Last update Jan. 7, 2021

Remdesivir

Low Risk

Moderately safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.

A nucleoside analog and RNA polymerase inhibitor. Used in the treatment of Ebola virus infection (Martínez 2020). It is also active against other viruses.
Used experimentally and authorized in the treatment of the COVID-19 coronavirus (Aleissa 2020, Dong 2020, Martínez 2020, SEFH 2020).

Since the last update we have not found any published data on its excretion in breastmilk.

Its pharmacokinetic characteristics (moderately elevated molecular weight, high plasma protein binding and high pKa) make it very unlikely its excretion into breast milk in significant concentration.

Furthermore, remdesivir has very low oral absorption due to extensive first-pass metabolism (Hale, Aleissa 2020). This low oral bioavailability hinders transfer to infant plasma from breastmilk,

A 19-day-old premature newborn infected with Ebola was treated with intravenous Remdesivir for 12 days without experiencing any side effects and recovered from the infection. Growth and psychomotor development were normal throughout the first year of life (Dörnemann 2017). Two infants younger than 7 days old and six younger than 5 years old who received remdesivir for the treatment of Ebola (Mulangu 2019) did not experience any adverse events (Aleissa 2020).
The FDA authorizes the use for the treatment of COVID-19 in children over 3.5 kg (FDA 2020).

If direct administration to newborns, even premature infants, does not cause problems, it is very unlikely that it will do so through breast milk, especially when a minimum concentration in milk and no oral absorption is expected.


See below the information of these related products:

Alternatives

We do not have alternatives for Remdesivir.

Suggestions made at e-lactancia are done by APILAM team, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Remdesivir in other languages or writings:

  • 2-ethylbutyl (2S)-2-{[(S)-{[(2R,3S,4R,5R)-5-{4-aminopyrrolo[2,1-f][1,2,4]triazin-7-yl}-5-cyano-3,4-dihydroxyoxolan-2-yl]methoxy}(phenoxy)phosphoryl]amino}propanoate (Chemical name)
  • C27 H35 N6 O8 P (Molecular formula)
  • GS 5734 / GS-5734 (Experimental code/s)
  • J05AX?? (ATC Code/s)

Group

Remdesivir belongs to this group or family:

Tradenames

Main tradenames from several countries containing Remdesivir in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. ≈ 0 %
Molecular weight 603 daltons
Protein Binding 88 -94 %
pKa 10.23 -
T1/2 20 hours

References

  1. Dong L, Hu S, Gao J. Discovering drugs to treat coronavirus disease 2019 (COVID-19). Drug Discov Ther. 2020;14(1):58-60. Abstract
  2. Martinez MA. Compounds with therapeutic potential against novel respiratory 2019 coronavirus. Antimicrob Agents Chemother. 2020 Mar 9. pii: AAC.00399-20. Abstract
  3. SEFH - Sociedad Española de Farmacia Hospitalaria. Procedimientos de farmacia hospitalaria para la gestión del tratamiento con antivirales en la enfermedad por el nuevo coronavirus sars-cov-2 (COVID-19). Recomendaciones de la Sociedad Española de Farmacia Hospitalaria. 2020 Full text (in our servers)
  4. Aleissa MM, Silverman EA, Paredes Acosta LM, Nutt CT, Richterman A, Marty FM. New Perspectives on Antimicrobial Agents: Remdesivir Treatment for COVID-19. Antimicrob Agents Chemother. 2020 Dec 16;65(1). pii: e01814-20. Abstract Full text (link to original source)
  5. FDA. Fact sheet for healthcare providers emergency use authorization (eua) of Veklury® (remdesivir) for hospitalized pediatric patients weighing 3.5 kg to less than 40 kg or hospitalized pediatric patients less than 12 years of age weighing at least 3.5 kg. Fact sheet. 2020 Full text (link to original source)
  6. Mulangu S, Dodd LE, Davey RT Jr, Tshiani Mbaya O, Proschan M, Mukadi D, Lusakibanza Manzo M, Nzolo D, Tshomba Oloma A, Ibanda A, Ali R, Coulibaly S, Levine AC, Grais R, Diaz J, Lane HC, Muyembe-Tamfum JJ; PALM Writing Group., Sivahera B, Camara M, Kojan R, Walker R, et al. A Randomized, Controlled Trial of Ebola Virus Disease Therapeutics. N Engl J Med. 2019 Dec 12;381(24):2293-2303. Abstract Full text (link to original source)
  7. Dörnemann J, Burzio C, Ronsse A, Sprecher A, De Clerck H, Van Herp M, Kolié MC, Yosifiva V, Caluwaerts S, McElroy AK, Antierens A. First Newborn Baby to Receive Experimental Therapies Survives Ebola Virus Disease. J Infect Dis. 2017 Jan 15;215(2):171-174. Abstract Full text (link to original source)
  8. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Full text (link to original source)

Total visits

7,314

Help us improve this entry

How to cite this entry

Do you need more information or did not found what you were looking for?

   Write us at elactancia.org@gmail.com

e-lactancia is a resource recommended by La Liga de la Leche de Euskadi

Would you like to recommend the use of e-lactancia? Write to us at corporate mail of APILAM