Camostat mesylate is a synthetic serine protease inhibitor with potent anti-inflammatory and anti-fibrotic properties. It primarily acts by inhibiting transmembrane protease serine 2 (TMPRSS2), trypsin, and other proteases. In the Indian context, it is primarily used for the management of chronic pancreatitis and associated pain, and has gained significant attention for its potential role in modulating viral entry mechanisms, though this remains an off-label use.
Adult: 100-200 mg orally three times daily (300-600 mg/day). The standard Indian regimen often starts at 100 mg TDS.
Note: Administer orally with a glass of water, preferably after meals to improve gastrointestinal tolerance and reduce nausea. The tablet should be swallowed whole, not crushed or chewed.
Camostat is a potent, low-molecular-weight inhibitor of several serine proteases. Its primary therapeutic action in pancreatitis is the inhibition of trypsin, kallikrein, fibrinolysin, and thrombin within the pancreas and systemically. By inhibiting trypsin, it prevents the auto-activation cascade of pancreatic zymogens that leads to autodigestion, inflammation, and pain. It also inhibits the formation of kinins (via kallikrein inhibition), reducing vascular permeability, edema, and pain.
Pregnancy: Category N (Not classified by US FDA). Animal studies are insufficient. Use only if potential benefit justifies potential risk to the fetus. Not recommended during pregnancy.
Driving: Camostat may cause dizziness. Patients should be cautioned about operating machinery or driving if they experience this effect.
| Warfarin, Acenocoumarol | Increased risk of bleeding due to additive anticoagulant effect. Camostat has anti-thrombin and anti-fibrinolytic activity. | Major |
| Other Antiplatelets (Clopidogrel, Aspirin) | Potential additive effect on bleeding risk. Monitor for bruising, bleeding time. | Moderate |
| Protease Inhibitors (e.g., Ritonavir, Nelfinavir) | Theoretical interaction as both are protease inhibitors. Clinical significance unknown. | Minor |
| Antacids, H2 Blockers, PPIs | No significant pharmacokinetic interaction expected. May be used together for symptomatic relief in pancreatitis. | Minor |
Same composition (Camostat (100mg)), different brands: