Index of Herbs

Herbal formula

Canephron (BNO 1045)

Also known as Canephron N, Canephron N Dragees, Canephron N Tropfen, Canephron Uno, BNO 1045, centaury, lovage, and rosemary tablets

A German three-herb tablet for mild cystitis that spared antibiotics in most women in one trial, but eased symptoms more slowly.

Main use: Mild uncomplicated cystitis (bladder infection) in women

Early or mixed evidence

3 ingredients

Updated October 22, 2026

Key points

  1. 01

    Three powdered herbs in equal parts

    Each Canephron N tablet holds 18 mg each of centaury herb, lovage root, and rosemary leaf. Canephron Uno has 36 mg of each per tablet, and the drops are an alcoholic extract of the same mixture.

  2. 02

    Close to an antibiotic on one measure, worse on others

    In 659 women with cystitis, 16.5% on Canephron and 10.2% on single-dose fosfomycin needed more antibiotics. That passed a loose 15-point margin, but early relief and bacterial clearance favored fosfomycin.

  3. 03

    A kidney infection signal

    Five women on Canephron developed pyelonephritis versus one on fosfomycin, a difference that was not statistically significant. Pooled trials show that avoiding immediate antibiotics raises the risk of kidney infection.

  4. 04

    Registered on tradition, studied by its maker

    In the European Union it is a traditional herbal medicine, registered on long use rather than proven efficacy. Bionorica sponsored the main trial, and company employees helped design and analyze it.

  5. 05

    Fluids, red flags, and who should avoid it

    Not for edema from heart or kidney failure, fluid restriction, stomach ulcers, carrot-family or anethole allergy, or under 12. Fever, flank pain, or blood in the urine needs a doctor. The drops contain alcohol.

Canephron N is a German herbal medicine for mild bladder complaints made by Bionorica SE of Neumarkt, Bavaria, the company that also makes Sinupret. Every version combines the same three dried plants in equal parts: centaury herb, lovage root, and rosemary leaf. Canephron N Dragees, orange coated tablets, contain 18 mg of each powdered herb; Canephron Uno tablets contain 36 mg of each; and Canephron N Tropfen are drops made from a water-and-alcohol extract of the same mixture. In research papers the tablet is known by its code, BNO 1045. In Germany all three are sold in pharmacies without a prescription, and the authors of the main trial reported in 2018 that the product was approved in 28 countries, including Germany and Ukraine. Much of its older research comes from Eastern Europe and Central Asia.

Canephron is not licensed on proof of efficacy. In Germany and Sweden it is registered as a traditional herbal medicinal product, a European Union category that requires evidence of long medicinal use and acceptable quality, but not clinical trials. The German leaflet states that it is registered for its indication “exclusively on the basis of long-standing use”: supportive treatment, alongside specific measures, of mild complaints in inflammatory diseases of the lower urinary tract, and flushing of the urinary tract to reduce deposits of kidney gravel. Sweden’s Medical Products Agency registered the tablets in December 2014, after accepting evidence of at least 30 years of use, including 15 in the EU, for relieving symptoms of recurrent mild lower urinary tract infections in women and for preventing recurrent kidney stones, always with generous fluid intake and only after a doctor has excluded serious disease. The European Medicines Agency (EMA) has written no monograph on the three-herb combination, although it has separate monographs on each herb. EMA’s 2012 assessment of lovage root noted that the United Kingdom had recently registered a tablet of the same three herbs for minor urinary complaints associated with cystitis in women only, but no product containing lovage or centaury appears in the October 2025 list of traditional herbal registrations kept by the Medicines and Healthcare products Regulatory Agency (MHRA).

Unusually for a traditional product, Canephron has also been tested in a large randomized controlled trial (a study that assigns treatments by chance) against an antibiotic, and that trial is the reason it appears in European urology guidelines. The real question it raises is not only whether the herbs do anything, but whether taking a herbal product instead of an antibiotic for a bladder infection is a good trade: fewer antibiotics overall, in exchange for slower relief and a small extra risk of a kidney infection. How the herbs might work is not settled. The German prescribing information for the drops cites laboratory and animal experiments suggesting anti-inflammatory, antispasmodic, pain-relieving, and antibacterial effects, while Sweden’s assessors concluded that the mechanism cannot be considered clarified. This page covers what is in each version, what the trials found, how it is taken, and when it should not be used. The results belong to the product, not to centaury, lovage, or rosemary on their own. Nothing here is medical advice.

