Remdesivir – a death protocol
By Craig Paardekooper

DATA SOURCE

Eudra-vigilance data for all medicines, substances, products and vaccines between 2017 and 2024. [500 Mb
compressed].
Note :••

Single-line datafile has fields – “PATHOLOGY”, “DRUGS”, REACTION” . It has a one symptom per line.
Multi-line datafile has fields – “PATHOLOGY”, “DRUG”, REACTION”. It has one record per line. Each
record can have multiple symptoms.

•

All fields should be converted to lower case before analysis, and all null rows removed.

Download link https://www.dropbox.com/scl/fi/phs3y74e3fytltuuv7otx/eudra.zip?rlkey=5hwm09juhwp7cmks6qx8uw17a&st=
lhie7ev0&dl=0

CONTENTS
Remdesivir
1. Remdesivir symptoms
2. Biomarkers of Liver Injury
3. Clinical Observations (liver Injury)
4. Clinical Observations (kidney Injury)

Anti-Retro-Viral Drugs and Liver Injury
5. Comparison of all drugs : liver injury – “transaminases increased”
6. Comparison of all drugs : liver injury – “hepatic enzyme increased”
7. What are Anti-retro-viral drugs ?

Anti-Retro-Viral Drugs and Kidney Injury
8. Comparison of all drugs : kidney injury – “renal”
9. Comparison of all drugs : kidney injury – “kidney”
10. Comparison of all drugs : kidney injury – “nephr”
11. Clinical Observations

Ritonavir
12. Ritonavir symptoms
13. Clinical Observations (Ritonavir, Paxlovid, Tamiflu)

14. Disproportionality Analyses
•
•
•
•
•

WHO 1
WHO 2
FAERS 1
FAERS 2BNPV

15. Summary
16. Conclusion
17. Appendix A : Remdesivir EUA : suspicious circumstances
18. Appendix B : Remdesivir Ebola trials 201919. Appendix C : Python code for data reading

SYMPTOMS OF REMDESIVIR contents

METHOD

1.
2.
3.
4.
5.
6.

The multi-line data file was used.
All records where the REACTION is null were removed.
All records where the DRUG is null were removed.
All reports for Remdesivir where selected
The frequency of each unique symptom in the filtered records was counted.
Each symptom count was divided by the total number of symptoms (7734) to give the percentage of all
symptoms for a particular symptom.

RESULTSTABLE 1 : Symptoms of Remdesivir ordered by incidence.

SYMPTOM
death
bradycardia
covid-19
alanine aminotransferase increased
acute kidney injury
transaminases increased
drug ineffective
off label use
renal impairment
aspartate aminotransferase increased
respiratory failure
covid-19 pneumonia
sinus bradycardia
liver function test increased
hepatic enzyme increased
hypertransaminasaemia
blood creatinine increased
hypotension
hepatic function abnormal
pneumonia
dyspnoea
renal failure
cardiac arrest
rash

FREQ
410
251
241
216
200
166
158
157
130
124
112
105
99
90
89
89
84
71
71
71
66
66
64
59

%
5.30
3.25
3.12
2.79
2.59
2.15
2.04
2.03
1.68
1.60
1.45
1.36
1.28
1.16
1.15
1.15
1.09
0.92
0.92
0.92
0.85
0.85
0.83
0.76

It can be seen that almost all of the most common symptoms have to do with liver injury and kidney injury.

BIOMARKERS OF LIVER INJURY contents

Three liver enzymes

Alanine aminotransferase (ALT) is used in the assessment of liver disease (not a test of liver function).
Increased values indicate hepatocyte injury and leakage of intracellular enzymes, such as could
occur in acute hepatitis, hepatic trauma, neoplasia (occasionally), and cirrhosis.
https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceuticalscience/alanine-aminotransferase

Elevated transaminases : The most common causes of elevated transaminase levels are nonalcoholic
fatty liver disease and alcoholic liver disease. Uncommon causes include drug-induced liver injury,
hepatitis B and C, and hereditary hemochromatosis.
https://pubmed.ncbi.nlm.nih.gov/29431403/

Aspartate aminotransferases : High levels of AST in the blood may be a sign of hepatitis, cirrhosis,mononucleosis, or other liver diseases. High AST levels may also be a sign of heart problems or
pancreatitis.
https://medlineplus.gov/lab-tests/ast-test/

Elevated liver enzymes often are a sign of inflamed or damaged cells in the liver. Inflamed or injured
liver cells leak higher levels of certain chemicals into the bloodstream. These chemicals include liver
enzymes that may appear higher than usual on blood tests.
https://www.mayoclinic.org/symptoms/elevated-liver-enzymes/basics/definition/sym-20050830

CLINICAL OBSERVATIONS (Remdesivir : Liver Injury) contents

Remdesivir-associated hepatotoxicity has been observed as increased transaminases more than fivetimes the upper limit of normal in hospitalized patients with COVID-19
https://www.mdpi.com/2813-0618/3/1/5

Studies have shown that many of these drugs could have adverse side-effects, including drug-induced
liver injury—also known as DILI… https://www.mdpi.com/1648-9144/58/12/1848

This table shows that –Remdesivir induces an elevation of alanine aminotransferases (ALT) to more than 10 times the upper
limit of normal – causing hepatocellular damage.
Ritonavir, otherwise known as Paxlovid, induces an elevation of ALT to more than 5 times the upper limit
of normal – causing hepatocellular damage.

The highest incidence rate of DILI (Drug Induced Liver Injury) per 10,000 defined daily doses (DDD) was withremdesivir (992.7/10,000 DDD). while another study by Kaur et al. reported the first case of DILI caused byremdesivir in a newborn with COVID-19 - https://www.mdpi.com/2077-0383/10/19/4432

So the two main drugs used to combat COVID, both induce excessive liver injury.

