Camostat mesylate

A serine protease inhibitor.

Phase of research

Potential treatment - pre-clinical evidence

How it helps


Drug status

Used to treat other disease

Supporting references
Contradictory references
AI-suggested references
Clinical trials

General information

Camostat (mesylate) is a serine protease inhibitor. It has anti-inflammatory, antifibrotic, and potential antiviral activities (NCIt). Data of Ou et al. (2021) suggets that camostat blocks TMPRSS2 mediated viral entry at the cell membrane but does not impede TMPRSS2 mediated entry in endosomes.

Camostat mesylate on DrugBank
Camostat mesylate on PubChem
Camostat on Wikipedia


Structure image - Camostat mesylate


Supporting references

Link Tested on Impact factor Notes Publication date
The anticoagulant nafamostat potently inhibits SARS-CoV-2 infection in vitro: an existing drug with multiple possible therapeutic effects
lung epithelium-derived Calu-3 cells

10-fold less active than nafamostat mesylate

Alpha 1 Antitrypsin is an Inhibitor of the SARS-CoV2-Priming Protease TMPRSS2
TMPRSS2 Preprint
HEK-293T cell culture

inhibited TMPRSS2 proteolytic function

Generation of human bronchial organoids for SARS-CoV-2 research
human bronchial organoids May/26/2020
A SARS-CoV-2 protein interaction map reveals targets for drug repurposing
Small molecule
in silico 42.78 Apr/30/2020
SARS-CoV-2 and SARS-CoV differ in their cell tropism and drug sensitivity profiles
CaCo-2 cells

limited activity

An Enzymatic TMPRSS2 Assay for Assessment of Clinical Candidates and Discovery of Inhibitors as Potential Treatment of COVID-19
in vitro Jun/23/2020
Computational drug re-purposing targeting the spike glycoprotein of SARS-CoV-2 as an effective strategy to neutralize COVID-19
Spike protein Small molecule In silico
in silico 3.26

Predicted to bind the SARS-CoV-2 spike protein RBD.

Hydroxychloroquine-mediated inhibition of SARS-CoV-2 entry is attenuated by TMPRSS2
Spike protein TMPRSS2 Cathepsin L In vitro Mechanism
hACE2-HEK293T cells; hACE2-H1299 cells; hACE2-H1975 cells; Vero cells; Calu-3 cells; SARS-CoV-2 S pseudovirus 6.22

Acts synergistically with <a href=

Spontaneous binding of potential COVID-19 drugs (Camostat and Nafamostat) to human serine protease TMPRSS2
TMPRSS2 Small molecule In silico
in silico 6.02

Predicted to bind the active site of the TMPRSS2 protease (with less specificity than nafamostat).

SARS-CoV-2 variants B.1.351 and P.1 escape from neutralizing antibodies
Spike protein RNA Small molecule Peptide In vitro Antibody Mixed substance
Caco-2 cells; Vero cells; Sera of vaccinated individuals; (VSV) SARS-CoV-2 Spike-pseudotyped virus (WT, B.1.1.7, B.1.351, ant P.1 variants) 38.64

Camostat displayed in vitro inhibition of SARS-CoV-2 Spike-pseudotyped virus infection for all tested emergent Spike variants (B.1.1.7, B.1.351, and P.1).

Drug repurposing screens reveal cell-type-specific entry pathways and FDA-approved drugs active against SARS-Cov-2
Small molecule In vitro Screening
Huh7.5 cells; Calu-3 cells; primary normal human bronchial epithelial cells; iPSC-derived AT2 cells; SARS-CoV-2 strain USA WA1/2020 8.11

Camostat inhibited SARS-CoV-2 infection in Calu-3 cells but not in Vero or Huh7.5 cells.

Structure-based phylogeny identifies Avoralstat as a TMPRSS2 inhibitor that prevents SARS-CoV-2 infection in mice
Small molecule Enzyme assay Peptide Animal model In vitro In silico
in silico; in vitro enzyme assay; Calu-3 2B4 cells; hACE2-BALB/c mice; (VSV) SARS-CoV-2 Spike pseudovirus; SARS-CoV-2 live virus 11.86

Camostat mesylate inhibited TMPRSS2 in vitro with an IC50 of ca. 1.01 nM. It inhibited pseudoviral entry in Calu-3 cells with an EC50 of ca. 0.7 μM. The compound significantly reduced viral replication in cell culture (more than a ten-fold decrease in viral RNA signal with a 1 μM dose). It significantly reduced lung viral loads in mice after a viral challenge.