See also

Herbs for Urinary Tract Health

02 The blend

What’s in it

Ingredients in label order. Results from trials of this formula belong to the combination, not to any single herb in it.

  1. Centaury · Herb (flowering aerial parts)

    18 mg powdered herb per Canephron N tablet (36 mg per Canephron Uno tablet)

    Centaurium erythraea

    Centaurium erythraea, an intensely bitter herb of the gentian family. On its own, the European Medicines Agency (EMA) accepts centaury only as a traditional remedy for mild indigestion and temporary loss of appetite, not for urinary complaints, and it has never been tested alone in a published clinical trial. Its share of Canephron’s effect cannot be separated from the other two herbs.

    Read the centaury monograph →

  2. Lovage · Root

    18 mg powdered root per Canephron N tablet (36 mg per Canephron Uno tablet)

    Levisticum officinale

    Levisticum officinale, a celery-scented plant of the carrot family (Apiaceae). EMA accepts lovage root tea, 4–6 g a day, as a traditional remedy to increase urine flow and flush the urinary tract in minor urinary complaints. The labeled Canephron dose supplies 108 mg a day, a small fraction of that tea dose. Lovage is the reason for the product’s warning about allergy to Apiaceae plants and anethole.

    Read the lovage monograph →

  3. Rosemary · Leaf

    18 mg powdered leaf per Canephron N tablet (36 mg per Canephron Uno tablet)

    Salvia rosmarinus

    Rosmarinus officinalis, now classified by botanists as Salvia rosmarinus. Sweden’s Medical Products Agency confirmed that all three herbs in Canephron meet their European Pharmacopoeia quality standards and are simply dried and milled for the tablets. As with the other two herbs, there are no trials of rosemary leaf on its own for urinary infections.

    Read the rosemary monograph →

03 Evidence

What the research shows

Early or mixed evidence

Our rating for mild uncomplicated cystitis (bladder infection) in women, based on trials of this combination.

The key study is a trial sponsored by Bionorica and published by Wagenlehner and colleagues (Urologia Internationalis 2018). At 51 centers in Germany, Poland, and Ukraine, 659 women aged 18 to 70 with typical symptoms of a new, uncomplicated bladder infection that had begun no more than six days earlier were randomized to Canephron N tablets, two tablets three times a day for seven days (325 women), or a single 3 g dose of the antibiotic fosfomycin trometamol (334 women). The trial was double-blind and double-dummy: each woman also took a dummy version of the treatment she was not getting, so neither patients nor doctors knew who had which. Women with signs of a kidney infection or a complicated infection, a history of recurrent infections, or antibiotic use in the previous 30 days were excluded, and paracetamol was the only extra medicine allowed for symptoms. The main outcome was the share of women who needed an additional antibiotic for their infection by day 38. Among women who followed the protocol, 83.5% on Canephron and 89.8% on fosfomycin needed none, a difference of 6.3 percentage points (95% confidence interval 0.5 to 12.0 points in favor of fosfomycin); across all randomized women it was 8.3 points (2.7 to 13.8). Because the worst plausible difference stayed inside the 15-point margin set in advance, the authors declared Canephron “non-inferior,” meaning not unacceptably worse. The paper itself says this margin was chosen “instead of the 10% that is usually applied,” and against a 10-point margin the result would not have qualified. Bionorica employees were involved in the design, data collection, analysis, and interpretation, and the academic authors Florian Wagenlehner and Kurt Naber reported consulting fees from the company.

