Cepharanthine: A Review of the Antiviral Potential of a Japanese-Approved Alopecia Drug in COVID-19

Three years ago, a review was conducted on Cepharanthine (CEP), a naturally occurring alkaloid derived from Stephania cepharantha Hayata, which has anti-inflammatory, antioxidative, immunomodulating, antiparasitic, and antiviral properties. The review highlighted CEP's potential as an antiviral agent in combating COVID-19, caused by the SARS-CoV-2 virus. CEP suppresses nuclear factor-kappa B (NF-κB) activation, lipid peroxidation, nitric oxide (NO) production, cytokine production, and expression of cyclooxygenase, all of which are crucial to viral replication and inflammatory response. Against SARS-CoV-2 and similar viruses, CEP predominantly inhibits viral entry and replication at low doses. It was identified as the most potent coronavirus inhibitor among 2,406 clinically approved drug repurposing candidates in a preclinical model.