AI-suggested references

Link Publication date
Structural Basis of SARS-CoV-2- and SARS-CoV-Receptor Binding and Small-Molecule Blockers as Potential Therapeutics.
Low risk of the TMPRSS2 inhibitor camostat mesylate and its metabolite GBPA to act as perpetrators of drug-drug interactions.
Camostat mesylate against SARS-CoV-2 and COVID-19-Rationale, dosing and safety.
Camostat Mesylate May Reduce Severity of Coronavirus Disease 2019 Sepsis: A First Observation
Human airway lineages derived from pluripotent stem cells reveal the epithelial responses to SARS-CoV-2 infection
Virtual drug repurposing study against SARS-CoV-2 TMPRSS2 target
The TMPRSS2 Inhibitor Nafamostat Reduces SARS-CoV-2 Pulmonary Infection in Mouse Models of COVID-19
On a knife's edge of a COVID-19 pandemic: is containment still possible?
Computational screening of phytochemicals from three medicinal plants as inhibitors of transmembrane protease serine 2 implicated in SARS-CoV-2 infection.
Structural Basis of Covalent Inhibitory Mechanism of TMPRSS2-Related Serine Proteases by Camostat
Inhibition of SARS-CoV-2 entry through the ACE2/TMPRSS2 pathway: a promising approach for uncovering early COVID-19 drug therapies
Semi-Mechanistic Pharmacokinetic-Pharmacodynamic Model of Camostat Mesylate-Predicted Efficacy against SARS-CoV-2 in COVID-19
Pharmacological Therapeutics Targeting RNA-Dependent RNA Polymerase, Proteinase and Spike Protein: From Mechanistic Studies to Clinical Trials for COVID-19
Strong Binding of Leupeptin with TMPRSS2 Protease May Be an Alternative to Camostat and Nafamostat for SARS-CoV-2 Repurposed Drug: Evaluation from Molecular Docking and Molecular Dynamics Simulations
Structural insights and inhibition mechanism of TMPRSS2 by experimentally known inhibitors Camostat mesylate, Nafamostat and Bromhexine hydrochloride to control SARS-coronavirus-2: A molecular modeling approach.
Pharmacological Modulators of Autophagy as a Potential Strategy for the Treatment of COVID-19.
Establishment of a pseudovirus neutralization assay based on SARS-CoV-2 S protein incorporated into lentiviral particles.
Repurposing Therapeutics for Potential Treatment of SARS-CoV-2: A Review
The Anticoagulant Nafamostat Potently Inhibits SARS-CoV-2 S Protein-Mediated Fusion in a Cell Fusion Assay System and Viral Infection In Vitro in a Cell-Type-Dependent Manner
Virtual Screening of Natural Products against Type II Transmembrane Serine Protease (TMPRSS2), the Priming Agent of Coronavirus 2 (SARS-CoV-2)
Synergistic Block of SARS-CoV-2 Infection by Combined Drug Inhibition of the Host Entry Factors PIKfyve Kinase and TMPRSS2 Protease
Camostat mesylate inhibits SARS-CoV-2 activation by TMPRSS2-related proteases and its metabolite GBPA exerts antiviral activity
In Silico Molecular Characterization of Human TMPRSS2 Protease Polymorphic Variants and Associated SARS-CoV-2 Susceptibility
Metadichol : A Novel Nanolipid Formulation That Inhibits SARS-CoV-2 and a Multitude of Pathological Viruses In Vitro
Topical TMPRSS2 inhibition prevents SARS-CoV-2 infection in differentiated human airway cultures

