The Science behind Canoxidin®

Canoxidin: the premier, clinically validated solution for preventing complications associated with indwelling urological devices.

The use of indwelled urological devices is frequently linked to a variety of clinical complications:

  • Catheter-associated Urinary Tract Infections (CaUTIs).
  • Obstructions that prevent the complete voiding of urine.
  • Development of encrustations and incrustations, which can impede voiding, complicate device removal, and potentially result in renal failure or death.
  • Noninfectious issues, including bladder spasms, urgency, hematuria (blood in the urine), leakage, pain, and localised skin trauma.

Patients prone to stone formation exhibit a higher susceptibility to these complications, and the risk of encrustation increases with the duration of device use (1). Statistical data indicates that among patients with long-term catheters, up to 70% experience CAUTIs and approximately 50% encounter catheter blockages (2).

Unique Combination of Active Ingredients

  • Canoxidin® decreases more than 8 times the probability of severe to complete blockage of urological devices (11).
  • Canoxidin® significantly reduced overall incrustation (11).
  • Canoxidin® allows safer and longer indwelling time of urological devices.

How Canoxidin Works to Prevent Stent Encrustation

Canoxidin uses a dual mechanism of action to reduce bacterial growth and prevent mineral deposits (encrustation) on urinary stents and other indwelling urological devices.

Process of Stent Encrustation

  • Device insertion → Bacterial contamination can occur.
  • Conditioning film forms → Proteins and organic molecules coat the device surface.
  • Urine becomes more alkaline (due to urease-producing bacteria), promoting crystal formation.
  • Canoxidin action: L-methionine acidifies the urine, helping prevent this pH increase.
  • Crystal deposition (heteronucleation) → Minerals, ions, and organic matter accumulate on the device.
  • Canoxidin action: Phytate and theobromine inhibit crystal formation and growth.
  • Outcome if untreated → Encrustation can lead to blockage and leakage of the stent.

Canoxidin targets two critical steps in stent encrustation

Urine acidification (L-methionine) to reduce conditions that favour crystal formation

Crystal growth inhibition (phytate and theobromine) to prevent mineral deposition on the device.

How Canoxidin Helps Prevent Foley Catheter Encrustation and CaUTI

Canoxidin works by interrupting the key steps that lead to catheter blockage and infection through a dual mechanism: urine acidification and inhibition of crystal formation.

Process of Encrustation

Catheter insertion introduces bacteria (with intermittent catheters, new contamination may occur at each catheterization).

Conditioning film formation occurs as proteins and organic molecules coat the catheter surface.

Bacterial adhesion by urease-producing organisms (e.g., Proteus, Klebsiella, and Morganella) raises urine pH (alkalinisation).

Canoxidin action: L-methionine acidifies the urine, counteracting this pH increase.

Bacteria-induced crystal deposition begins on the catheter surface.

Canoxidin action: Phytate and theobromine inhibit crystal formation and growth.

Without intervention, crystal buildup can lead to partial or complete catheter blockage, resulting in: Incomplete bladder emptying, Bacteriuria and Catheter-associated urinary tract infection (CAUTI).

Canoxidin targets two critical steps in encrustation

Helps prevent catheter encrustation by acidifying urine (L-methionine)

Inhibits crystal formation (phytate and theobromine), reducing the risk of blockage and subsequent catheter-associated urinary tract infections.

8-Fold Reduction in Global Encrustations

“These results demonstrate an 8-fold reduction in global encrustation for the [Canoxidin] experimental group, together with a striking reduction in the degree of such encrustation in every analysis, when considering distinct stent ends or the sum of all ends… The use of an oral composition [Canoxidin] in patients indwelling a double J ureteral stent resulted in fewer stent encrustations.” (11)

Torrecilla et al.,BMC Urol. 2020

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10-Fold Reduction in Encrustation Formation

This study of patients who had indwelling Foley catheters showed that Canoxidin® reduced the formation of encrustations (10-fold reduction) with an excellent short-term safety profile. (12)

Evidence from Borau et al., Actas Urol Esp., 2024

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References
  1. Vanderbrink BA, Rastinehad AR, Ost MC, Smith AD. Encrusted urinary stents: evaluation and endourologic management. J Endourol. 2008 May;22(5):905-12. doi: 10.1089/end.2006.0382. PMID: 18643720.
  2. Nicolle LE. Catheter associated urinary tract infections. Antimicrob Resist Infect Control. 2014;3:23. Published 2014 Jul 25. doi:10.1186/2047-2994-3-23
  3. Barros, A. A., et al. Ureteral Stents Technology: Biodegradable and Drug-Eluting Perspective. Reference Module in Materials Science and Materials Engineering Comprehensive Biomaterials II, Volume 7, 2017, Pages 793-812.
  4. Türk C, et al. Guidelines on Urolithiasis. European Association of Urology 2016. Update 2018 https://uroweb.org/guideline/urolithiasis/#4
  5. Siener R, Struwe F, Hesse A. Effect of L-Methionine on the Risk of Phosphate Stone Formation. Urology. 2016 Dec;98:39-43.
  6. Grases F., Ramis, M., Costa-Bauza, A. Effects of phytate and pyrophosphate on brushite and hydroxyapatite crystallization – Comparison with the action of other polyphosphates, Urol. Res. 2000, 28, 136–140.
  7. Conte et al, Urinary lithogenic risk test: Usefulness in the evaluation of renal lithiasis treatment using crystallization inhibitors (citrate vs phytate), Arch. Esp. Urol. 52, 3 (305-3/0), 1999.
  8. Curhan et al, Dietary factors and the risk of incident Kidney Stones in Younger Women. Arch Intern Med. 2004;164:885-891.
  9. Grases F, Rodríguez A, Costa-Bauza A. et al. Theobromine inhibits uric acid crystallization. A potential application in the treatment of uric acid nephrolithiasis. PLoS ONE 9(10): e111184.
  10. Hernandez Y, et al. Comparison of Two Dietary Supplements for Treatment of Uric Acid Renal Lithiasis: Citrate vs. Citrate + Theobromine. Nutrients 2020.
  11. Torrecilla C, et al. Reduction of ureteral stent encrustation by modulating the urine pH and inhibiting the crystal film with a new oral composition: a multicenter, placebo controlled, double blind, randomized clinical trial. BMC Urol. 2020 Jun 5;20(1):65.
  12. A. Borau, E. Amaya, P. Delía et al., Single-center, double-blind, randomized, placebo-controlled pilot study of Canoxidin® for prevention of catheter encrustation in patients with indwelling catheters, Actas Urológicas Españolas, https://doi.org/10.1016/j.acuroe.2024.06.004