Due to antagonism observed in cell culture, concomitant use of remdesivir with chloroquine phosphate or hydroxychloroquine sulfate is not recommended [see Warnings and Precautions, Microbiology/Resistance information] .
Clinical drug-drug interaction studies have not been performed with remdesivir.
In vitro, remdesivir is a substrate for drug metabolizing enzyme CYP3A4, and is a substrate for Organic
Anion Transporting Polypeptides 1B1 (OATP1B1) and P-glycoprotein (P-gp) transporters. In vitro,
Remdesivir is an inhibitor of CYP3A4, OATP1B1, OATP1B3, and MATE1. GS-704277 is a substrate for OATP1B1 and OATP1B3. The clinical relevance of these in vitro assessments has not been established.
Remdesivir is not a substrate for CYP1A1, 1A2, 2B6, 2C9, 2C19, or OATP1B3. GS-704277 and GS-441524 are not substrates for CYP1A1, 1A2, 2B6, 2C8, 2C9, 2D6, or 3A5. GS-441524 is also not a substrate for CYP2C19 or 3A4. GS-704277 and GS 441524 are not substrates for OAT1, OAT3, OCT1, OCT2, MATE1, or MATE2K. GS 441524 is also not a substrate for OATP1B1 or OATP1B3.