Clinical trials

ID Title Status Phase Start date Completion date
NCT04353284 Camostat Mesylate in COVID-19 Outpatients Completed Phase 2 Jun/09/2020 Apr/22/2021
  • Alternative id - 2000027971
  • Interventions - Drug: Camostat Mesilate|Other: Placebo
  • Study type - Interventional
  • Study results - No Results Available
  • Locations - Yale University, New Haven, Connecticut, United States
  • Study designs - Allocation: Randomized|Intervention Model: Parallel Assignment|Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)|Primary Purpose: Treatment
  • Enrollment - 74
  • Age - 18 Years and older   (Adult, Older Adult)
  • Outcome measures - Change in SARS-COV-2 viral load|Change in positive COVID-19 status|Change in COVID-19 symptom severity|Change in COVID-19 symptom frequency|Change in body temperature
NCT04435015 The Utility of Camostat Mesylate in Patients With COVID-19 Associated Coagulopathy (CAC) and Cardiovascular Complications Not yet recruiting Phase 1|Phase 2 Nov/01/2021 Dec/31/2021
  • Alternative id - 2000028279
  • Interventions - Drug: Camostat Mesylate|Drug: Microcrystalline Cellulose, NF
  • Study type - Interventional
  • Study results - No Results Available
  • Locations -
  • Study designs - Allocation: Randomized|Intervention Model: Parallel Assignment|Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)|Primary Purpose: Treatment
  • Enrollment - 200
  • Age - 18 Years and older   (Adult, Older Adult)
  • Outcome measures - Percent change in plasma D-Dimer|Overall Safety and adverse event|Change in plasma Fibrinogen levels|Change in plasma troponin|New onset cardiomyopathy|Duration of intubation|Length of stay in the intensive care unit|Time to discharge from hospital|Occurrence of major adverse cardiovascular events
NCT04355052 Open Label Study to Compare Efficacy, Safety and Tolerability of Hydroxychloroquine Combined With Azithromycin Compared to Hydroxychloroquine Combined With Camostat Mesylate and to "no Treatment" in SARS CoV 2 Virus Recruiting Phase 3 Apr/11/2020 Dec/11/2020
  • Alternative id - 7092-20-SMC
  • Interventions - Drug: hydroxychloroquine in combination with camostat mesylate|Drug: Hydroxychloroquine in combination of Azithromycin
  • Study type - Interventional
  • Study results - No Results Available
  • Locations - Sheba Medical Center, Ramat Gan, Israel|Sheba Medical Center, Tel HaShomer, Israel
  • Study designs - Allocation: Randomized|Intervention Model: Single Group Assignment|Masking: None (Open Label)|Primary Purpose: Treatment
  • Enrollment - 250
  • Age - 18 Years to 120 Years   (Adult, Older Adult)
  • Outcome measures - clinical state as reflected by NEWS scoring|positive PCR|prevention of ICU|prevention of assisted ventilation|prevention of ECMO|death
NCT04608266 CAMOVID : Evaluation of Efficacy and Safety of Camostat Mesylate for the Treatment of SARS-CoV-2 Infection - COVID-19 in Ambulatory Adult Patients Terminated Phase 3 Dec/03/2020 Dec/02/2021
  • Alternative id - APHP200702
  • Interventions - Drug: Camostat Mesylate|Drug: Placebo
  • Study type - Interventional
  • Study results - No Results Available
  • Locations - Centre Hospitalier Victor Dupouy, Argenteuil, France|AP-HP Hôpital Henri Mondor, Créteil, France|Centre Hospitalier Sud Ile de France - Melun, Melun, France|AP-HP Hôpital Bichat, Paris, France|APHP - Saint Louis, Paris, France|Centre de Santé Richerand, Paris, France
  • Study designs - Allocation: Randomized|Intervention Model: Parallel Assignment|Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)|Primary Purpose: Treatment
  • Enrollment - 70
  • Age - 18 Years and older   (Adult, Older Adult)
  • Outcome measures - Hospitalization for COVID-19 deterioration or death without hospitalization|Adverse events|Serious adverse events|Investigational medication discontinuation|Hospitalization for COVID-19 deterioration or death without hospitalization, evaluated by independent adjudication comittee|Clinical improvement using the Word Health Organization (WHO) COVID-19 scale|Need for intensive care|Duration of hospitalization|Need for invasive mechanical ventilation for severe COVID-19|Need for oxygen therapy for COVID-19|Overall survival|Duration of symptoms|SARS-CoV-2 virological assessment|SARS-CoV-2 serological assessment|Peripheral blood lymphocyte phenotyping|Acute kidney failure|Renal function|Concentration of urea in blood|Concentration of potassium in blood|Liver function|Liver function (2)
NCT04681430 Reconvalescent Plasma/Camostat Mesylate Early in SARS-CoV-2 Q-PCR (COVID-19) Positive High-risk Individuals Completed Phase 2 Jan/08/2021 Oct/29/2021
  • Alternative id - RES-Q-HR|2020-004695-18
  • Interventions - Biological: Convalescent plasma|Drug: Camostat Mesilate|Drug: Placebo for Camostat Mesilate|Other: Standard of Care (SoC)
  • Study type - Interventional
  • Study results - No Results Available
  • Locations - Abteilung Infektiologie Klinik für Innere Medizin II Department Innere Medizin Universitätsklinikum Freiburg, Freiburg im Breisgau, Baden-Württemberg, Germany|Klinik und Poliklinik für Innere Medizin II Klinikum rechts der Isar Technische Universität München, München, Bavaria, Germany|Universitätsklinikum Frankfurt Medizinische Klinik 2: Hämatologie, Onkologie, Hämostaseologie, Rheumatologie, Infektiologie/HIV, Frankfurt am Main, Hessen, Germany|Universitätsklinikum Düsseldorf Klinik für Hepatologie und Infektiologie, Duesseldorf, North Rhine Westphalia, Germany|Klinikum Dortmund, Dortmund, North Rhine-Westphalia, Germany|Universitätsklinikum Essen, Essen, North Rhine-Westphalia, Germany
  • Study designs - Allocation: Randomized|Intervention Model: Parallel Assignment|Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)|Primary Purpose: Treatment
  • Enrollment - 22
  • Age - 18 Years and older   (Adult, Older Adult)
  • Outcome measures - WHO ordinal Covid-19 scale up to day 28|Cumulative number WHO categories 4b-8|Cumulative number WHO categories 3-4a|Not hospitalized|All-cause mortality|Reinfection|Secondary sclerosing cholangitis (SSC)|chronic pulmonary disease as sequelae from COVID-19|patients with remdesivir treatment|COVID-19 WHO status of patients at start of remdesivir treatment|patients with dexamethasone treatment|COVID-19 WHO status of patients at start of dexamethasone treatment|resolution of COVID-19 symptoms|negative SARS-CoV-2-PCR test|Oxygen therapy|COVID-19 pneumonia|Percentage of participants requiring mechanical ventilation|Number of ventilation days per participant up to day 90|hospital stay and intensive care|Mortality|SAEs|Grade 3/4 AEs|SARS-CoV-2 antibody IgA concentrations|SARS-CoV-2 antibody IgG concentrations|SARS-CoV-2 neutralizing antibody titers|Plasma treatment screening failures