N,N-Dimethylsphingosine is a potent and specific inhibitor of sphingosine kinase, the key enzyme in the phosphorylation of sphingosine to sphingosine-1-phosphate. It has also been reported to inhibit protein kinase C (another enzyme that is responsible for phosphorylating amino acids) in certain types of cells.1 It induces apoptosis (including in a number of cancer cell lines), possibly due to the inhibition of sphingosine-1-phosphate synthesis and the resulting increase in ceramides. It acts as a stereospecific enhancer for epidermal growth factor receptor kinase.2 At very low doses N,N-dimethylsphingosine protects the heart against ischemia/reperfusion injury due to its activating sphingosine kinase (via PKCε) which is critical for myocardial ischemic preconditioning.3 It can help prevent neointimal hyperplasia, which may be the result of inhibiting ERK-1/2 and Akt signalling, and modulation of smooth muscle growth.4