Veklury (remdesivir)

What is Veklury?

Veklury is a brand-name prescription medication that’s FDA-approved to treat COVID-19 or suspected COVID-19 in certain hospitalized people. The drug is approved for use in adults and in children who are at least 12 years old and weigh at least 88 pounds (lb) (40 kilograms [kg]).

The FDA has also granted the drug an Emergency Use Authorization for use in certain other children. To learn more, see the “FDA approval” section below.

About COVID-19

COVID-19, which is caused by the new coronavirus, is a disease that can affect your respiratory system and other parts of your body. COVID-19 may cause a cough, fever, trouble breathing, and many other symptoms. But some people with COVID-19 don’t experience any symptoms.

Although many cases of COVID-19 are mild or moderate, some cases can be very severe and even life threatening. When this article was last updated, more than 240,000 people had died from COVID-19 in the United States. And more than 1,200,000 people had died worldwide.

Drug details

The active drug ingredient in Veklury is remdesivir, which belongs to a class of drugs called antivirals. (A class of drugs is a group of medications that work in a similar way.) Veklury fights the virus that causes COVID-19, which is called SARS-CoV-2.

Veklury comes in two forms:

• a liquid solution that has a strength of 100 milligrams per 20 milliliters (mg/mL)
• a powder that’s mixed into a liquid solution* and has a strength of 100 mg/20 mL

Both forms are given as an intravenous (IV) infusion, which is an injection into a vein given over a period of time. (Veklury is infused over a time span of 30 minutes to 2 hours.) Veklury is only given in the hospital. It’s typically given once per day for either 5 or 10 days, depending on how severe the disease is.

* Children weighing 7.7 lb to less than 88 lb (3.5 kg to less than 40 kg) should be given only the powder form of Veklury.

FDA approval

Veklury is the first medication to be approved by the Food and Drug Administration (FDA) to treat COVID-19. It was approved in October 2020 to treat COVID-19 or suspected COVID-19 in certain hospitalized people. The drug is approved for use in adults and in children who are at least 12 years old and weigh at least 88 lb (40 kg).

The FDA has also granted an Emergency Use Authorization (EUA) for Veklury. EUAs can be granted in emergency situations when there are no other options for the treatment of a disease. With an EUA, the FDA still looks at available evidence that shows the benefits and risks of using a medication.

For Veklury, the EUA allows its use in:

• children who weigh between 7.7 lb (3.5 kg) and 88 lb (40 kg)
• children who are younger than 12 years old and weigh more than 7.7 lb (3.5 kg)

Once more studies are done and more information is available about Veklury’s use in children, the FDA can approve or deny the medication for use in these children. (Before approval for its current uses was given, Veklury was prescribed for those uses under an EUA.)

For more information on EUAs, see “What’s the difference between FDA approval and Emergency Use Authorization?” in the “Common questions about Veklury” section below.

Effectiveness

For information on the effectiveness of Veklury, see the “Veklury uses” section below.

Veklury generic

Veklury is available only as a brand-name medication in the United States. It’s not currently available in generic form in the U.S. A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

To help make sure other countries also have access, the manufacturer of Veklury is allowing pharmaceutical companies in other countries to produce remdesivir (the generic form of Veklury).

Veklury side effects

Veklury can cause mild or serious side effects. The side effects of Veklury are still being studied, and those listed below might not represent all side effects. More side effects may become known as the drug is used more often.

For more information on the possible side effects of Veklury, talk with your doctor. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. However, at this time, Veklury isn’t FDA-approved. The drug is available for use only through an Emergency Use Authorization the FDA granted. To learn more, see “FDA Emergency Use Authorization” in the “What is Veklury?” section above.

Even though the drug has not been approved for use in certain younger children at this time, you can still notify the FDA through MedWatch about any side effects your child has with Veklury.

Mild side effects

Mild side effects of Veklury can include:*

• decreased levels of hemoglobin (a protein in red blood cells)
• fever
• high or increased blood sugar level
• nausea
• rash

As Veklury is used more often, more side effects may be reported. Talk with your doctor if you have questions about specific side effects that you may experience with Veklury.

* To learn about other mild side effects, talk with your doctor or see the Veklury patient information.

Serious side effects

Serious side effects from Veklury aren’t common, but they can occur. Talk with your doctor if you develop serious side effects while you receive this treatment in the hospital.

Serious side effects and their symptoms can include:

• Seizures. Symptoms may include:
  • confusion
  • loss of consciousness
  • uncontrolled movements of your arms and legs
• Decreased kidney function. Symptoms may include:
  • decreased urination
  • swelling in your legs
  • confusion
  • trouble breathing
• Increased prothrombin time (a blood level that measures the risk of blood clotting). An increased prothrombin time may indicate an increased risk of blood clots. Symptoms of a blood clot may include:
  • swelling or pain in your arms or legs
  • redness or warmth in your arms or legs
  • trouble breathing or chest pain
• Allergic reaction.*
• Increased levels of liver enzymes, which may be a sign of liver damage.*

* This side effect is described below in “Side effect details.”