CLINICAL OBSERVATIONS (Remdesivir : Kidney Injury) contents
WHO Disproportionality Analysis contents
Prior studies found a strong association between administration of remdesivir and AKIs (Acute Kidney
Injury) in COVID-19 patients. One comparative study examined the differential ARF/AKI (Acute Renal
Failure/ Acute Kidney Injury) risk among COVID-19 patients treated with remdesivir or other antivirals
such as hydroxychloroquine, lopinavir/ritonavir, and tocilizumab using data derived from WHO's post marketing pharmacovigilance data (VigiBase) . This study discovered a 20-fold increase in the odds ofreporting Acute renal failure as an adverse event after taking remdesivir (ROR = 20.3; 95% CI: 15.7-26.3)
compared to users of the other antivirals
Gérard AO, Laurain A, Fresse A, Parassol N, Muzzone M, Rocher F, Esnault VLM, Drici MD. Remdesivir
and Acute Renal Failure: A Potential Safety Signal From Disproportionality Analysis of the WHO Safety
Database. Clin Pharmacol Ther. 2021 Apr;109(4):1021-1024. doi: 10.1002/cpt.2145. Epub 2021 Jan 16.
Erratum in: Clin Pharmacol Ther. 2022 Jun;111(6):1343. PMID: 33340409
https://digitalcommons.usf.edu/cgi/viewcontent.cgi?article=11021&context=etd
Although there was no evidence of remdesivir related nephrotoxicity in Phase I clinical studies, dosedependent kidney injury and/or reduced function was detected in the repeated dose toxicity studies ofremdesivir in animals, which correlated with histopathology findings of renal tubular atrophy,
basophilia and casts [3]. Grein et al. reported renal impairments, acute kidney injury and hematuria in 8%, 6 % and 4 % of the remdesivir recipients, respectively [2]. A COVID-19 patient, who was treated byour team in Wuhan in March 2020, suffered from acute renal failure after using remdesivir. This case
was also reported in a RCT in China [6]. Therefore, it is important to monitor kidney function during
remdesivir treatment, particularly for those with pre-existing renal impairments or those receiving
combination therapies with other nephrotoxins. Fan Q, Zhang B, Ma J, Zhang S. Safety profile of theantiviral drug remdesivir: An update. Biomed Pharmacother. 2020 Oct;130:110532. doi:
10.1016/j.biopha.2020.110532. Epub 2020 Jul 22. PMID: 32707440; PMCID: PMC7373689
https://www.researchgate.net/publication/343138058_Safety_profile_of_the_antiviral_drug_remdesivir_An_update/link/5f18734b45851515ef3e7438/download?_tp=eyJjb250ZXh0Ijp7ImZpcnN0UGFnZSI6In
B1YmxpY2F0aW9uIiwicGFnZSI6InB1YmxpY2F0aW9uIn19
WHO Disproportionality Analysis contents
To provide additional data, we performed a pharmacovigilance analysis on the World HealthOrganization global database of individual case safety reports, VigiBase (https://www.whoumc.org/vigibase/vigibase/). This database gathers spontaneous reports of suspected adverse drug
reactions from >130 countries, which makes it a powerful tool to perform disproportionality analyses. 3
This approach, based on a case–noncase method, estimates whether an adverse event is differentiallyreported for a specific drug compared with other drugs. Among 1,565,117 reports registered fromJanuary 1st until August 30th, 2020, 5532 concerned COVID-19 patients and have been included in thisstudy. Of them, 434 (7.8%) cases were related to kidney disorders, including 327 (5.9%) reported withremdesivir. In remdesivir kidney disorder cases, 217 (66.3%) patients were male, with a median age of
65 (interquartile range, 55–73) years (Supplementary Table S1). Remdesivir was discontinued early
after kidney disorder onset, with a median treatment duration of 3 (interquartile range, 1–4) days. In thevast majority of cases (316 [96.6%]), no other drug was suspected in the onset of kidney disorders.
Reactions were serious in 301 (92.0%) cases, with a fatal outcome for 15 (4.6%) patients. They weremainly AKI in 295 (90.2%) cases and tubular necrosis in 8 (2.4%) cases.
Compared with the use of chloroquine, hydroxychloroquine, dexamethasone, sarilumab, or
tocilizumab, the use of remdesivir was associated with an increased reporting of kidney disorders(reporting odds ratio, 7.2; 95% confidence interval, 5.7–9.0)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7907730/
FAERS Disproportionality Analysis contents
The U.S. Food and Drug Administration (FDA) has stated that the prescription of remdesivir should becautious for patients with estimated glomerular filtration rate (eGFR) < 30 (because remdesivir makes itworse) and some studies reported risk of adverse renal events. The available information on the renalsafety profile for remdesivir is limited, thus we analyzed the renal and urinary adverse reactions
attributed to remdesivir reported in a large open pharmacovigilance database. We obtained reports ofremdesivir and other drugs used to treat COVID-19 (tocilizumab, hydroxychloroquine,
lopinavir/ritonavir) registered by September 30 2020, from the U.S. Food and Drug Administration
Adverse Event Reporting System (FAERS). We analyzed the reporting odds ratios (RORs) for reports ofadverse renal and urinary events for remdesivir and other drugs. We found 2,922 reports with remdesivir
registered in FAERS for COVID-19. Among these, 493 renal and urinary adverse effects (16.9%) werereported. The most frequent events were acute kidney injury (338; 11.6%), renal impairment (86; 2.9%),
and renal failure (53; 1.8%). Versus hydroxychloroquine, lopinavir/ritonavir, or tocilizumab, the use ofremdesivir was associated with an increased chance of reporting renal and urinary disorders regardlessof gender and age of patients (2.53; 95%CI: 2.10-3.06). The ROR remained significant when we
restricted the analysis to hydroxychloroquine (4.31; 95%CI: 3.25-5.71) or tocilizumab (3.92; 95%CI:
2.51-6.12). Our results reinforce this already reported signal, emphasizing that it could be extremely
useful for health professionals who prescribe this new antiviral to treat COVID-19, mainly knowing its
low efficacy.
https://pubmed.ncbi.nlm.nih.gov/34787281/

COMPARISON WITH OTHER DRUGS contents“transaminases increased”

Elevation of transaminases and increase of alanine aminotransferases are both biomarkers of liver injury.
But how does this level of liver injury compare with all the other 25,000 drugs in Eudra-vigilance? To answer this
I took one symptom – “transaminases increased” – and counted the frequency of this symptom in all otherdrugs.

