Potential for the Use of Tetrandrine in the Treatment of
SARS-CoV-2 Infection
It is probable from the available evidence that oral tetrandrine could
be an effective agent for the treatment of SARS-CoV-2 infection in
humans.
The level of inhibition of viral replication in lung attainable with
standard oral dosing of tetrandrine could be of value for the treatment,
or potentially the prophylaxis (pending caveats about long-term use and
toxicity) of SARS-CoV-2 infection. Prophylaxis is suggested because
early administration of tetrandrine relative to infection has been shown
to be more effective in vitro in the context of HCoV-OC43
[18] and this may also apply to SARS-CoV-2.
As tetrandrine is already licensed and used in China as an oral tablet
at the doses cited above, it is probable that these doses are safe to be
administered more widely. However, evidence of conclusive
pharmacokinetic and toxicological studies, as well as clinical trials
are required.
Additionally, as tetrandrine is likely to operate in a different manner
to antiviral agents currently being considered for the treatment of
SARS-CoV-2 infection, it might make for a suitable synergistic adjunct.
The administration of tetrandrine using inhalation by aerosol also
stands a possibility of being effective and would have the advantage of
direct delivery to the key site of infection. However, this requires
further research.