Table 4. Open in new tab Antiviral...

Agent

Pediatric Dose/Duration

Comment

Remdesivir

Pediatric and adult dosing (verify dosing and preparation with manufacturer) • <40 kg: 5 mg/kg IV loading dose on day 1; followed by 2.5 mg/kg IV every 24 hours • ≥40 kg: 200 mg IV loading dose on day 1; followed by 100 mg IV every 24 hours Recommended duration • Up to 10 days, with 5-day duration favored for fast responders (5- vs 10-day duration being studied in clinical trials)

Available through single-patient expanded-access requests for children (as of 14 April 2020). Children aged >12 years are also eligible for clinical trials at certain sites (NCT04292730 and NCT04292899).

Hydroxychloroquine

Adults • 800 mg PO followed by 400 mg PO at 6, 24, and 48 hours after initial dose (duration could be extended for up to 5 days on a case-by-case basis) or • 400 mg PO BID on day 1, followed by 200 mg PO BID for up to 5 days Infants, children, and adolescents • 13 mg/kg (maximum: 800 mg) PO followed by 6.5 mg/kg (maximum: 400 mg) PO at 6, 24, and 48 hours after initial dose (duration could be extended for up to 5 days on a case-by-case basis) or • 6.5 mg/kg/dose (maximum: 400 mg/dose) PO BID on day 1, followed by 3.25 mg/kg/dose (maximum: 200 mg/dose) PO BID for up to 5 days Neonates • Dosing not established; consider use on a case-by-case basis Recommended duration • No more than 5 days. The duration studied for acute malaria is 3 days.

Consider use if patient not a candidate for remdesivir. Recommend against combination therapy with azithromycin.

Lopinavir- ritonavir

Adults • Lopinavir 400 mg/ritonavir 100 mg (2 tablets) PO twice daily Neonates aged ≥14 days and postmenstrual age ≥42 weeks to children aged <18 years • Lopinavir 300 mg/m² (maximum 400 mg/dose) PO twice daily Recommended duration • 7–14 days

Panel was divided on whether lopinavir-ritonavir should/could be considered for any patient with coronavirus disease 2019. Recommend against combination therapy with ribavirin.

Table 4.

Open in new tab

Antiviral Agents

Agent	Pediatric Dose/Duration	Comment
Remdesivir	Pediatric and adult dosing (verify dosing and preparation with manufacturer) • <40 kg: 5 mg/kg IV loading dose on day 1; followed by 2.5 mg/kg IV every 24 hours • ≥40 kg: 200 mg IV loading dose on day 1; followed by 100 mg IV every 24 hours Recommended duration • Up to 10 days, with 5-day duration favored for fast responders (5- vs 10-day duration being studied in clinical trials)	Available through single-patient expanded-access requests for children (as of 14 April 2020). Children aged >12 years are also eligible for clinical trials at certain sites (NCT04292730 and NCT04292899).
Hydroxychloroquine	Adults • 800 mg PO followed by 400 mg PO at 6, 24, and 48 hours after initial dose (duration could be extended for up to 5 days on a case-by-case basis) or • 400 mg PO BID on day 1, followed by 200 mg PO BID for up to 5 days Infants, children, and adolescents • 13 mg/kg (maximum: 800 mg) PO followed by 6.5 mg/kg (maximum: 400 mg) PO at 6, 24, and 48 hours after initial dose (duration could be extended for up to 5 days on a case-by-case basis) or • 6.5 mg/kg/dose (maximum: 400 mg/dose) PO BID on day 1, followed by 3.25 mg/kg/dose (maximum: 200 mg/dose) PO BID for up to 5 days Neonates • Dosing not established; consider use on a case-by-case basis Recommended duration • No more than 5 days. The duration studied for acute malaria is 3 days.	Consider use if patient not a candidate for remdesivir. Recommend against combination therapy with azithromycin.
Lopinavir- ritonavir	Adults • Lopinavir 400 mg/ritonavir 100 mg (2 tablets) PO twice daily Neonates aged ≥14 days and postmenstrual age ≥42 weeks to children aged <18 years • Lopinavir 300 mg/m² (maximum 400 mg/dose) PO twice daily Recommended duration • 7–14 days	Panel was divided on whether lopinavir-ritonavir should/could be considered for any patient with coronavirus disease 2019. Recommend against combination therapy with ribavirin.

Agent	Pediatric Dose/Duration	Comment
Remdesivir	Pediatric and adult dosing (verify dosing and preparation with manufacturer) • <40 kg: 5 mg/kg IV loading dose on day 1; followed by 2.5 mg/kg IV every 24 hours • ≥40 kg: 200 mg IV loading dose on day 1; followed by 100 mg IV every 24 hours Recommended duration • Up to 10 days, with 5-day duration favored for fast responders (5- vs 10-day duration being studied in clinical trials)	Available through single-patient expanded-access requests for children (as of 14 April 2020). Children aged >12 years are also eligible for clinical trials at certain sites (NCT04292730 and NCT04292899).
Hydroxychloroquine	Adults • 800 mg PO followed by 400 mg PO at 6, 24, and 48 hours after initial dose (duration could be extended for up to 5 days on a case-by-case basis) or • 400 mg PO BID on day 1, followed by 200 mg PO BID for up to 5 days Infants, children, and adolescents • 13 mg/kg (maximum: 800 mg) PO followed by 6.5 mg/kg (maximum: 400 mg) PO at 6, 24, and 48 hours after initial dose (duration could be extended for up to 5 days on a case-by-case basis) or • 6.5 mg/kg/dose (maximum: 400 mg/dose) PO BID on day 1, followed by 3.25 mg/kg/dose (maximum: 200 mg/dose) PO BID for up to 5 days Neonates • Dosing not established; consider use on a case-by-case basis Recommended duration • No more than 5 days. The duration studied for acute malaria is 3 days.	Consider use if patient not a candidate for remdesivir. Recommend against combination therapy with azithromycin.
Lopinavir- ritonavir	Adults • Lopinavir 400 mg/ritonavir 100 mg (2 tablets) PO twice daily Neonates aged ≥14 days and postmenstrual age ≥42 weeks to children aged <18 years • Lopinavir 300 mg/m² (maximum 400 mg/dose) PO twice daily Recommended duration • 7–14 days	Panel was divided on whether lopinavir-ritonavir should/could be considered for any patient with coronavirus disease 2019. Recommend against combination therapy with ribavirin.

Abbreviations: BID, twice daily; IV, intravenous; PO, by mouth (per oral).

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