Dipyridamole, a vasodilator and antiplatelet drug, has been proposed as a possible COVID-19 therapeutic.
Mechanism of potential benefit
Dipyridamole is said to "[have the] potential to inhibit multiple processes that have been recently linked to COVID-19 severity," such as purinergic signaling (related to inflammation and thrombosis), and may help induction of type 1 IFNs.
Dipyridamole has also been shown to have direct anti-viral effects against SARS-CoV-2, showing anti-SARS-CoV-2 activity in vitro in Vero cells. Dipyridamole's anti-SARS-CoV-2 activity may occur via binding to the SARS-CoV-2 protease Mpro (see Fig. 1B).
- Yogendra Kanthi, Jason S. Knight, et. al: "New (re)purpose for an old drug: purinergic modulation may extinguish the COVID-19 thromboinflammatory firestorm"
- "Potential therapeutic effects of dipyridamole in the severely ill patients with COVID-19"
A list of clinical trials of dipyridamole for COVID-19:
- Dipyridamole to Prevent Coronavirus Exacerbation of Respiratory Status (DICER) in COVID-19 (DICER). Intervention: Dipyridamole 100mg po 4 times a day
- Aggrenox To Treat Acute Covid-19 (ATTAC-19) Intervention: Dipyridamole ER 200mg/ Aspirin 25mg bid for 2 weeks.
- Trial of Open Label Dipyridamole- In Hospitalized Patients With COVID-19 (TOLD). Intervention: Dipyridamole 100mg 3 times a day for 7 days
A proof-of-concept trial of 31 COVID-19 patients was carried out in China in early 2020, finding signs of potential benefit.