Your browser doesn't support javascript.
Acetylcysteine for the Treatment of Suspected Remdesivir-Associated Acute Liver Failure in COVID-19: A Case Series.
Carothers, Chancey; Birrer, Kara; Vo, Mai.
  • Carothers C; Department of Pharmacy, Orlando Regional Medical Center, Orlando, Florida, USA.
  • Birrer K; Department of Pharmacy, Orlando Regional Medical Center, Orlando, Florida, USA.
  • Vo M; Department of Critical Care Medicine, Orlando Regional Medical Center, Orlando, Florida, USA.
Pharmacotherapy ; 40(11): 1166-1171, 2020 11.
Article in English | MEDLINE | ID: covidwho-812649
ABSTRACT
Remdesivir is a direct-acting nucleoside RNA polymerase inhibitor with activity against the novel severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) virus used in the treatment of coronavirus disease 2019 (COVID-19) pneumonia. Here, we present two cases of suspected remdesivir-associated acute liver failure (ALF) in which the liver failure improved after continuous infusion acetylcysteine and withdrawal of remdesivir. Both patients had significant increases in transaminases between day 3 and day 10 of remdesivir therapy accompanied by coagulopathy and encephalopathy. After initiation of continuous infusion acetylcysteine, the transaminases of both patients rapidly improved. Ultimately, one patient fully recovered while the other died of suspected septic shock. Due to its novel nature and only recent widespread use, there are very little data on the risk of ALF from remdesivir. Additionally, the data for the use of acetylcysteine to manage non-acetaminophen-induced ALF are limited. It is important to consider the risk of remdesivir-associated ALF when weighing the risk versus benefits of use, and acetylcysteine may have a role in its management.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Antiviral Agents / Acetylcysteine / Adenosine Monophosphate / Liver Failure, Acute / Alanine / COVID-19 Drug Treatment Type of study: Case report / Diagnostic study / Prognostic study Limits: Aged / Female / Humans Language: English Journal: Pharmacotherapy Year: 2020 Document Type: Article Affiliation country: Phar.2464

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Antiviral Agents / Acetylcysteine / Adenosine Monophosphate / Liver Failure, Acute / Alanine / COVID-19 Drug Treatment Type of study: Case report / Diagnostic study / Prognostic study Limits: Aged / Female / Humans Language: English Journal: Pharmacotherapy Year: 2020 Document Type: Article Affiliation country: Phar.2464