Comparative Pharmacology
Head-to-head clinical analysis: VEKLURY versus ZOVIRAX.
Peer-Reviewed Evidence
Head-to-head clinical analysis: VEKLURY versus ZOVIRAX.
VEKLURY vs ZOVIRAX
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Remdesivir is a nucleotide analog prodrug that, after intracellular metabolism, incorporates into nascent viral RNA chains causing synthesis termination and inhibition of RNA-dependent RNA polymerase (RdRp). It targets the SARS-CoV-2 RdRp with selectivity over human RNA polymerases.
After intracellular phosphorylation to acyclovir triphosphate, selectively inhibits viral DNA polymerase and incorporates into viral DNA, causing chain termination.
200 mg IV on Day 1, then 100 mg IV once daily for 5 to 10 days.
Herpes simplex: 200 mg orally 5 times daily for 10 days; or 400 mg orally 3 times daily for 5-10 days. Herpes zoster: 800 mg orally 5 times daily for 7-10 days. IV: 5-10 mg/kg every 8 hours for immunocompromised patients with HSV/VZV.
None Documented
None Documented
Remdesivir: ~1 hour (parent); GS-441524: ~27 hours (terminal). Context: GS-441524 accumulation may occur with daily dosing.
Terminal elimination half-life is 2.5-3.3 hours in adults with normal renal function; prolonged to 19.5 hours in anuria (creatinine clearance <10 mL/min).
Renal: 10% unchanged remdesivir; 49% as metabolite GS-441524; 18% as other metabolites. Fecal: 47.5% as metabolites. Biliary: minor.
Renal excretion of unchanged drug via glomerular filtration and tubular secretion accounts for 76-82% of elimination; fecal excretion is less than 2%.
Category C
Category C
Antiviral
Antiviral