Nafamostat
Nafamostat is a serine protease inhibitor primarily used in the treatment of acute pancreatitis and disseminated intravascular coagulation. It is a synthetic anticoagulant with multiple targets, including thrombin, plasmin, and kallikrein. Nafamostat is also known for its antiviral properties, particularly against SARS-CoV-2, the virus responsible for COVID-19.
Pharmacology
Nafamostat functions by inhibiting various serine proteases, which are enzymes that cleave peptide bonds in proteins. Its anticoagulant properties are due to its ability to inhibit thrombin and plasmin, two key enzymes in the coagulation cascade. By inhibiting these enzymes, Nafamostat prevents the formation of blood clots, which can be beneficial in conditions such as disseminated intravascular coagulation.
Clinical Use
Nafamostat is primarily used in the treatment of acute pancreatitis and disseminated intravascular coagulation. It is also used as an anticoagulant in patients undergoing hemodialysis. More recently, Nafamostat has been investigated for its potential use in the treatment of COVID-19. It has been found to inhibit SARS-CoV-2 by blocking the TMPRSS2 enzyme, which the virus uses to enter human cells.
Side Effects
Like all medications, Nafamostat can cause side effects. These may include hypotension (low blood pressure), hyperkalemia (high potassium levels in the blood), and nausea. In rare cases, it can cause serious allergic reactions.
Research
Research into the use of Nafamostat for the treatment of COVID-19 is ongoing. Early studies suggest that it may be effective in inhibiting SARS-CoV-2, but more research is needed to confirm these findings and to determine the optimal dosage and treatment duration.
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Contributors: Prab R. Tumpati, MD