Veklury dosage: Your clear guide to COVID‑19 treatment

Did you know the exact amount of Veklury you receive can be the difference between a quick recovery and a tough hospital stay? In the next few minutes I’ll walk you through the numbers, the form of the medicine, how it’s actually given, and the safety checkpoints you shouldn’t miss. No medical‑school jargon, just straight‑up information you can share with a friend, a caregiver, or your own doctor.

What Is Veklury

Veklury is the brand name for remdesivir, an antiviral that blocks the coronavirus’s ability to copy its RNA. Think of it as a molecular roadblock that slows the virus down enough for your immune system to catch up. Since the pandemic began, Veklury has become one of the main COVID‑19 treatment options, especially for patients who need a hospital‑level intervention.

There are two Veklury forms on the market:

• Lyophilized powder (100 mg per vial) that you reconstitute with sterile water.
• Pre‑mixed solution (100 mg/20 mL, 5 mg/mL) ready for dilution.

Both forms have the same Veklury strength—100 mg of the active drug—but the preparation steps differ a bit. Knowing which one your pharmacy supplies helps you understand the preparation checklist we’ll cover later.

Adult Dosage Details

Standard loading dose

For anyone weighing at least 40 kg (about 88 lb), the first day’s dose is a single 200 mg IV infusion. This “loading dose” quickly fills the bloodstream with enough drug to start knocking the virus off its stride.

Maintenance dose

After Day 1, the regimen switches to a 100 mg IV infusion once a day. The treatment length depends on how sick the patient is:

• Non‑ventilated patients: 5 days, with the option to add up to 5 more days if there’s no clear improvement.
• Patients on invasive ventilation or ECMO: a straight 10‑day course.

Infusion timing

Veklury is flexible about infusion speed—anywhere from 30 to 120 minutes. Slower rates can help reduce the chance of infusion‑related reactions, which we’ll explore in the safety section.

All the adult dosing info comes straight from the official Veklury dosing guide released in early 2025.

Pediatric Dosage Guide

Children aren’t just “small adults,” especially when it comes to medication. Veklury dosing for kids is weight‑based, and the drug is approved for patients from birth up to 17 years old, as long as they weigh at least 1.5 kg (about 3.3 lb).

Weight categories

Below is the quick‑reference table that many hospitals print out and stick on the IV pole. It shows the loading and daily maintenance doses in milligrams per kilogram (mg/kg), plus the total milligram amount you’ll actually draw up.

Weight Range	Loading Dose	Maintenance Dose	Typical Total (Day 1 + Day 2‑5)
≥ 40 kg (adults & older teens)	200 mg (flat dose)	100 mg daily	≈ 800 mg for 5‑day course
3 kg – < 40 kg	5 mg/kg (e.g., 15 kg → 75 mg)	2.5 mg/kg daily	≈ (5 × weight kg) mg + (2.5 × weight kg × days) mg
1.5 kg – < 3 kg	2.5 mg/kg (e.g., 2 kg → 5 mg)	1.25 mg/kg daily	≈ (2.5 × weight kg) mg + (1.25 × weight kg × days) mg

Neonates and infants

For babies under 28 days old, the same weight‑based dosing applies, but the infusion volume is tiny. Most hospitals use a 0.9 % sodium chloride bag that’s only 25 mL, 50 mL, or 100 mL, and a syringe pump to keep the rate steady. A real‑world example: a newborn weighing 1.8 kg would get a 4.5 mg loading dose (2.5 mg/kg) diluted into a 25 mL bag and run over 30‑45 minutes.

All pediatric recommendations mirror the FDA Emergency Use Authorization fact sheet that was updated in 2022 for children as small as 3.5 kg.

How It’s Administered

Preparation steps

1. Reconstitution: If you have the lyophilized powder, add 20 mL of sterile water. Swirl—don’t shake.
2. Dilution: Transfer the reconstituted solution into a 250 mL (or appropriate size) 0.9 % sodium chloride bag. For tiny pediatric doses, you may use a 25 mL bag.
3. Labeling: Clearly write “Veklury – remdesivir – [patient weight] kg – [date/time]”.
4. Infusion set‑up: Connect the bag to an infusion pump (or gravity drip if a pump isn’t available). Set the pump for a 30‑120 minute window.