Side effects in children

It’s not known what side effects children may have with Veklury. At this time, Veklury is approved for use only in adults and in children who are at least 12 years of age and who weigh at least 88 pounds (lb) (40 kilograms [kg]).

In children younger than 12 years who weigh more than 7.7 lb (3.5 kg) and those of any age who weigh between 7.7 lb (3.5 kg) and 88 lb (40 kg), Veklury may still be used under the Emergency Use Authorization.

For more information, see “FDA approval” in the “What is Veklury?” section above.

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on certain side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after receiving Veklury.

Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your tongue, mouth, or throat
• trouble breathing

In clinical trials, some people taking Veklury had an allergic reaction. But it’s not known exactly how many people in the trials may have had an allergic reaction.

Because Veklury is given by intravenous (IV) infusion, it’s possible that you could experience a reaction to the infusion itself. (With an IV infusion, the drug is injected into a vein over a period of time.) Symptoms of an infusion-related reaction to Veklury may include:

• high or low blood pressure
• slow or fast heart rate
• shortness of breath
• wheezing
• sweating
• shaking

Your doctor may give you a dose of Veklury over a time period of up to 2 hours. Giving your dose over a longer period of time may help prevent an allergic or infusion-related reaction.

If you notice any of these symptoms while you’re receiving Veklury, tell your doctor. They’ll likely be monitoring you for any symptoms of an allergic reaction as well. If you do develop an allergic reaction to Veklury, you shouldn’t take the drug again.

Increased levels of liver enzymes

Increased levels of liver enzymes may occur with Veklury. But it’s not known how many people have developed this side effect while receiving the drug.

When liver cells become inflamed or damaged, they may release enzymes into your blood. (Enzymes are proteins that aid chemical changes in your body.) An increase in these levels may mean that your liver isn’t working as well as usual.

Your doctor will monitor your liver function with blood tests while you’re receiving Veklury. Symptoms of liver problems can include:

• belly pain
• jaundice (yellowing of the skin or the white of the eyes)
• feeling tired
• nausea or vomiting

If you experience symptoms of liver problems during your Veklury treatment, tell your doctor right away. They’ll likely be monitoring you for any symptoms as well. You may be given blood tests to see whether Veklury is the cause of your symptoms. If your liver levels become too high or you develop symptoms of liver damage, your doctor may recommend that you stop using Veklury.

Veklury cost

For information on the price of Veklury, talk with your insurance company. You can also contact the manufacturer of Veklury, Gilead Sciences.

Before approving coverage for Veklury, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Veklury, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Veklury, or if you need help understanding your insurance coverage, reach out to your insurance company. You can also find assistance through the Advancing Access program from Gilead Sciences. This program can help answer questions about the cost of the drug and provide other information. For more information, you can call the Advancing Access program at 800-226-2056 or visit their website.

Generic version

Veklury is available only as a brand-name medication in the United States. It’s not currently available in generic form in the U.S. A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

To help make sure other countries also have access, the manufacturer of Veklury is allowing pharmaceutical companies in other countries to produce remdesivir (the generic form of Veklury).

Veklury uses

The Food and Drug Administration (FDA) approves prescription drugs to treat certain conditions. Veklury is the first medication to be approved by the FDA to treat COVID-19.

Veklury for COVID-19 or suspected COVID-19 in hospitalized people

Veklury is FDA-approved to treat COVID-19 or suspected COVID-19 in certain hospitalized people. The drug is for use in adults and in children who are at least 12 years old and weigh at least 88 pounds (lb) (40 kilograms [kg]).*

COVID-19, which is caused by the new coronavirus, is a disease that can affect your respiratory system and other parts of your body. Some people with COVID-19 don’t experience any symptoms, while others may have many. Symptoms can include:

• cough
• fever
• trouble breathing
• loss of sense of taste or smell

Although many cases of COVID-19 are mild or moderate, some cases can be severe and even life threatening. A severe case of COVID-19 means you’re having trouble breathing and either have a low oxygen level or require a machine, such as a ventilator, to help you breathe.

When this article was last updated, more than 240,000 people had died from COVID-19 in the United States.

* At this time, the FDA hasn’t approved Veklury in younger children. However, it has granted an Emergency Use Authorization for certain children who weigh less than 88 lb (40 kg) or are younger than 12 years old. To learn more, see “FDA approval” in the “What is Veklury?” section above.

Effectiveness of Veklury for people hospitalized with COVID-19 or suspected COVID-19

Clinical trials have been performed to test the effectiveness of Veklury in people with COVID-19.

Veklury use in adults

The first trial looked at adults hospitalized with a mild, moderate, or severe coronavirus infection. They were given either Veklury or a placebo (a treatment with no active drug in it) for up to 10 days.

Researchers in this study wanted to see if Veklury helped people recover from COVID-19 quicker than a placebo plus the standard of care. Researchers defined recovery as one of the following:

• being discharged from the hospital with no limits on activities
• being discharged from the hospital but with limits on activity or needing oxygen therapy at home
• still being hospitalized but no longer needing oxygen therapy or medical treatment

The results showed that:

• about half of the people who took Veklury recovered in 10 days, while about half of the people taking the placebo recovered in 15 days
• people with mild-to-moderate COVID-19 recovered in about 5 days, whether they were taking Veklury or a placebo
• people with severe COVID-19 who took Veklury recovered in about 11 days, while people with severe COVID-19 who took a placebo recovered in about 18 days

Other clinical studies, such as the Solidarity study from the World Health Organization (WHO), have also looked at the effectiveness of Veklury. In this study, which included over 11,000 people from over 30 countries, there was no overall benefit seen with Veklury treatment in reducing a person’s:

• risk for death while in the hospital
• need for ventilation (use of a machine that helps the lungs work)
• length of hospital stay

So, more research is needed to continue to assess how well Veklury works for COVID-19.

Veklury use in children and adults

Another trial was done to test Veklury in adults as well as in children ages 12 years and older. They were all hospitalized with a severe coronavirus infection and received either Veklury or the standard COVID-19 treatments* for either 5 or 10 days.

The results showed that on day 11, people who’d taken Veklury for 5 days had better health than those who’d taken the standard treatments. But on day 11, people who’d taken Veklury for 10 days had about the same health status as those who’d taken the standard treatments.

* In the studies mentioned, “standard COVID-19 treatment” refers to the standard care provided for people with COVID-19 at individual hospitals participating in the study.

Ongoing studies

Other clinical trials for Veklury are ongoing. These include the use of the drug outside of the hospital setting and the use of Veklury in children from birth to age 18 years. More information will be available once the trials are complete.

Veklury for other conditions

You may wonder if Veklury is used for other conditions. Below is information on uses for Veklury that aren’t considered appropriate.

Veklury for HIV (not an appropriate use)

At this time, Veklury hasn’t been studied for treating HIV. No clinical trials are looking at the use of Veklury in people with HIV. It’s not known if Veklury may work or be a safe and effective treatment option for HIV.

Veklury is an antiviral drug, which means that it works to block a virus (SARS-CoV-2) from reproducing. It’s not known if Veklury works to block other types of viruses, such as HIV.

Veklury belongs to a specific class of antiviral drugs called nucleotide analogs. (A class of drugs is a group of medications that work in a similar way.) Some medications that are used to treat HIV, such as didanosine and zidovudine (Retrovir), are also nucleotide analogs.

If you have questions about treatments for HIV, talk with your doctor.

Veklury for Ebola (not an appropriate use)

Remdesivir, the active drug in Veklury, was originally developed for the treatment of Ebola. This is a rare but serious disease that’s caused by a viral infection.

Remdesivir was tested in a clinical trial of people with Ebola. However, the drug hasn’t been approved for this use and isn’t recommended as a treatment option for people with Ebola. This is because the results of the trial showed an increase in the number of deaths among people who received remdesivir when compared with other treatments. As a result, the testing was stopped early.

If you have questions about treatments for Ebola, talk with your doctor.

Veklury and children

Veklury has Food and Drug Administration (FDA) approval to treat COVID-19 or suspected COVID-19 in hospitalized children who are at least 12 years old and weigh at least 88 lb (40 kg).

At this time, the FDA hasn’t approved Veklury for use in children not in the group described above. However, it has granted an Emergency Use Authorization for children under 12 years old weighing at least 7.7 lb (3.5 kg) and children of any age weighing 7.7 lb (3.5 kg) to 88 lb (40 kg). For more information, see “FDA approval” in the “What is Veklury?” section above.

Veklury hasn’t been extensively studied in children with COVID-19. Some clinical studies included children ages 12 years and up who had COVID-19, but they also included adults. The researchers didn’t differentiate the results in adults from those in children. So we don’t know whether the drug was as safe and effective in children as it is in adults.

If you have questions about how Veklury works for treating COVID-19 in children, talk with your child’s doctor.

Who makes Veklury?

Veklury, which contains remdesivir, is made by the pharmaceutical company Gilead Sciences. It’s an antiviral medication.

Gilead Sciences originally developed remdesivir for the treatment of Ebola, which is a rare but serious disease that’s caused by a viral infection. But the drug hasn’t been shown to be effective for this condition.

COVID-19 is also caused by a viral infection, so the current pandemic has sparked new interest in remdesivir.

How Veklury works

COVID-19, which is caused by the new coronavirus, is a disease that can affect your respiratory system and other parts of your body. COVID-19 may cause a cough, fever, trouble breathing, and many other symptoms. However, some people with COVID-19 don’t experience any symptoms.

Although many cases of COVID-19 are mild or moderate, some cases can be very severe and even life threatening. When this article was last updated, more than 240,000 people had died from COVID-19 in the United States. And more than 1,200,000 people had died worldwide.