METHOD

1.
2.
3.
4.
5.
6.

The single-line data file was used.
All records where the REACTION is null were removed.
All records where the DRUG is null were removed.
All reports were selected where REACTION = “transaminases increased”
The frequency of reports for each drug was counted
Each report count was divided by the total number of reports for each drug to give the percentage ofreports.

RESULTSTABLE 2 : All drugs ordered by incidence of “transaminases increased”

DRUG
ESMYA [ULIPRISTAL ACETATE][FLUVASTATIN, FLUVASTATIN SODIUM]
TRABECTEDIN [TRABECTEDIN][PYRAZINAMIDE]
OFEV 150 MG SOFT CAPSULES [NINTEDANIB]MULTAQ 400 MG FILM-COATED TABLETS[DRONEDARONE]VEKLURY [REMDESIVIR][ROSUVASTATIN CALCIUM]
YONDELIS [TRABECTEDIN][FLUVASTATIN SODIUM][ISONIAZID]REMDESIVIR [REMDESIVIR]
VFEND 200 MG FILM-COATED TABLETS[VORICONAZOLE][CEFTRIAXONE, CEFTRIAXONE DISODIUM,
CEFTRIAXONE DISODIUM SALTHEMIHEPTAHYDRATE, CEFTRIAXONESODIUM, CEFTRIAXONE, LIDOCAINEHYDROCHLORIDE]
IRINOTECAN HYDROCHLORIDE TRIHYDRATE[IRINOTECAN HYDROCHLORIDE TRIHYDRATE]

FREQ
106
96
19
49
13

TOT
1482
1484
299
786
229

%
7.15
6.47
6.35
6.23
5.68

14
106
92
52
125
69
57

264
2268
1998
1133
3013
1822
1511

5.30
4.67
4.60
4.59
4.15
3.79
3.77

15

416

3.61

14

405

3.46

12

355

3.38

[DISULFIRAM]
STOCRIN [EFAVIRENZ]PAZOPANIB [PAZOPANIB]OLYSIO 150 MG HARD CAPSULES[SIMEPREVIR][ATORVASTATIN CALCIUM]PACLITAXEL ALBUMIN-BOUND [PACLITAXELALBUMIN-BOUND][CEFOPERAZONE SODIUM, SULBACTAMSODIUM, CEFOPERAZONE, SULBACTAM][PARACETAMOL]
KALETRA 200 MG/50 MG FILM-COATEDTABLETS [LOPINAVIR, RITONAVIR]KIVEXA [ABACAVIR SULFATE, LAMIVUDINE,ABACAVIR, LAMIVUDINE][ETHAMBUTOL, ETHAMBUTOLHYDROCHLORIDE][ATORVASTATIN, ATORVASTATIN CALCIUM,
ATORVASTATIN CALCIUM TRIHYDRATE]EUCREAS [METFORMIN HYDROCHLORIDE,VILDAGLIPTIN][PITAVASTATIN]TAMIFLU 75 MG HARD CAPSULE[OSELTAMIVIR]KISQALI [RIBOCICLIB]MULTAQ [DRONEDARONE]

44
11
58

1341
342
1866

3.28
3.22
3.11

10
20

325
698

3.08
2.87

11

397

2.77

38
43

1399
1662

2.72
2.59

23

890

2.58

19

739

2.57

67

2676

2.50

65

2786

2.33

35
12

1511
519

2.32
2.31

13
97
86

584
4429
3928

2.23
2.19
2.19

Remdesivir has a high incidence of reports where transaminases are increased – about 5%
Paxlovid (Ritonavir) has about half that incidence – about 2.5%
Tamiflu has about the same incidence as Paxlovid.
Other drugs belonging to the Remdesivir family are shown shaded in grey. These drugs are all ANTI-RETROVIRAL DRUGS. In Table 2 they include –REMDESIVIR (Veklury)
SIMEPREVIR
LOPINAVIRRITONAVIR (Paxlovid)
ABACAVIROSELTAMIVIR (Tamiflu)

COMPARISON WITH OTHER DRUGS contents“hepatic enzyme increased”

Elevation of hepatic enzyme is a biomarker of liver injury.
If you've ever had a liver function test as part of an annual physical, you may know that the exam
screens for certain biomarkers, like liver enzymes in the blood. If these substances are found to beelevated, it may mean that you have a liver disease or have been exposed to some medications orenvironmental toxins.
https://www.pfizer.com/news/articles/in_search_of_a_better_biomarker_why_studying_liver_enzymes_
matters_for_drug_safety

METHOD

1.
2.
3.
4.
5.
6.

The single-line data file was used.
All records where the REACTION is null were removed.
All records where the DRUG is null were removed.
All reports were selected where REACTION = “hepatic enzyme increased”
The frequency of reports for each drug was counted
Each report count was divided by the total number of reports for each drug to give the percentage ofreports.

