Casirivimab/imdevimab

Casirivimab/imdevimab, sold under the brand name REGEN‑COV among others, is a combination medicine used for the treatment and prevention of COVID19. It consists of two human monoclonal antibodies, casirivimab and imdevimab that must be mixed together and administered as an infusion or subcutaneous injection. The combination of two antibodies is intended to prevent mutational escape. It is also available as a co-formulated product. It was developed by the American biotechnology company Regeneron Pharmaceuticals.

Casirivimab/imdevimab
REGN10933 (blue) and REGN10987 (orange) bound to SARS-CoV-2 spike protein (pink). From PDB: 6VSB, 6XDG.
Combination of
CasirivimabMonoclonal antibody against spike protein of SARS-CoV-2
ImdevimabMonoclonal antibody against spike protein of SARS-CoV-2
Clinical data
Trade namesREGEN-COV, Ronapreve
AHFS/Drugs.comMonograph
MedlinePlusa620063
License data
Pregnancy
category
  • AU: B2
Routes of
administration
Intravenous, subcutaneous injection
ATC code
Legal status
Legal status
  • AU: S4 (Prescription only)
  • CA: ℞-only / Schedule D
  • UK: POM (Prescription only)
  • US: ℞-only via emergency use authorization
  • EU: Rx-only
  • Rx-only
Identifiers
DrugBank
KEGG
Casirivimab
Monoclonal antibody
TypeWhole antibody
SourceHuman
TargetSpike protein of SARS-CoV-2
Clinical data
Other namesREGN10933
ATC code
  • None
Identifiers
CAS Number
DrugBank
UNII
KEGG
Imdevimab
Monoclonal antibody
TypeWhole antibody
SourceHuman
TargetSpike protein of SARS-CoV-2
Clinical data
Other namesREGN10987
ATC code
  • None
Identifiers
CAS Number
DrugBank
UNII
KEGG

The most common side effects include allergic reactions, which include infusion related reactions, injection site reactions, brief pain, weakness and others.

The combination is approved under the brand name Ronapreve for medical use in Japan, the United Kingdom, the European Union, and Australia.

In January 2022, the U.S. Food and Drug Administration (FDA) revised the authorizations for two monoclonal antibody treatments – bamlanivimab/etesevimab (administered together) and casirivimab/imdevimab – to limit their use to only when the recipients are likely to have been infected with or exposed to a variant that is susceptible to these treatments because data show these treatments are highly unlikely to be active against the omicron variant.

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