The virus that causes COVID-19 is called SARS-CoV-2. The disease spreads when you come into contact with droplets that contain the virus. The droplets spray into the air when people with the virus cough, sneeze, or even just talk. The droplets can then be breathed in by other people, or can land on surfaces. If you touch a contaminated surface and then touch your mouth, eyes, or nose, the virus may enter your body.

The active drug ingredient in Veklury is remdesivir, which belongs to a class of drugs called antivirals. (A class of drugs is a group of medications that work in a similar way.)

As an antiviral, Veklury helps prevent the SARS-CoV-2 virus from replicating (copying itself). This eventually causes death of the virus.

How long does it take to work?

Veklury begins working after you receive your first dose.

A clinical trial looked at adults hospitalized with a mild, moderate, or severe coronavirus infection. They were given either Veklury or a placebo (treatment with no active drug in it).

The results showed that people who were given Veklury recovered in about 10 days. This was compared with people given a placebo, who recovered in about 15 days.

In these studies, “recovery” was defined as one of the following:

• being discharged from the hospital with no limits on activities
• being discharged from the hospital but with limits on activity or needing oxygen therapy at home
• still being hospitalized but no longer needing oxygen therapy or medical treatment

Veklury dosage

The Veklury dosage your doctor prescribes will depend on several factors. These include:

• the severity of your coronavirus infection
• your weight
• other medical conditions you may have, such as kidney problems
• whether you require a machine, such as a ventilator or extracorporeal membrane oxygenation (ECMO) machine, to help you breathe

Your doctor will prescribe the smallest dosage that provides the desired effect. This means that you may receive Veklury for either 5 or 10 days, depending on the severity of your condition.

Before you start Veklury treatment, your doctor will check your kidney function. You may have a kidney problem without knowing it, and Veklury may worsen certain kidney problems. Your doctor will also check your liver function. Veklury may affect how well your liver works, and it may worsen liver problems. (To learn more, see the “Veklury precautions” section below.)

In addition, your doctor will also check your prothrombin time. (This is a blood test that measures how quickly your blood can clot.) Veklury can increase your prothrombin time, which indicates an increased risk of blood clots.

The following information describes dosages that are commonly used or recommended. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Veklury comes in two forms:

• a liquid solution that has a strength of 100 milligrams per 20 milliliters (mg/mL)
• a powder that’s mixed into a liquid solution and has a strength of 100 mg/20 mL

Children less than 12 years old weighing at least 7.7 pounds (lb) (3.5 kilograms [kg]) and children of any age weighing 7.7 lb (3.5 kg) to 88 lb (40 kg) should be given only the powder form of Veklury.*

Both the liquid solution and powder forms are given as an intravenous (IV) infusion. An infusion is an injection into a vein that’s given over a period of time. Veklury infusions take about 30 minutes to 2 hours.

* Veklury isn’t approved for use in children less than 12 years old weighing at least 7.7 lb (3.5 kg) or children of any age weighing 7.7 lb (3.5 kg) to 88 lb (40 kg). But the FDA has granted an Emergency Use Authorization for this use. For more information, see “FDA approval” in the “What is Veklury?” section above.

Dosage for adults hospitalized with COVID-19 or suspected COVID-19

For adults hospitalized with COVID-19 or suspected COVID-19, the Veklury dose on day 1 is 200 mg. For either 5 or 10 days afterward, the dose is 100 mg.

Breathing status

If you don’t need a machine, such as a ventilator or ECMO machine, to help you breathe, you’ll likely receive Veklury once a day for 5 days. (An ECMO machine acts as your heart and your lungs, and puts oxygen into your blood.)

But if your condition doesn’t improve after 5 days, your doctor may give you the medication once a day for another 5 days (10 days total).

If you do need a ventilator or ECMO machine, you’ll likely receive Veklury once a day for 10 days.

Children’s dosage

Veklury is only FDA-approved for use in children ages 12 years and older who weigh at least 88 lb (40 kg). In this age range, children are given the same dosage of Veklury as adults. For details, see the “Dosage for adults hospitalized with COVID-19 or suspected COVID-19” section above.

However, the Food and Drug Administration (FDA) has also granted the drug an Emergency Use Authorization for use in certain other children. To learn more, see “FDA approval” in the “What is Veklury?” section above.

The dosage of Veklury for children depends on their body weight. For instance, if they weigh 7.7 lb to less than 88 lb (3.5 kg to less than 40 kg),* their dosage is:

• 5 milligrams (mg) of Veklury per kilogram (kg) of body weight on day 1
• 2.5 mg of Veklury per kg of body weight on day 2 and onward

If your child is younger than 12 years old but weighs more than 88 lb (40 kg), they’ll take the adult dosage of Veklury. For details, see “Dosage for adults hospitalized with COVID-19 or suspected COVID-19” above.

* Veklury comes as a liquid solution and a powder that’s mixed into a solution. Children who weigh 7.7 lb to less than 88 lb (3.5 kg to less than 40 kg) should be given only the powder form of the drug.