RESULTSTABLE 3 : All drugs ordered by incidence of “hepatic enzyme increased”

DRUG
ABACAVIR SULFATE [ABACAVIR SULFATE]
APREPITANT [APREPITANT]ABACAVIR SULFATE, LAMIVUDINE[ABACAVIR SULFATE, LAMIVUDINE]
APREMILAST [APREMILAST]ABATACEPT [ABATACEPT]ACLIDINIUM BROMIDE [ACLIDINIUM
BROMIDE]
ARAVA [LEFLUNOMIDE]
ADALIMUMAB [ADALIMUMAB][FLUTAMIDE][ANHYDROUS PAMIDRONATE DISODIUM,
PAMIDRONATE DISODIUM]
ORENCIA [ABATACEPT]
APTIVUS [TIPRANAVIR]AMPRENAVIR [AMPRENAVIR]ABACAVIR, LAMIVUDINE [ABACAVIR,LAMIVUDINE]

FREQ
TOT
%
1029
2040 50.44118
285
841 33.88823
245
154
615

901 27.19201
770
203922 15.68078

78
4242
2113
139

524 14.8855
30951 13.70553
16216 13.03034
1101 12.62489

12
42
17
11

100
12
403 10.42184
171 9.94152
111 9.90991

22257 8.560311

REBIF [INTERFERON BETA-1A]
ANTIBIOTICS [NOT AVAILABLE]ALOXI [PALONOSETRON, PALONOSETRONHYDROCHLORIDE][FLUVASTATIN SODIUM]

28
11

362 7.734807
165 6.666667

22
184

331 6.646526
3013 6.10687[CEFTRIAXONE, CEFTRIAXONE DISODIUM,
CEFTRIAXONE DISODIUM SALTHEMIHEPTAHYDRATE, CEFTRIAXONESODIUM, CEFTRIAXONE, LIDOCAINEHYDROCHLORIDE][PERAZINE, PERAZINE DIMALONATE]

24
12

405 5.925926
212 5.660377

13
60

232 5.603448
1084 5.535055

14

259 5.405405

13

242 5.371901

17
11
79
10
33
68
66
11
325
82
11

324
210
1576
201
698
1482
1484
248
7868
1998
283

43
55
16

1127 3.815439
1511 3.639974
467 3.426124

92
33
10

2814 3.269367
1030 3.203883
320
3.125

311
52
11
15
66

10123
1822
401
548
2412

38

1399 2.716226

75

2786 2.692032

21

782 2.685422[CEFTRIAXONE, CEFTRIAXONE SODIUM,
CEFTRIAXONE, LIDOCAINEHYDROCHLORIDE]
DELAMANID [DELAMANID]CEFUROXIME SODIUM [CEFUROXIMESODIUM]
ERELZI [ETANERCEPT, ETANERCEPT,HYDROCHLOROTHIAZIDE]ACLASTA [ZOLEDRONIC ACID,ZOLEDRONIC ACID MONOHYDRATE]KETEK [TELITHROMYCIN]
LEFLUNOMIDE [LEFLUNOMIDE]
TYGACIL [TIGECYCLINE][ATORVASTATIN CALCIUM]
ESMYA [ULIPRISTAL ACETATE][FLUVASTATIN, FLUVASTATIN SODIUM]
AGOMELATINE [AGOMELATINE]
ENBREL [ETANERCEPT][ROSUVASTATIN CALCIUM]
LYSODREN [MITOTANE][HEPATITIS B SURFACE ANTIGEN,
HEPATITIS A VACCINEREMDESIVIR [REMDESIVIR]TERIFLUNOMIDE [TERIFLUNOMIDE]
TWINRIX ADULT [ALUMINIUM PHOSPHATE,HEPATITIS A VIRUS
VIRAMUNE [NEVIRAPINE][VORICONAZOLE][TERBINAFINE, TERBINAFINEHYDROCHLORIDE][ISONIAZID]EPIDYOLEX [CANNABIDIOL]LUMYKRAS [SOTORASIB]ABACAVIR [ABACAVIR][CEFOPERAZONE SODIUM, SULBACTAMSODIUM, CEFOPERAZONE, SULBACTAM][ATORVASTATIN, ATORVASTATINCALCIUM, ATORVASTATIN CALCIUM
TRIHYDRATE]MYCAMINE [MICAFUNGIN, MICAFUNGINSODIUM]

5.246914
5.238095
5.01269
4.975124
4.727794
4.588394
4.447439
4.435484
4.130656
4.104104
3.886926

3.0722122.854007
2.7431422.737226
2.736318

ZIAGEN [ABACAVIR, ABACAVIR SULFATE]CELSENTRI [MARAVIROC]
TAMIFLU 75 MG HARD CAPSULE[OSELTAMIVIR]

13
15

485 2.680412
579 2.590674

15

584 2.568493

Remdesivir has a high incidence of reports where transaminases are increased – about 3.63%
Paxlovid (Ritonavir) has about half that incidence – about 1.4%
Tamiflu has an incidence of 2.5%.

Other drugs belonging to the Remdesivir family are shown shaded in grey. They include –ABACAVIR
TIPRANAVIR
AMPRENAVIRREMDESIVIR (Veklury)
OSELTAMIVIR (Tamiflu)
RITONAVIR (Paxlovid)

Note that out of all drugs in Eudra-vigilance, Abacavir has the highest incidence of hepatic enzyme increased.

WHAT ARE ANTI-RETRO-VIRAL DRUGS ? contents

Remdesivir belongs to a family of drugs called ANTI-RETROVIRAL drugs – they are used to treat HIV. A full list ofthese drugs can be found here - https://en.wikipedia.org/wiki/List_of_antiviral_drugs
Antiretroviral Drug
Abacavir
Acyclovir (Aciclovir)

For Treating
HIV
Herpes Simplex, chickenpox,[2] varicella zoster virus

Adefovir
Amantadine
AmpligenAmprenavir (Agenerase)
Atazanavir
Atripla (Efavirenz/emtricitabine/tenofovir)
Baloxavir marboxil (Xofluza)[4]Biktarvy (Bictegravir/emtricitabine/tenofovir alafenamide)
Boceprevir
Bulevirtide
Cidofovir
Cobicistat (Tybost)[6]Combivir (Lamivudine/Zidovudine)
Daclatasvir (Daklinza)
Darunavir
Delavirdine
Descovy (Emtricitabine/tenofovir alafenamide)
Didanosine
Docosanol
Dolutegravir
Doravirine (Pifeltro)[7]Edoxudine
Efavirenz
Elvitegravir
Emtricitabine
Enfuvirtide
Ensitrelvir
Entecavir
Etravirine (Intelence)[8]Famciclovir
Fomivirsen
Fosamprenavir
Foscarnet
Ganciclovir (Cytovene)[9]Ibacitabine
Ibalizumab (Trogarzo)[11]
Idoxuridine
Imiquimod
Indinavir
Inosine pranobex
Lamivudine

