Nafamostat is a synthetic serine protease inhibitor and an anticoagulant used in haemodialysis. It induces apoptosis by upregulating TNFR1 expression, inhibits NF-κB activity by blocking IκBα phosphorylation, and can also inhibit SARS-CoV-2 and COVID-19.

Nafamostat (10-80 μg/mL, 3-48 h) treatment of MDAPanc-28 cells can inhibit NF-κB activity by blocking IκBα phosphorylation, and when the concentration reaches 80 μg/mL and the treatment time is 24-48 h, it can induce apoptosis of MDAPanc-28 cells by upregulating the expression of tumor necrosis factor receptor 1 (TNFR1). [1]

Nafamostat (10 mg/kg, intraperitoneal injection, once a day, 18 days) was used to treat A129 mice infected with Zika virus (ZIKV), and it was found that Nafamostat has a good antiviral effect in vivo. [3]