Breathing status

If your child doesn’t need a machine, such as a ventilator or ECMO, to help them breathe, they’ll likely receive Veklury once a day for 5 days.

But if your child’s condition doesn’t improve after 5 days, their doctor may give them the medication once a day for another 5 days (10 days total).

If they do need a ventilator or ECMO machine, they’ll likely receive Veklury once a day for 10 days.

Will I need to use this drug long term?

No, you’ll likely receive Veklury for either 5 or 10 days.

If you don’t need a machine, such as a ventilator or ECMO machine, to help you breathe, you’ll likely receive Veklury for 5 days. But if your condition doesn’t improve after 5 days, your doctor may give you the medication for another 5 days (10 days total).

If you do need a ventilator or ECMO machine, you’ll likely receive Veklury for 10 days.

Alternatives to Veklury

Veklury is the only drug that’s approved by the Food and Drug Administration (FDA) to treat COVID-19. Other drugs are available that may help treat COVID-19 or suspected COVID-19. However, none of these drugs are approved by the FDA for these specific uses.

Some drugs may be a better fit for you than others. If you’re interested in finding an alternative to Veklury, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Since Veklury is the only FDA-approved drug for COVID-19, all of the other drugs listed here are used off-label to treat COVID-19. (Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.) Many drugs are being studied for treating COVID-19. But most of the drugs being studied are being tested in small groups, and their effectiveness in treating COVID-19 isn’t yet known.

Alternatives for COVID-19 or suspected COVID-19 in hospitalized people

According to guidelines from the National Institutes of Health, examples of other drugs that may be used to treat COVID-19 or suspected COVID-19 include:

• steroids, such as dexamethasone (Hemady) or prednisone
• lopinavir/ritonavir (Kaletra)
• oseltamivir (Tamiflu)

Veklury vs. hydroxychloroquine

You may wonder how Veklury compares with other medications that are prescribed for similar uses. Here we look at how Veklury and hydroxychloroquine are alike and different.

Ingredients

The active drug ingredient in Veklury is remdesivir.

Hydroxychloroquine is the active drug ingredient in Plaquenil.

Uses

Veklury is used to treat COVID-19 or suspected COVID-19 in certain hospitalized people. The drug is approved for use in adults as well as in children who are at least 12 years old and weigh at least 88 pounds (lb) (40 kilograms [kg]).

At this time, the Food and Drug Administration (FDA) hasn’t approved Veklury for use in younger children. However, the FDA has granted an Emergency Use Authorization (EUA) for the drug in children younger than 12 years old who weigh at least 7.7 lb (3.5 kg) and children of any age weighing between 7.7 lb (3.5 kg) and 88 lb (40 kg). To learn more, see “FDA approval” in the “What is Veklury?” section above.

Hydroxychloroquine is an FDA-approved drug, but it’s not approved to treat COVID-19. Hydroxychloroquine used to have EUA status to treat COVID-19, but the EUA has been revoked. The FDA removed the EUA status for hydroxychloroquine because it determined that the risks of taking the drug for COVID-19 were greater than the benefits. At this time, hydroxychloroquine isn’t recommended to treat COVID-19.

However, hydroxychloroquine is FDA-approved for the following uses:

• treatment or prevention of malaria
• treatment of certain forms of lupus called chronic discoid lupus and systemic lupus erythematosus
• treatment of rheumatoid arthritis (RA)

Drug forms and administration

Veklury comes in two forms: a liquid solution and a powder that’s mixed into a liquid solution.* Both forms are given as an intravenous (IV) infusion, which are injections into a vein given over a period of time. Veklury is typically given once a day for either 5 or 10 days.

Hydroxychloroquine comes as a tablet that you swallow. Depending on what condition the drug is used for, hydroxychloroquine may be taken twice a day to once a week.

* Children weighing 7.7 lb to less than 88 lb (3.5 kg to less than 40 kg) should be given only the powder form of Veklury.

Side effects and risks

Below, we describe both mild and serious side effects of Veklury and hydroxychloroquine.

Side effects of Veklury

The most common side effects of Veklury include:

• nausea
• rash
• decreased hemoglobin level
• a high or increased blood sugar level

Veklury may also cause more serious side effects. These include:

• allergic reaction
• seizures
• increased levels of liver enzymes, which may be a sign of liver damage

For more information on side effects, see the “Veklury side effects” section above.

Side effects of hydroxychloroquine

At this time, hydroxychloroquine isn’t recommended to treat COVID-19 due to its lack of effectiveness against the disease and the many side effects of the drug.

Mild side effects of hydroxychloroquine may include:

• nausea
• vomiting
• rash
• decrease in blood sugar
• decrease in appetite that can lead to weight loss
• changes in emotions, such as becoming nervous or irritable

Serious side effects that may occur with hydroxychloroquine include:

• changes in vision (such as blurry vision)
• decreased hearing
• liver problems, such as hepatitis or increased levels of liver enzymes (which may be a sign of liver damage)
• severe, life threatening rash, such as Stevens-Johnson syndrome
• changes in blood levels, such as decreased levels of red blood cells, platelets, or white blood cells
• heart problems, such as heart failure

These aren’t all the side effects that hydroxychloroquine may cause. If you have questions about the side effects of hydroxychloroquine, talk with your doctor.