Hepatitis B[3]Influenza
Avian Influenza
HIV
HIV
HIV
Influenza A/B
HIV
Hepatitis C genotype 1[5]Hepatitis D/B
AIDS
HIV
HIV
Hepatitis C
HIV
HIV
Hepatitis B
HIV
Herpes Simplex
HIV
HIV
Herpes Simplex
HIV
HIV
HIV
HIV
COVID-19
HIV
HIV
Herpes Zoster
AIDS
HIV
HerpesCytomegalovirus (CMV)[10]Herpes labialis
HIV
HerpesGenital wart, Basal cell carcinoma, Actinic keratosis
HIV
Herpes Simplex
HIVLetermovir (Prevymis)[12]Lopinavir
Loviride
Maraviroc
Methisazone
Molnupiravir
Moroxydine
Nelfinavir
Nevirapine
Nirmatrelvir/ritonavir (Paxlovid)
Nitazoxanide
NorvirOseltamivir (Tamiflu)[13]
Penciclovir
Peramivir (Rapivab)[14]
Pleconaril
Podophyllotoxin
Raltegravir
Remdesivir
Ribavirin
Rilpivirine (Edurant)[16]
Rimantadine
Ritonavir
Saquinavir
Simeprevir (Olysio)
Sofosbuvir
Stavudine
Taribavirin (Viramidine)
Telaprevir
Telbivudine (Tyzeka)
Tenofovir alafenamide
Tenofovir disoproxil
Tipranavir
Trifluridine
Trizivir
Tromantadine
TruvadaUmifenovir
Umifenovir (Arbidol)
Valaciclovir (Valtrex)[20]

Cytomegalovirus (CMV)
HIV
HIV
HIV
Smallpox
COVID-19
Influenza
HIV
HIV
COVID-19
Broad-spectrum antiviralHIV
Influenza
HerpesInfluenza
Picornavirus
Genital wart
HIV
COVID-19
Hepatitis C[15]HIV
Influenza A
HIV
HIV
Hepatitis C
Hepatitis C[17]HIV
Hepatitis Syndromes in which Ribavirin is active[18]Hepatitis C
Hepatitis B
Hepatitis B
Hepatitis B, HIV[19]HIV
Eyes related Herpes
HIV
Herpes Simplex
HIV
Influenza
Influenza
Herpes Simplex/Zoster

Valganciclovir (Valcyte)[21]Vicriviroc
Vidarabine
Zalcitabine
Zanamivir (Relenza)[22]Zidovudine

Cytomegalovirus (CMV)
HIV-1
Herpes Simplex, Varicella Zoster
HIV
Influenza A, Influenza B
HIV[23]

COMPARISON WITH OTHER DRUGS contents“renal” symptoms“Renal” means “Kidney”

METHOD

1.
2.
3.
4.
5.
6.

The single-line data file was used.
All records where the REACTION is null were removed.
All records where the DRUG is null were removed.
All reports were selected where REACTION = “renal”
The frequency of reports for each drug was counted
Each report count was divided by the total number of reports for each drug to give the percentage ofreports.

RESULTSTABLE 4 : All drugs ordered by incidence of “renal” symptoms
DRUG
ATRIPLA [EMTRICITABINE, EFAVIRENZ, TENOFOVIRDISOPROXIL, EMTRICITABINE, EFAVIRENZ, TENOFOVIRDISOPROXIL FUMARATE]TRUVADA [EMTRICITABINE, TENOFOVIR DISOPROXIL
FUMARATE]STRIBILD [EMTRICITABINE, TENOFOVIR DISOPROXIL
FUMARATE, COBICISTAT, ELVITEGRAVIR]TRUVADA [EMTRICITABINE, TENOFOVIR DISOPROXIL,EMTRICITABINE, TENOFOVIR DISOPROXIL FUMARATE][ACEBUTOLOL HYDROCHLORIDE]STRIBILD [EMTRICITABINE, TENOFOVIR DISOPROXIL
FUMARATE, COBICISTAT, ELVITEGRAVIR,EMTRICITABINE, TENOFOVIR DISOPROXIL, COBICISTAT,ELVITEGRAVIR]HEPSERA TABLETS [ADEFOVIR DIPIVOXIL]VIREAD [TENOFOVIR DISOPROXIL, TENOFOVIRDISOPROXIL FUMARATE]TENOFOVIR DISOPROXIL FUMARATE [TENOFOVIRDISOPROXIL FUMARATE][ESOMEPRAZOLE MAGNESIUM]
EPIVIR FILM-COATED TABLETS [LAMIVUDINE][LOXOPROFEN, LOXOPROFEN SODIUM]TRUVADA 200 MG/245 MG FILM-COATED TABLETS[EMTRICITABINE, TENOFOVIR DISOPROXIL FUMARATE]

FREQ

TOT

%

37831

58696

64.45

18354

31035

59.14

4453

9031

49.31

1612
173

3486
386

46.24
44.82

484
52

1107
136

43.72
38.24

1477

4168

35.44

323
51
26
30

954
177
102
122

33.86
28.81
25.49
24.59

138

564

24.47

What is noticeable is the extreme prevalence of drugs with a similar name to Remdesivir. This family of drugs
appears to be associated with very high levels of renal toxicity = kidney disorder.
All of these drugs belong to the Remdesivir family and are called ANTI-RETRO-VIRAL drugs – they ae used totreat HIV.
Tenofovir

Abacavir

EpivirAdefovir

Valaciclovir

Dolutegravir

Cidofovir

Aciclovir

Ganciclovir

Indinavir

NorvirRemdesivir

Atazanavir

Raltegravir

Ritonavir
Lopinavir

Entecavir

One of these drugs – Ritonavir – is otherwise known as Paxlovid. We are told –Paxlovid, an oral antiviral pill that can be taken at home, is the go-to treatment for COVID-19. If you
are at high risk for severe disease from COVID, and you take it within the first five days of experiencing
symptoms, it will lower your risk of getting so sick that you need to be hospitalized.
https://www.yalemedicine.org/news/13-things-to-know-paxlovid-covid-19

Ritonavir has an incidence of 17.57% in Table 4 (not shown – table truncated)
Remdesivir has an incidence of 6.35% in Table 4 (not shown – table truncated)

As noted in TABLE 1, one of the highest ranking symptoms for Remdesivir is “acute kidney injury”. Whilst
Remdesivir is being prescribed in hospitals, Ritonavir is being recommended as the at-home remedy!

