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

The document reviews the potential of cepharanthine (CEP), a drug approved in Japan for alopecia, as an antiviral agent against COVID-19. CEP has demonstrated anti-inflammatory, antioxidative, immunomodulating, antiparasitic, and antiviral properties, and has been identified as a potent inhibitor of coronavirus in preclinical models, particularly in blocking viral entry and replication at low doses. It has shown effectiveness against various viruses, including HIV, HTLV, HBV, SARS-CoV, and SARS-CoV-2, and has been found to work synergistically with other antiviral agents. CEP's safety profile and potential for oral administration with minimal toxicity make it a strong candidate for repurposing as a COVID-19 treatment. However, further in vivo testing and clinical trials are necessary to confirm its effectiveness. Additionally, cepharanthine has been found to inhibit lipid peroxidation, stabilize cell membranes, prevent radiation-induced tissue damage, treat chronic idiopathic thrombocytopenic purpura, suppress angiogenesis and tumorigenicity in certain cancer cells, enhance autophagy in apoptosis-defective cells, and inhibit multidrug resistance in cancer therapy. These findings support the rationale for investigating cepharanthine as a potential COVID-19 treatment.