The other results were less favorable to the herbal product. On the Acute Cystitis Symptom Score, a questionnaire on which women rate six typical symptoms from 0 (none) to 3 (severe), the average score fell from 10.2 to 5.1 with Canephron and from 10.1 to 4.5 with fosfomycin by day 4, a small but statistically significant advantage for the antibiotic. By the end of treatment both groups averaged 2.1, and by day 38, 0.8 and 0.9. At the end of treatment, 31.1% of women on Canephron and 36.7% on fosfomycin had no significant bacteria in their urine, again favoring the antibiotic. About a quarter of the women had negative urine cultures at the start, so not everyone enrolled had a confirmed bacterial infection, and whether a woman took extra antibiotics was based partly on self-report. Five women on Canephron (1.5%) developed pyelonephritis (a kidney infection), one of them moderate and classed as serious, compared with one woman on fosfomycin (0.3%). The difference was not statistically significant, three of the five cases appeared on the day of enrollment or the day after, and the authors called for further study. Stomach and gut complaints were less common with Canephron (4.0% versus 6.6%), and no one died or stopped treatment because of a treatment-related side effect.

Independent pooled evidence puts the trial in context. Kaußner and colleagues (Clinical Microbiology and Infection 2022), funded by Germany’s Federal Ministry of Education and Research, analyzed individual data from 3,524 women in eight randomized trials that compared ways of avoiding immediate antibiotics, including painkillers, herbal products, delayed prescriptions, and placebo, with immediate antibiotics. Those strategies cut overall antibiotic use by 63%, but raised the odds of incomplete recovery about threefold (odds ratio 3.0), of later antibiotic treatment 3.5-fold, and of pyelonephritis 5.6-fold. Both major guidelines draw on this work. The European Association of Urology (EAU) guideline on urological infections (limited update, March 2026) strongly recommends using non-antibiotic options as an alternative to antibiotics in women who are not elderly, with shared decision-making, while warning that such strategies “may involve accepting a higher symptom burden and a slightly increased risk of complications such as pyelonephritis.” The German S3 guideline on uncomplicated urinary tract infections in adults (AWMF 043-044, 2024) says antibiotics should be recommended for acute uncomplicated cystitis, but that non-antibiotic treatment alone should be considered as an alternative for patients who are not elderly; its evidence table lists BNO 1045 among the options and reports that 84% of women avoided antibiotics with it. Wagenlehner sits on the EAU guideline panel and in the German guideline group and declared ties to Bionorica, as did other members; the German group had members with moderate conflicts abstain from votes on related recommendations.

For preventing repeat infections, the evidence is smaller and less rigorous. In an open-label trial (one in which everyone knows who gets what) at the Institute of Urology in Kyiv, Sabadash and Shulyak (Clinical Phytoscience 2017) gave 90 women aged 18 to 45 with recurrent E. coli cystitis seven days of the antibiotic ofloxacin, and half of them also took Canephron N, two tablets three times a day, for three months. Recurrences were 8.9% versus 17.8% at six months and 15.5% versus 35.5% at 12 months, both statistically significant. The authors declared no competing interests and named the lack of blinding as a limitation. The EAU guideline relies on this trial for a weak recommendation that patients may be advised to use the combination to reduce recurrent cystitis and antibiotic use. Germany’s Institute for Quality and Efficiency in Health Care (IQWiG), assessing herbal products for recurrent bladder infections in 2022, found only a “hint” of added benefit for the lovage, rosemary, and centaury preparation combined with antibiotics, based on a single study, no hint of benefit for specific symptoms, and no adverse event data for that comparison. The German S3 guideline states that no long-term prevention studies with valid data exist for diuretic herbal remedies, explicitly including lovage root with rosemary and centaury. A small open-label Russian trial (Amdiy and colleagues, Urologiia 2025) reported recurrences within a year in 13.9% of 36 women given antibiotics plus a month of Canephron N, compared with 38.7% of 31 women given antibiotics alone, after five control patients were lost following randomization.