COMPARISON WITH OTHER DRUGS contents“kidney disease” symptoms

METHOD

1.
2.
3.
4.
5.
6.

The single-line data file was used.
All records where the REACTION is null were removed.
All records where the DRUG is null were removed.
All reports were selected where REACTION = “kidney”
The frequency of reports for each drug was counted
Each report count was divided by the total number of reports for each drug to give the percentage ofreports.

RESULTSTABLE 5 : All drugs ordered by incidence of “kidney” symptoms
DRUG

FREQ

TOT

%

TRUVADA [EMTRICITABINE, TENOFOVIR DISOPROXIL,EMTRICITABINE, TENOFOVIR DISOPROXIL FUMARATE]

1689

3486

48.45

STRIBILD [EMTRICITABINE, TENOFOVIR DISOPROXIL
FUMARATE, COBICISTAT, ELVITEGRAVIR, EMTRICITABINE,TENOFOVIR DISOPROXIL, COBICISTAT, ELVITEGRAVIR]

477

1107

43.09

TRUVADA [EMTRICITABINE, TENOFOVIR DISOPROXIL
FUMARATE]

13160

31035

42.40

ATRIPLA [EMTRICITABINE, EFAVIRENZ, TENOFOVIR DISOPROXIL,EMTRICITABINE, EFAVIRENZ, TENOFOVIR DISOPROXIL
FUMARATE]
24802

58696

42.26

TENOFOVIR DISOPROXIL [TENOFOVIR DISOPROXIL]

115

278

41.37

INVOKANA [CANAGLIFLOZIN]

901

2184

41.25

[LOXOPROFEN, LOXOPROFEN SODIUM]

48

122

39.34

STRIBILD [EMTRICITABINE, TENOFOVIR DISOPROXIL
FUMARATE, COBICISTAT, ELVITEGRAVIR]

3329

9031

36.86

[DICLOFENAC, DICLOFENAC DIETHYLAMINE, DICLOFENACSODIUM]

82

224

36.61

[GENTAMICIN]

180

500

36.00

[OLMESARTAN MEDOXOMIL, AMLODIPINE BESILATE]

192

551

34.85

APROVEL 75 MG TABLETS [IRBESARTAN]

54

169

31.95

[OLMESARTAN MEDOXOMIL, HYDROCHLOROTHIAZIDE,AMLODIPINE BESILATE]

90

290

31.03

[PIPERACILLIN, TAZOBACTAM]

130

431

30.16

[ESOMEPRAZOLE MAGNESIUM]

53

177

29.94

Once again, there is a prevalence of drugs belonging to the Remdesivir family of anti-retro-virus drugs.
Paxlovid (Ritonivir) has an incidence of 11 %Remdesivir has an incidence of 6.3 %Tamiflu has an incidence of 1.3 %COMPARISON WITH OTHER DRUGS contents“nephr” symptoms

These include symptoms related to nephritis and other nephropathies.

METHOD

1.
2.
3.
4.
5.
6.

The single-line data file was used.
All records where the REACTION is null were removed.
All records where the DRUG is null were removed.
All reports were selected where REACTION = “nephr”
The frequency of reports for each drug was counted
Each report count was divided by the total number of reports for each drug to give the percentage ofreports.

RESULTSTABLE 6 : All drugs ordered by incidence of “nephr” symptoms

DRUG[GADODIAMIDE, GADODIAMIDE HYDRATE]OPTIMARK [GADOVERSETAMIDE]
CONTRAST MEDIA [NOT AVAILABLE][GADODIAMIDE]
REYATAZ HARD CAPSULES [ATAZANAVIR,ATAZANAVIR SULFATE][VANCOMYCIN HYDROCHLORIDE]CRIXIVAN [INDINAVIR, INDINAVIR SULFATE]REYATAZ 300 MG HARD CAPSULES [ATAZANAVIR,ATAZANAVIR SULFATE]
BASILIXIMAB [BASILIXIMAB][ESOMEPRAZOLE MAGNESIUM]
SIMULECT [BASILIXIMAB]
CIDOFOVIR [ANHYDROUS CIDOFOVIR, CIDOFOVIR]CRIXIVAN 400 MG HARD CAPSULES [INDINAVIR,
INDINAVIR SULFATE][PENICILLAMINE]BELIMUMAB [BELIMUMAB]
BOTULINUM TOXIN TYPE A [BOTULINUM TOXINTYPE A][LITHIUM]
DOLUTEGRAVIR [DOLUTEGRAVIR]CIDOFOVIR [CIDOFOVIR][HYDRALAZINE]REYATAZ [ATAZANAVIR, ATAZANAVIR SULFATE]

FREQ
484
1733
76
772

TOT
653
2438
114
1399

%
74.12
71.08
66.67
55.18

43
493
421

191
2241
2037

22.51
22.00
20.67

39
161
28
16
38

190
993
177
102
269

20.53
16.21
15.82
15.69
14.13

17
54
60

123
394
468

13.82
13.71
12.82

164
349
107
19
84
200

1280
2782
858
154
723
1739

12.81
12.54
12.47
12.34
11.62
11.50

Drugs belonging to the family of anti-retro-virals are strongly represented in the higher ranks of this table.
•••

