Remdesivir

Information from 5 patients indicate that milk levels of remdesivir and its active metabolite are very low in milk. Additionally, remdesivir is poorly absorbed orally, and the metabolite is only partially absorbed orally, so infants are not likely to absorb clinically important amounts of the drug from milk. Newborn infants have received intravenous remdesivir therapy for Ebola and for COVID-19 with no serious adverse drug reactions and it is FDA approved for use in infants of at least 28 days and weighing 3 kg.[1-3] Infants exposed via breastmilk have also not had any reported adverse reactions. Given this information, mothers receiving remdesivir do not need to avoid nursing, but until more data are available, remdesivir should be used with careful infant monitoring during breastfeeding.[4] The most common adverse effects reported after intravenous infusion include elevated aminotransferase and bilirubin levels and other liver enzyme elevations, diarrhea, rash, renal impairment and hypotension.