Last update July 15, 2022

Remdesivir

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

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, FDA 2020). Intravenous administration.

Its pharmacokinetic characteristics (moderately elevated molecular weight and high plasma protein binding) explain the negligible excretion observed in mother's milk. (Wada 2022)

Furthermore, remdesivir has very low oral bioavailability due to extensive first-pass metabolism (Hale, Jorgensen 2021, Aleissa 2020), minimizing transfer to infant plasma from ingested breast milk.

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). A 5-week-old premature infant with severe acute respiratory syndrome due to coronavirus infection was treated with remdesivir without experiencing drug-related side effects. (Frauenfelder 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. (Anderson 2021)


See below the information of these related products:

Alternatives

We do not have alternatives for Remdesivir since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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:

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 -
20 hours
M/P ratio 0.089 -
Theoretical Dose 0.0002 - 0.04 mg/Kg/d
Relative Dose 0.007 - 1.6 %

References

  1. Anderson PO. COVID-19 Drugs and Breastfeeding Update. Breastfeed Med. 2022 Apr 6. Consulted on May 5, 2022 Abstract
  2. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consulted on March 17, 2022 Full text (link to original source)
  3. 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. Consulted on Dec. 20, 2020 Abstract Full text (link to original source)
  4. Martinez MA. Compounds with therapeutic potential against novel respiratory 2019 coronavirus. Antimicrob Agents Chemother. 2020 Mar 9. pii: AAC.00399-20. Consulted on March 10, 2020 Abstract Full text (link to original source)
  5. Wada YS, Saito J, Hashii Y, Kishi T, Kobayashi M, Kamiya T, Mizuno K. Remdesivir and Human Milk: A Case Study. J Hum Lact. 2022 Feb 21:8903344221076539. Abstract
  6. Jorgensen SCJ, Davis MR, Lapinsky SE. A review of remdesivir for COVID-19 in pregnancy and lactation. J Antimicrob Chemother. 2021 Dec 24;77(1):24-30. Abstract Full text (link to original source)
  7. Anderson PO. Antivirals for COVID-19 and Breastfeeding. Breastfeed Med. 2020 Oct;15(10):605-607. Abstract
  8. 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. None 2020 Full text (in our servers)
  9. Dong L, Hu S, Gao J. Discovering drugs to treat coronavirus disease 2019 (COVID-19). Drug Discov Ther. 2020;14(1):58-60. Abstract Full text (link to original source)
  10. 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)
  11. Frauenfelder C, Brierley J, Whittaker E, Perucca G, Bamford A. Infant With SARS-CoV-2 Infection Causing Severe Lung Disease Treated With Remdesivir. Pediatrics. 2020 Sep;146(3). pii: e20201701. Abstract Full text (link to original source)
  12. 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)
  13. 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)

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