During the infusion

Watch the patient’s vitals every 15 minutes. Common signs of an infusion reaction include:

• Sudden drop or rise in blood pressure.
• Flushed skin, itching, or rash.
• Shortness of breath or wheezing.

If anything looks off, the infusion should be stopped immediately, and an antihistamine or epinephrine may be required—just like any other IV medication.

Post‑infusion monitoring

Even after the line is removed, keep an eye on the patient for at least an hour. Some reactions (like fever or chills) can appear a little later.

Safety & Risks

Common side effects

Most people tolerate Veklury well. The most frequent adverse event is mild nausea. Liver enzymes (ALT, AST) can rise, especially in patients who already have liver involvement from COVID‑19.

Serious warnings

• Hypersensitivity: Includes anaphylaxis. Slower infusion rates (up to 120 minutes) can lower the risk, but you still need immediate access to emergency meds.
• Liver injury: If ALT climbs above 10 × the upper limit of normal, consider stopping the drug.
• Kidney function: Veklury isn’t recommended for patients with an estimated glomerular filtration rate (eGFR) under 30 mL/min. Check renal labs before starting and during treatment.
• Drug interactions: Co‑administering chloroquine or hydroxychloroquine can diminish Veklury’s antiviral activity, so avoid that combo.

All these safety points are highlighted in the official safety information published by Gilead.

Balancing benefits and risks

Every medication is a trade‑off. In controlled trials (ACTT‑1 and later studies), Veklury shortened the median recovery time by about 5 days for hospitalized patients. That’s a solid benefit, especially when you consider the alternative—prolonged ventilation or ICU stay. But the same studies also flagged the liver and kidney signals, reminding us to monitor labs closely.

The key is communication: ask your healthcare team why they chose Veklury, what baseline labs they’ve taken, and how they’ll watch for side effects. Knowing the “why” makes the infusion feel less like a mystery and more like a collaborative plan.

Practical Tools

Dosage calculator

For anyone who’s ever stared at a weight‑based table and felt a headache coming on, there’s good news: you can copy the formula below into a spreadsheet and let the computer do the math.

Loading dose (mg) = Weight (kg) × Loading factorMaintenance dose (mg) = Weight (kg) × Maintenance factorLoading factor = 5 mg/kg (≥ 3 kg) or 2.5 mg/kg (< 3 kg)Maintenance factor = 2.5 mg/kg (≥ 3 kg) or 1.25 mg/kg (< 3 kg)

Just plug in the patient's weight, and you'll have the exact milligram amounts for the day‑1 bag and the daily refill. Most hospital pharmacies already have a built‑in version, but it never hurts to double‑check.

Patient‑handout checklist

If you're the one receiving Veklury—or you're caring for someone who is—consider printing this short list and keeping it by the bedside:

• Confirm the Veklury form (powder vs. solution) and strength.
• Check that the infusion line is correctly labeled with dose and time.
• Ask the nurse to record vitals every 15 minutes during the run.
• Know the signs of an infusion reaction (rash, breathing difficulty, sudden BP change).
• Ask when the next liver and kidney labs will be drawn.
• Write down any new symptoms you notice, even if they seem minor.

Having a tangible checklist turns abstract safety advice into an actionable plan you can actually follow.

Wrapping It All Up

Here are the three take‑aways you should walk away with:

1. Adults get a 200 mg loading dose, then 100 mg daily. The total treatment length hinges on whether you need a ventilator.
2. Kids are dosed by weight, with a clear table to guide loading and maintenance. Tiny infants get 2.5 mg/kg loading and 1.25 mg/kg maintenance.
3. Safety matters. Keep an eye on liver enzymes, kidney function, and any infusion reactions—slow the rate if you're nervous, and never hesitate to ask the team to pause the drip.

Veklury isn't a magic bullet, but when used correctly it can tip the scales in favor of recovery. If you or a loved one are about to start the therapy, talk openly with the prescribing physician, ask about the specific form they'll use, and make sure you have a copy of the dosage chart in hand.

What's your experience with Veklury? Have you noticed any tips that made the infusion smoother? Share your story in the comments, and let's help each other navigate this treatment together.