Remdesivir has an incidence of 9%
Ritonavir, the active ingredient in Paxlovid, has an incidence of 4.88%
Oseltamivir, the active ingredient in Tamiflu, has an incidence of 0.3%

CLINICAL OBSERVATIONS (anti-retro-viral drugs and kidney disease) contents

Taking antiretroviral medications (ARVs) used to treat HIV infections or related health issues can also
cause kidney disease. Kidney problems can lead to ESRD or kidney failure.
https://www.iapac.org/fact-sheet/hiv-and-kidney-disease/

HIV positive people are typically treated with Antiretroviral therapy (ART) using the above drugs, and thishas been found to cause chronic kidney disease (CKD) 3 x more than for those not taking ART.
https://www.aidsmap.com/news/jun-2018/kidney-function-declines-faster-men-hiv-treatment-theirhiv-negative-peers
T
Tenofovir, one of the most effective and commonly prescribed antiretroviral medications for HIV/AIDS,
is associated with a significant risk of kidney damage and chronic kidney disease that increases overtime, according to a study of more than 10,000 patients led by researchers at the San Francisco VA
Medical Center (SFVAMC) and the University of California, San Francisco (UCSF)
https://www.ucsf.edu/news/2012/02/98532/tenofovir-leading-hiv-medication-linked-risk-kidneydamage

Antiretroviral therapy can contribute to renal dysfunction directly by inducing acute tubular necrosis,
acute interstitial nephritis, crystal nephropathy, and renal tubular disorders or indirectly via druginteractions.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3157198/

Drug-induced kidney injury is a major side effect in clinical practice, frequently leading to acute renal
failure (ARF). It accounts for more than 2% to 15% of cases of ARF in patients admitted to the hospitalor in the intensive care unit, respectively. The exact frequency of nephrotoxicity induced by antiviraldrugs is difficult to determine. Antiviral drugs cause renal failure through a variety of mechanisms.
Direct renal tubular toxicity has been described with a number of new medications with unique effects
on epithelial cells of the kidney. These include cidofovir, adefovir dipivoxil, and tenofovir, as well as
acyclovir. Additionally, crystal deposition in the kidney may promote the development of renal failure.
Several different drugs have been described to induce crystal nephropathy, including acyclovir and theprotease inhibitor indinavir. Renal injury associated with antiviral drugs involves diverse processes
having effects on the renal transporters, as well as on tubule cells.
https://www.ajkd.org/article/S0272-6386(05)00253-2/abstract

SYMPTOMS OF RITONAVIR (active ingredient in Paxlovid) contents

METHOD
1.
2.
3.
4.
5.
6.

The multi-line data file was used.
All records where the REACTION is null were removed.
All records where the DRUG is null were removed.
All reports for Ritonavir (Paxlovid) where selected
The frequency of each unique symptom in the filtered records was counted.
Each symptom count was divided by the total number of symptoms (46,435) to give the percentage of
all symptoms for a particular symptom.

RESULTSTABLE : Symptoms of Ritonavir (active ingredient in Paxlovid) ordered by incidence.
SYMPTOM
diarrhoea
drug interaction
off label use
nauseavomiting
acute kidney injury
osteonecrosis
renal failure
osteoporosis
pyrexiabone density decreased
foetal exposure during pregnancy
renal injury
anaemiabone loss
rashskeletal injury
hepatic cytolysis
cushing's syndrome
jaundice
asthenia
multiple fractures
headacheelectrocardiogram qt prolonged
chronic kidney disease
abdominal pain
hypertriglyceridaemia
fatigue

FREQ
1324
1248
1162
747
639
627
562
489
441
428
404
403
398
358
357
338
337
330
327
294
289
273
265
255
254
243
238
236

%
2.85
2.69
2.50
1.61
1.38
1.35
1.21
1.05
0.95
0.92
0.87
0.87
0.86
0.77
0.77
0.73
0.73
0.71
0.70
0.63
0.62
0.59
0.57
0.55
0.55
0.52
0.51
0.51

CLINICAL OBSERVATIONS (Ritonavir / Paxlovid / Tamiflu ) contents

Severe hepatotoxicity was observed in 31 (10.4%) of 298 patients (95% confidence interval [CI], 7.2%14.4%). Ritonavir use was associated with a higher incidence of toxicity (30%; 95% CI, 17.9%-44.6%)
https://jamanetwork.com/journals/jama/fullarticle/192258

As mentioned earlier, Paxlovid contains the medication ritonavir. Ritonavir is known to contribute toliver damage. This side effect is more likely to happen in people who already have liver problems.
https://www.goodrx.com/paxlovid/known-side-effects