The rest of the research is mixed in quality. A Bionorica-funded analysis of German medical practice records (Höller and colleagues, Antibiotics 2021), in which three of the six authors were company employees, compared 2,320 patients prescribed Canephron with 158,592 prescribed antibiotics for cystitis between 2016 and mid-2019. The Canephron group had fewer recurrences and fewer antibiotic prescriptions over the following year, with no difference in pyelonephritis, but people given a herbal product instead of an antibiotic probably differed in ways a records study cannot fully adjust for. After urogynecological surgery, Polish trials found no significant difference in urinary infections between three weeks of Canephron drops and three days of ciprofloxacin (562 women; 13.6% versus 11.0%) or between two weeks of Canephron and a single dose of fosfomycin (125 women), while in a third trial another herbal product, Femistina, outperformed Canephron drops (6.3% versus 15.6% of 320 women). Naber’s 2013 review of 17 studies from Eastern Europe and Central Asia, covering 3,115 patients, reported benefits and only one adverse effect, a skin rash, but cautioned that some studies were poorly designed. A 2026 meta-analysis by Ak and colleagues of 12 studies with 3,821 patients called Canephron an effective and safe alternative to antibiotics, but it pooled very different designs and comparators, and it described the Ukrainian add-on result as non-inferiority to antibiotics even though both groups in that trial received an antibiotic. No placebo-controlled trial of Canephron for an active bladder infection was found for this page, nor a Cochrane review, and there are no trials of centaury, lovage, or rosemary on their own for urinary infections.

04 In practice

How it is taken

Three German forms are sold, and they are not identical. Canephron N Dragees are orange coated tablets containing 18 mg each of powdered centaury herb, lovage root, and rosemary leaf; adolescents from 12 and adults take two tablets three times a day, swallowed whole with some liquid. Canephron Uno tablets contain 36 mg of each herb and are taken one tablet three times a day, so the daily amount, 108 mg of each herb, is the same. Canephron N Tropfen are drops made from a 1:56 extract of the three herbs in equal parts, using 59% ethanol and then purified water; the dose from age 12 is 5 ml three times a day, shaken before use, and each 5 ml contains 760 mg of alcohol (19% by volume). The BNO 1045 trial tested the Dragees at two tablets three times a day for seven days, and the prevention trial used the same dose for three months. Labels outside Germany differ: the Russian-language leaflet used in Russia and several neighboring countries allows one tablet three times a day for children aged 6 to 11, while Sweden’s regulator does not recommend the tablets for anyone under 18 with urinary symptoms.

Every label stresses plenty of fluid, because the product is meant to flush the urinary tract, and that is also why it must not be used by people who have been told to restrict fluids. The German tablet leaflet sets no fixed limit on how long Canephron N can be taken, but says to see a doctor if symptoms get worse or do not improve after about seven days. The newer Canephron Uno label is stricter: see a doctor if there is no improvement after about three days, and do not self-treat for more than two weeks. In the prevention studies, women took it for one to three months alongside or after antibiotics, which is a different use from taking it instead of one. The tablets contain glucose, sucrose, and lactose, about 0.2 g of available carbohydrate per tablet, which matters for people with diabetes who count carbohydrates and for those with hereditary sugar intolerances.

If you are thinking about Canephron instead of an antibiotic for a bladder infection, the evidence covers only a narrow situation: a woman who is not pregnant and not elderly, otherwise healthy, with typical mild cystitis symptoms, no fever or back pain, and a clear plan to get an antibiotic if things do not improve. In the main trial about one woman in six on Canephron ended up needing an antibiotic anyway. Kaußner’s pooled analysis found that, without immediate antibiotics, women with red blood cells in the urine and a positive urine culture were the most likely to recover incompletely, and those two findings also predicted later antibiotics and pyelonephritis, so a urine test can help with the decision. Men, children, pregnant women, and anyone with recurrent or complicated infections should be assessed by a doctor rather than self-treat. A pharmacist can check the label against your other medicines and health conditions.

05 Caution

Before you use Canephron (BNO 1045)

Canephron is generally well tolerated in trials, but it does cause side effects. The German labels list stomach and gut complaints such as nausea, vomiting, and diarrhea as common (up to 1 in 10 people), and allergic reactions, including rash, itching, and facial swelling, at an unknown frequency; anyone who notices side effects should stop taking it and see a doctor. In the 2018 trial, adverse events of any kind affected 15.1% of women on Canephron and 12.9% on fosfomycin. A case report from Moscow (Sychev and colleagues, International Journal of Risk & Safety in Medicine 2011) described a 66-year-old woman who developed jaundice, with a bilirubin of 369 µmol/L, about a week into a two-week course of Canephron N tablets. She was also taking risperidone and clomipramine, which can themselves harm the liver, but she had taken them for two years without problems and recovered while continuing them. A single report cannot prove cause, and no pattern of liver injury has been established, but unexplained jaundice, dark urine, or itching while taking any herbal product needs prompt medical review.