Effectiveness

Veklury and hydroxychloroquine have different approved uses by the Food and Drug Administration (FDA). Veklury is approved for use in hospitalized adults and some children with COVID-19. It also has an Emergency Use Authorization to treat COVID-19 in children younger than 12 years old who weigh at least 7.7 lb (3.5 kg) or in children weighing between 7.7 lb (3.5 kg) and 88 lb (40 kg). (To learn more, see “FDA approval” in the “What is Veklury?” section above.)

Hydroxychloroquine is not FDA-approved to treat COVID-19. In addition, the National Institutes of Health (NIH) recommends against its use for treating COVID-19. This is due to the drug’s lack of effectiveness shown in clinical trials and its many side effects.

These drugs haven’t been directly compared in clinical studies, but an ongoing clinical trial is looking at the effectiveness of Veklury when compared with hydroxychloroquine.

Effectiveness of using the drugs together

There’s also a possibility that remdesivir, the active drug in Veklury, and hydroxychloroquine can be used together to treat severe coronavirus infections.

However, so far, the combination of both medications hasn’t helped people recover from COVID-19. After 14 days, the rate of recovery was:

• 69% in people given remdesivir alone
• 57% in people given both remdesivir and hydroxychloroquine

Although the study showed that recovery was longer in people given both drugs, the number of deaths didn’t increase in people given both remdesivir and hydroxychloroquine. However, people given both drugs had a higher number of side effects and more severe side effects than people given remdesivir alone.

Also, according to clinical studies, the use of Veklury with hydroxychloroquine may decrease the effectiveness of Veklury. At this time, using Veklury and hydroxychloroquine together isn’t recommended.

Costs

For information on the price of Veklury, talk with your insurance company. The actual price you’ll pay for either drug depends on your insurance plan and your location.

Veklury vs. chloroquine

Like hydroxychloroquine, the drug chloroquine has been looked at as a possible treatment for COVID-19. Here’s how Veklury and chloroquine compare.

Ingredients

Veklury is a brand-name medication. It contains the active drug ingredient remdesivir.

Chloroquine is a generic medication. Chloroquine is also the active drug ingredient.

Uses

Veklury is used to treat COVID-19 or suspected COVID-19 in certain hospitalized people. The drug is approved for use in adults as well as in children who are at least 12 years old and weigh at least 88 pounds (lb) (40 kilograms [kg]).

At this time, the Food and Drug Administration (FDA) hasn’t approved Veklury for younger children. However, the FDA has granted an Emergency Use Authorization (EUA) for the drug in children who weigh at least 7.7 lb (3.5 kg) and are younger than 12 years old and for children of any age weighing 7.7 lb (3.5 kg) to 88 lb (40 kg). To learn more, see “FDA approval” in the “What is Veklury?” section above.

Chloroquine is an FDA-approved drug, but it’s not approved to treat COVID-19. Chloroquine used to have EUA status to treat COVID-19, but the EUA has been revoked. The FDA removed the EUA status for chloroquine because it determined that the risks of taking the drug for COVID-19 were greater than the benefits. At this time, chloroquine isn’t recommended to treat COVID-19.

However, chloroquine is FDA-approved for the following uses:

• treatment or prevention of malaria
• treatment of extraintestinal amebiasis

Drug forms and administration

Veklury comes in two forms: a liquid solution and a powder that’s mixed into a liquid solution.* Both forms are given as an intravenous (IV) infusion, which are injections into a vein given over a period of time. Veklury is typically given once a day for either 5 or 10 days.

Chloroquine is available as a tablet that you swallow. Depending on what condition the drug is used for, chloroquine may be taken anywhere from twice a day to once a week.

* Children weighing 7.7 lb to less than 88 lb (3.5 kg to less than 40 kg) should be given only this form of Veklury.

Side effects and risks

Below, we describe both mild and serious side effects of Veklury and chloroquine.

Side effects of Veklury

The most common side effects of Veklury include:

• nausea
• rash
• decreased hemoglobin level
• a high or increased blood sugar level

Veklury may also cause more serious side effects. These include:

• allergic reaction
• seizures
• increased levels of liver enzymes, which may be a sign of liver damage

For more information on side effects, see the “Veklury side effects” section above.

Side effects of chloroquine

At this time, chloroquine isn’t recommended to treat COVID-19 due to its lack of effectiveness against the disease and the many side effects of the drug.

Mild side effects of chloroquine may include:

• nausea
• vomiting
• rash
• decrease in blood sugar
• decrease in blood pressure

Serious side effects that may occur with chloroquine include:

• changes in vision (such as blurry vision)
• decreased hearing
• liver problems, such as hepatitis or increased levels of liver enzymes (which may be a sign of liver damage)
• severe, life threatening rash, such as Stevens-Johnson syndrome
• changes in blood levels, such as decreased levels of red blood cells, platelets, or white blood cells
• heart problems, such as heart failure

These aren’t all the side effects that chloroquine may cause. If you have more questions about the side effects of chloroquine, talk with your doctor.

