuki Moriyama, Masayuki Ota, Shinichiro Morioka, Wataru Matsuda, Tatsuki Uemura, Kentaro Kobayashi, Ryo Sasaki, Daisuke Katagiri, Satoshi Kutsuna, Kayoko Hayakawa, Norio Ohmagari
Formato: article
Lenguaje:EN
Publicado: Elsevier 2021
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Acceso en línea:https://doaj.org/article/460b8a8db4254010b8c675bebb5d2ae4
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Sumario:Remdesivir is an antiviral drug that results in clinical improvement after five days of treatment and accelerates recovery by 31%. No studies have discussed the pharmacokinetic analysis of remdesivir in patients with severe COVID-19 requiring extracorporeal membrane oxygenation (ECMO). A 63-year-old American man who underwent mechanical ventilation and ECMO for severe COVID-19 was administered remdesivir for ten days. The loading dosage was 200 mg at 7 PM on day 12 and 100 mg daily at 0:00 PM from day 13–21, administered within 1 h. The pharmacokinetic analysis was performed. The serum creatinine concentration was within the normal range of 0.5–0.7 mg/dL during treatment. According to the pharmacokinetic analysis, the plasma concentrations of remdesivir and GS-441524 4 h after administration (C4) were 662 ng/mL and 58 ng/mL, respectively, and the concentrations 18 h after administration (C18) were 32 ng/mL and 44 ng/mL, respectively. Therefore, the half-life of remdesivir and GS-441524 was 3.2 and 35.1 h, respectively. Monitoring the plasma concentrations of remdesivir and GS-441524 in patients undergoing ECMO may be necessary.