Do not take Canephron if you are allergic to any of its ingredients, to other plants of the carrot family (Apiaceae) such as anise or fennel, or to anethole, an aromatic compound in their essential oils. The German labels also rule it out with a stomach or peptic ulcer. Flushing treatment must not be used with edema (fluid buildup) caused by reduced heart or kidney function, or when a doctor has advised limiting fluids, because drinking more is part of the treatment. People with hereditary fructose intolerance, glucose-galactose malabsorption, or similar sugar intolerances should not take the tablets. No interactions with other medicines are known, but none have been formally studied, so this reflects an absence of reports rather than proof of safety. The drops contain alcohol: the prescribing information calculates that a 5 ml dose in a 12-year-old girl weighing 39 kg would raise blood alcohol by about 3.25 mg per 100 ml, compared with about 50 mg per 100 ml after an adult drinks a glass of wine or 500 ml of beer, and it names a health risk for pregnant and breastfeeding women and people with alcohol dependence. There are not enough data to recommend doses for people with reduced kidney or liver function.

Advice on pregnancy is inconsistent. The German leaflet for Canephron N tablets (2017) and the prescribing information for Canephron Uno (2024) say use in pregnancy may be considered if a doctor thinks it necessary, and the Uno document cites experience from 300 to 1,000 pregnancies without signs of birth defects or harm to the baby; the EAU guideline also notes that the combination has been studied in pregnant women without teratogenic (birth defect) effects. In contrast, the prescribing information for the drops (2023) says to avoid it in pregnancy as a precaution because there are no or very limited data, Sweden’s regulator does not recommend the tablets in pregnancy or breastfeeding for lack of safety data, and EMA does not recommend lovage root tea in pregnancy. All German labels say not to use it while breastfeeding, because it is not known whether its constituents pass into milk. In Germany it is not for children under 12, and Sweden’s assessors did not recommend it for children or for men with urinary symptoms because of the risk of complications that need a doctor.

Some symptoms mean a herbal product is the wrong choice. The labels say to see a doctor immediately for persistent fever, cramps, lower abdominal pain, blood in the urine, difficulty passing urine, or sudden inability to pass urine. Fever, chills, or pain in the back or side can signal pyelonephritis, and the German S3 guideline gives its strongest grade of recommendation to starting effective antibiotics as early as possible for acute pyelonephritis. Seek care, too, if symptoms do not improve within the label’s time limit, get worse, or keep coming back, and from the start if you are pregnant, male, a child, or have kidney disease, a urinary catheter, or a weakened immune system. Canephron should never be used to delay that care, and it does not replace an antibiotic when a clinician judges one necessary.

06 Questions

Frequently Asked Questions

Three dried herbs in equal parts: centaury herb (Centaurium erythraea), lovage root (Levisticum officinale), and rosemary leaf. Canephron N tablets contain 18 mg of each powdered herb and Canephron Uno tablets 36 mg of each, so both supply 108 mg of each herb a day at the labeled dose. Canephron N drops are made from a water-and-alcohol extract of the same 1:1:1 mixture. BNO 1045 is the research code for the tablet tested in the main trial.

Sometimes, for some women, at a cost. In the main trial of 659 women with uncomplicated cystitis, 83.5% of those on Canephron N and 89.8% of those on a single dose of fosfomycin needed no further antibiotic by day 38. That counted as non-inferior only because the margin was set at 15 points rather than the usual 10. Symptoms eased a little more slowly on Canephron, and five women versus one developed a kidney infection. European and German guidelines say non-antibiotic treatment can be considered for women who are not elderly, through shared decision-making with a doctor. Our urinary health guide covers the wider options.