Effectiveness

Veklury and chloroquine have different approved uses by the Food and Drug Administration (FDA). Veklury is approved for use in hospitalized adults and some children with COVID-19. It also has an Emergency Use Authorization to treat COVID-19 in children younger than 12 years old who weigh at least 7.7 lb (3.5 kg) and children weighing between 7.7 lb (3.5 kg) and 88 lb (40 kg). (To learn more, see “FDA approval” in the “What is Veklury?” section above.)

Chloroquine isn’t FDA-approved to treat COVID-19. In addition, the National Institutes of Health (NIH) recommends against its use for treating COVID-19. This is due to the drug’s lack of effectiveness shown in clinical trials and its many side effects.

These drugs haven’t been directly compared in clinical studies, but an ongoing clinical trial is comparing the use of remdesivir, the active drug in Veklury, with either chloroquine or hydroxychloroquine. Hydroxychloroquine is in the same drug class as chloroquine. (A drug class is a group of medications that work in a similar way.)

Also, according to clinical studies, using Veklury with chloroquine may decrease the effectiveness of Veklury. At this time, using both chloroquine and Veklury isn’t recommended.

Costs

For information on the price of Veklury, talk with your insurance company. The actual price you’ll pay for either drug depends on your insurance plan and your location.

Common questions about Veklury

Here are answers to some frequently asked questions related to Veklury.

Are drugs other than Veklury being studied for COVID-19 treatment?

Yes, other drugs besides Veklury are being studied for treating COVID-19. However, the Food and Drug Administration (FDA) hasn’t approved any treatments other than Veklury for COVID-19 at this time.

Ongoing clinical trials around the world are looking at many different drugs to treat COVID-19, including:

• hydroxychloroquine* (Plaquenil)
• chloroquine†
• steroids, such as dexamethasone (Hemady) or prednisone
• azithromycin (Zithromax)
• lopinavir/ritonavir (Kaletra)
• oseltamivir (Tamiflu)

Tamiflu was also tested in Wuhan, China, when the COVID-19 pandemic first began. The results showed that the drug didn’t help people recover from COVID-19.

If you have questions about Veklury or other treatments for COVID-19 or suspected COVID-19, talk with your doctor. They may be able to share new clinical trial data and help you determine the best option for you.

* For more information about hydroxychloroquine, see the “Veklury vs. hydroxychloroquine” section above.
† To learn more about chloroquine, see the “Veklury vs. chloroquine” section above.

Can Veklury cure COVID-19?

No. It’s not believed that Veklury can cure COVID-19. However, the drug may reduce the amount of time that you have COVID-19.

A clinical trial looked at adults hospitalized with a mild, moderate, or severe coronavirus infection. They were given either Veklury or a placebo (treatment with no active drug in it).

The results showed that people who were given Veklury recovered in about 10 days. This was compared with people given a placebo, who recovered in about 15 days.

In these studies, “recovery” was defined as one of the following:

• being discharged from the hospital with no limits on activities
• being discharged from the hospital but with limits on activity or needing oxygen therapy at home
• still being hospitalized but no longer needing oxygen therapy or medical treatment

If you have questions about Veklury or other treatments for COVID-19 or suspected COVID-19, talk with your doctor.

Can Veklury help prevent me from getting COVID-19?

At this time, Veklury isn’t used to help prevent COVID-19. In fact, there are currently no FDA-approved medications for the prevention of COVID-19.

However, there are several steps you can take to help avoid getting COVID-19. These include:

• Wearing a cloth face covering over your nose and mouth.
• Not touching your mouth, eyes, or nose.
• Washing your hands with soap and water for 20 seconds or more. If you don’t have soap and water, use hand sanitizer instead.
• Staying 6 feet (2 meters) away from others.

For more tips on how to help prevent COVID-19, see this article.

If you have questions about Veklury or other treatments for COVID-19 or suspected COVID-19, talk with your doctor.

What’s the difference between FDA approval and Emergency Use Authorization?

FDA approval of a drug usually takes many years and many clinical trials to prove that the medication is safe and effective. A drug that is FDA-approved goes through four phases of testing, where it’s studied in healthy and sick people. During this time, side effects are also reported so people know what to expect when the drug comes onto the market.

The average amount of time from when a drug is created to when it gains FDA approval and is available to consumers is about 10 years.

An Emergency Use Authorization (EUA), on the other hand, can be granted by the FDA in emergency situations. For an EUA to be granted, there must be no other options for the treatment of a disease.

With an EUA, the FDA still looks at available evidence that shows the benefits and risks of using a medication. However, there’s less clinical research on the drug than usual. When more studies have been done and more information is available about the drug, the FDA can approve or deny the medication.