Tamiflu/oseltamivir phosphate (OP), an anti-influenza drug, has a highly doubted safety especially after
many cases of abnormal behaviour and deaths reported after being used. Such controversy was also
locally and globally generated, especially after being heavily used in COVID-19 treatment protocol. This
study was designed to evaluate the effect of three different doses of OP on the liver and kidneys of maleadult albino rats through histological approaches, measuring their DNA integrity and biochemical
analyses. Different doses of Tamiflu applied to humans were converted to rats, then observed theireffects on the liver and kidneys. Rats were divided into four groups. G1: considered as control group.
The rest of the three treated groups were received the same calculated dose of Tamiflu (6.75 mg/kg b.w.)
in three different durations. G2, G3 and G4 represented the animals orally received OP, in which the rats
received OP twice for 5 consecutive days, once for 10 and 45 days, respectively.
Our data showed numerous deleterious necrotic and fibrotic histopathological changes in the liver,and kidneys; as well as necrotic DNA smears, by using electrophoresis, in OP-treated rats of G2 and G4.
In addition, OP significantly increased the serum cellular hepatic/renal toxicity markers (ALT, AST, ALP,
GGT, indirect bilirubin, urea, creatinine, uric acid, & Na+). Also, it showed a reduction in the levels of
serum total protein, albumin and K+ ions in rats of G2 and G4 compared with G1. In G3, OP treatment
did not significantly alter hepatic/renal histological, DNA integrity and biochemical analyses in rats.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8787452/
FAERS Disproportionality Analysis 2 contents
The primary suspected drugs related to AKI (acute kidney injury) in more than half of the reports(75.60%, 127/168) were four common anti-COVID-19 drugs (remdesivir, tocilizumab,hydroxychloroquine, and lopinavir/ritonavir). Compared with other drugs in the same time window,
remdesivir and lopinavir/ritonavir were associated with an increased risk of AKI in all COVID-19 patients(ROR: 3.97, 95% CI: 3.51–4.50; ROR: 4.02, 95% CI: 3.11–5.19, respectively). In COVID-19 patients with
DM, remdesivir was significantly associated with AKI (ROR: 5.65, 95% CI: 4.06–7.87)
https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.833679/full
BNPV Disproportionate Analysis contents
228 reports after administration of Paxlovid : The main reported unexpected adverse drug reaction(ADRs) were high blood pressure (n = 7), confusion (n = 5), acute kidney injuries (AKI, n = 7) and various
skin reactions (n = 22)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9990891/
Re-read these hospital reports of 2020. What caused the rise in people needing dialysis?
https://edition.cnn.com/2020/04/17/health/coronavirus-kidney-dialysis-need/index.html

Summary contents
1.

When we look at Remdesivir on its own, the most frequent symptoms are all to do with liver injury andkidney injury

2.

When we compare Remdesivir with all other drugs for a biomarker of liver injury (increasedtransaminases), we find that Remdesivir occurs in the top 0.03 % - only 1 in 3000 drugs are associatedwith such an incidence.

3.

Remdesivir belongs to a family of drugs that consistently elevate hepatic enzyme – a biomarker for liverdisease.

4.

Remdesivir belongs to a family of drugs strongly associated with symptoms of kidney disease identified
by keywords •••••“renal” / “kidney”“kidney disease”.
“nethropathy”, “nephritis”“proteinuria”“fluid retention”

8.

Tamiflu, a weaker member of the Remdesivir family, still causes significant renal and hepatic disorder.

9.

The family of drugs to which Remdesivir belongs are ANTI-RETRO-VIRAL drugs, used to treat HIV,
HEPATITUS and INFLUENZA.

Conclusion contents
Anti-retro-viral drugs used in hospitals and at home as a preventative measure, increase the incidence of acutekidney injury. It is therefore probable that many of the kidney and liver injuries occurring during the COVID“pandemic” may be due to the protocols and prophylactics used – Remdesivir, Paxlovid, Tamiflu.
People were not adequately warned of this danger – and instead were encouraged to follow “the Science”,
trading their liver and kidney function for “safety” from a disease that generated no excess mortality in 2020.
The processes by which we detoxify the body are metabolism (liver) and excretion (kidneys). Impairment of liverand kidney function prevents detoxification resulting in persistence of toxins and poisoning. This will haveproduced a host of debilitating symptoms.
The anti-retro-viral drugs are also used to treat HIV and may be responsible for a leading cause of death among
HIV infected people – namely kidney and liver failure.
https://academic.oup.com/cid/article/50/10/1387/377418,
https://onlinelibrary.wiley.com/doi/pdf/10.1111/hiv.12937

40 years ago we had the HIV “epidemic”, managed by Dr Fauci. 40 years later we have the Covid “pandemic”
managed by the same person – applying the same drugs used against HIV – with the same devastating effects
on kidney and liver function.

Appendix A

contents

REMDESIVIR EMERGENCY USE AUTHORIZATION – suspicious circumstances

https://www.science.org/content/article/very-very-bad-look-remdesivir-first-fda-approved-covid-19-drug

APPENDIX B contents

Remdesivir Trials

1.

A Randomized, Controlled Trial of Ebola Virus Disease Therapeutics
A randomized multi-intervention trial was later conducted during the EVD outbreak in the DRC. 18
Patients of any age, including pregnant women, were eligible for enrolment if they tested positive for
EBOV. Patients received standard supportive care along with an assignment to one of four treatment
arms in a 1:1:1:1 ratio. Study treatments included ZMapp (a triple monoclonal antibody), MAb114 (asingle human monoclonal antibody derived from an Ebola survivor), REGN-EB3 (a mixture of threehuman immunoglobulin G1 [IgG1] monoclonal antibodies), and intravenous remdesivir. Remdesivir
was administered at a dose of 200 mg on day 1, followed by 100 mg daily for 9–13 days. Weight-based
doses were used for paediatric patients.
The primary outcome was mortality at day 28.
Nearly 700 patients had been randomized when an interim analysis led to early cessation of the trial.
The data and safety monitoring board found higher mortality in the ZMapp and remdesivir groups
compared to the MAb114 and REGN-EB3 groups. Further, the REGN-EB3 group had met a prespecified
threshold for efficacy.
A total of 673 patients were included in the final analysis. The mean age of enrolled patients was 29
years and 56% of patients were women (6% of whom were pregnant). At day 28, mortality rates were:Remdesivir (53.1%),
ZMapp (49.7%),
MAb114 (35.1%),
REGN-EB3 (33.5%).
For Remdesivir, 85 and 29% of patients with high- and low-viral loads at baseline died, respectively.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10680050/
https://archive.ph/7WwFH#selection-5071.188-5071.253
https://carterheavyindustries.wordpress.com/2021/09/21/fauci-remdesivir/

2.

Compassionate Use of Remdesivir for Patients with Severe Covid-19

Very small sample. Not clear what caused remission – since no control group – did ventilation help
or did they recover spontaneously ? Would more have recovered without Remdesivit?

APPENDIX C contents

Python Code for Reading the Data

1. Getting frequency of each symptom of Remdesivir

2. Comparing Remdesivir with all other drugs for frequency of the symptom “transaminases increased”