Antiviral drugs used in COVID-19 treatment in Vietnam

Substance

Indications

Contraindications 

Dosage

Note

Remdesivir

- Inpatient, mild severity and at least one risk factor for severe progression; moderate and severe, disease onset less than 10 days with respiratory failure requiring oxygen, HFNC, non-invasive mechanical ventilation

- Combined with corticosteroids when the disease is moderate or higher (preferably dexamethasone).

- For cases that have been treated with remdesivir before invasive ventilation or ECMO, remdesivir can be continued for a full course.

History of hypersensitivity to any ingredient in the formulation

+ People ≥ 12 years old and weighing > 40kg: 200mg on the first day, 100mg/day after that, 1 time intravenous infusion for 30 - 120 minutes.

+ Children ≥ 28 days old or ≥ 3.0 kg to < 40 kg: the first days 5mg/kg, the following days 2.5mg/kg/day IV once in 30 - 120 minutes

+ Duration of treatment: 5 days, if there is no clinical improvement, treatment can be continued for another 5 days.

- PNCT and breastfeeding: There are no complete data. Not recommended unless benefits outweigh risks.

- Monitor patients during infusion and within 1 h after infusion to detect and promptly handle anaphylaxis and infusion reactions (if any).

- Monitor liver enzyme elevation during drug use. Discontinue use if ALT rises above 5 times upper limit of normal during treatment

- Note that the patient has an estimated glomerular filtration rate (eGFR < 30mL/min)

- For more detailed information about the drug, follow the instructions for use of the drug

Nirmatrelvir in combination with Ritonavir

- People with COVID-19 patients, adults and children 12 years of age and older who weigh at least 40 kg, are mild and moderate and have at least 1 high risk of developing severe disease (including hospitalization and death). .

Use within 5 days of onset of symptoms or positive test

- Dosage:

+ Glomerular filtration rate eGFR ≥ 60 mL/min: 300 mg of nirmatrelvir (2 tablets of 150 mg) orally with 100 mg of ritonavir (1 tablet of 100 mg), x 2 times/day.

- Treatment time: 05 days.

+ Glomerular filtration rate eGFR ≥ 30 to 60 mL/min: 150 mg nirmatrelvir (1 150 mg tablet) orally with 100 mg ritonavir (1 100 mg tablet), twice daily.

+ If eGFR < 30 mL/min or severe hepatic impairment (Child-Pugh C): not recommended

- For more detailed information about the drug, follow the instructions for use of the drug

Watch out for serious drug interactions or contraindications through inhibition of CYP3A4 .

- Not recommended for use in patients with severe liver or kidney failure

Molnupiravir

Patients ≥ 18 years of age with mild or moderate COVID-19 but at risk of becoming severe; and  within 5 days of symptom onset or positive test

Pregnant

Take 800mg/time x 2 times/day (every 12 hours) x 5 days

Female patients should exclude pregnancy before use.

When taking the drug: For female patients, ensure that effective contraception is used from the time of use until 4 days after the last dose; For male patients, it is important to ensure that effective contraception is used from the start of treatment until 3 months after the last dose.