At this time, Veklury is FDA-approved for use in adults hospitalized with COVID-19. It is also FDA-approved for use in children hospitalized with COVID-19 who are at least 12 years old and weigh at least 88 pounds (lb) (40 kilograms [kg]).

But Veklury is also available for use under an EUA in other children requiring hospitalization due to COVID-19. Specifically, it may be used under the EUA for children younger than 12 years old weighing at least 7.7 lb (3.5 kg) and for children of any age weighing between 7.7 lb (3.5 kg) and 88 lb (40 kg).

Veklury interactions

Veklury can interact with some medications. At this time, Veklury hasn’t been studied with other medications. It isn’t known what drug interactions may occur other than those listed below.

Veklury isn’t known to interact with herbs, supplements, or foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase the number of side effects or make them more severe.

Veklury and other medications

Below are medications that can interact with Veklury. This section doesn’t contain all drugs that may interact with Veklury.

Before starting Veklury treatment, talk with your doctor. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor.

Veklury and hydroxychloroquine or chloroquine

Veklury shouldn’t be used along with hydroxychloroquine (Plaquenil) or chloroquine. This is because hydroxychloroquine and chloroquine can block the effects of Veklury. By taking hydroxychloroquine or chloroquine with Veklury, Veklury may not work as well to treat COVID-19 or suspected COVID-19.

If you’re taking hydroxychloroquine or chloroquine, talk with your doctor before you start Veklury treatment.

Veklury and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Veklury. However, you should still check with your doctor or pharmacist before using any of these products during your Veklury treatment.

Veklury and foods

There aren’t any foods that have been specifically reported to interact with Veklury. If you have any questions about eating certain foods with Veklury, talk with your doctor.

Veklury and alcohol

It’s not known if there are any drug interactions between Veklury and alcohol. However, alcohol can decrease your rate of breathing. Because COVID-19 is a respiratory illness that can cause trouble breathing, drinking alcohol may make the condition worse.

Veklury is for use in certain people hospitalized with COVID-19 or suspected COVID-19. As a result, it’s unlikely that you’ll be able to drink alcohol during treatment.

How Veklury is given

You’ll be given Veklury according to your doctor’s or healthcare provider’s instructions.

Veklury comes in two forms: a liquid solution and a powder that’s mixed into a liquid solution.*

Both the liquid solution and powder forms are given as an intravenous (IV) infusion. An infusion is an injection into a vein that’s given over a period of time. Veklury infusions take about 30 minutes to 2 hours. You’ll receive this infusion in the hospital.

* Children weighing 7.7 lb to less than 88 lb (3.5 kg to less than 40 kg) should be given only this form of Veklury.

When you would receive Veklury

Veklury is typically given once a day for either 5 or 10 days, as recommended by your doctor. It’s only given to people with COVID-19 who are hospitalized due to the disease. For dosage details, see the “Veklury dosage” section above.

Veklury and pregnancy

It’s not known if Veklury is safe to use during pregnancy.

In animal studies, there were no issues with the development of offspring born to females given Veklury. However, at this time, Veklury should be used only if the benefit of treatment is greater than the risk to the developing fetus.

If you’re pregnant or planning to become pregnant, talk with your doctor before starting Veklury treatment.

Veklury and breastfeeding

It’s not known if Veklury is safe to use while breastfeeding or if the drug is present in breast milk.

In animal studies, Veklury was present in offspring born to females given Veklury. It’s also possible that the virus that causes COVID-19 may be transmitted from someone who has the virus to a breastfed child.

Because of this risk, tell your doctor if you’re breastfeeding before you start Veklury treatment. They may recommend other ways to feed your child while you’re receiving Veklury.

Veklury precautions

This drug comes with several precautions. Before you’re given Veklury, talk with your doctor about your health history. Veklury may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

• Liver conditions. Veklury may cause increased levels of liver enzymes, which may be a sign of liver damage. If you already have a liver condition, such as hepatitis, this increase may become dangerous. Your doctor will monitor you before and during your treatment with Veklury. If your liver enzyme levels become too high, your doctor may stop giving you Veklury and try a different medication.
• Kidney problems. Veklury may cause kidney problems. If you already have kidney problems, such as chronic kidney disease, using Veklury may worsen your kidney function. Depending on how severe your kidney problems are, Veklury may not be safe for you. Your doctor will monitor you before and during your treatment with Veklury. If the tests show that your kidneys aren’t working as well as usual, your doctor may stop giving you Veklury and try a different medication.
• Allergic reaction. If you’ve had an allergic reaction to Veklury or any of its ingredients, you shouldn’t be treated with Veklury. Ask your doctor what other medications are better options for you.
• Pregnancy. It’s not known if Veklury is safe to use during pregnancy. For more information, see the “Veklury and pregnancy” section above.
• Breastfeeding. It’s not known if Veklury is safe to use while breastfeeding. For more information, see the “Veklury and breastfeeding” section above.

Note: For more information about the potential negative effects of Veklury, see the “Veklury side effects” section above.