Possibly a little, compared with taking an antibiotic straight away. In the 2018 trial, 1.5% of women on Canephron and 0.3% on fosfomycin developed pyelonephritis; the difference was not statistically significant, and three of the five cases began within a day of enrollment. A pooled analysis of 3,524 women in eight trials found that strategies avoiding immediate antibiotics, including herbal products, raised the odds of pyelonephritis 5.6-fold while cutting antibiotic use by 63%. Fever, chills, back or side pain, or vomiting needs a doctor the same day.

The evidence is thin. One open-label trial in 90 Ukrainian women found fewer recurrences over 12 months when three months of Canephron N was added to a course of antibiotics (15.5% versus 35.5%), and the European urology guideline gives a weak recommendation based on it. Germany’s IQWiG found only a hint of benefit from a single study, and the German S3 guideline says valid long-term prevention studies are lacking. IQWiG found stronger evidence for cranberry products against placebo. See our urinary health guide for other prevention measures.

Canephron N Dragees contain 18 mg of each herb per tablet and are taken as two tablets three times a day; this is the form tested in the BNO 1045 trial. Canephron Uno contains 36 mg of each herb and is taken as one tablet three times a day, the same daily amount, with a stricter label: see a doctor if there is no improvement after about three days, and self-treat for no more than two weeks. Canephron N Tropfen are drops, 5 ml three times a day, with 760 mg of alcohol per dose (19% by volume). In Germany all three are for ages 12 and up.

The labels disagree. The German tablet labels say use in pregnancy may be considered if a doctor thinks it necessary, and the Canephron Uno prescribing information cites 300 to 1,000 pregnancies without signs of harm. The label for the drops says to avoid it in pregnancy as a precaution, and Sweden’s regulator does not recommend it in pregnancy or breastfeeding for lack of safety data. None of the German labels allow it while breastfeeding. A bladder infection in pregnancy always needs a doctor, so do not self-treat with Canephron.

Both uva ursi and Canephron (BNO 1045) have been tested as alternatives to immediate antibiotics for uncomplicated cystitis, and the German S3 guideline lists them alongside the painkillers ibuprofen and diclofenac as non-antibiotic options. Across these approaches, antibiotic use fell, but incomplete recovery and kidney infections were more common than with antibiotics. No trial comparing Canephron with uva ursi directly was found for this page. Like Canephron, these remedies are for mild, uncomplicated bladder symptoms only.

Do not take it if you are allergic to its herbs, to carrot-family plants such as anise or fennel, or to anethole; if you have a stomach ulcer; or if you have edema from heart or kidney failure or have been told to limit fluids. In Germany it is not for children under 12, and Sweden does not recommend it for anyone under 18 or for men with urinary symptoms, because these need a medical assessment. The drops contain alcohol, which matters in pregnancy, while breastfeeding, and for people with alcohol dependence.

07 References

Sources

These references support the claims on this page. They are not an endorsement of any product. Each ingredient’s monograph carries its own full source list.

  1. Non-Antibiotic Herbal Therapy (BNO 1045) versus Antibiotic Therapy (Fosfomycin Trometamol) for the Treatment of Acute Lower Uncomplicated Urinary Tract Infections in Women: A Double-Blind, Parallel-Group, Randomized, Multicentre, Non-Inferiority Phase III Trial

    Urologia Internationalis (PubMed 30231252), 2018

    Wagenlehner et al.: 659 women, BNO 1045 2 tablets 3 times daily for 7 days versus fosfomycin 3 g; no additional antibiotics 83.5% versus 89.8%; 15% margin instead of the usual 10%; slower day 4 symptom relief; pyelonephritis 5 versus 1; Bionorica sponsorship, employee and consultant authors.

  2. Efficacy of CLR Compared to Fosfomycin Trometamol in Acute Lower uUTIs (NCT02639520)

    ClinicalTrials.gov, 2017

    Trial registration for the centaury, lovage root, and rosemary leaf (CLR) tablet versus fosfomycin: blinded, randomized, 659 women aged 18–70, lead sponsor Bionorica SE.

  3. Reducing antibiotic use in uncomplicated urinary tract infections in adult women: a systematic review and individual participant data meta-analysis

    Clinical Microbiology and Infection (PubMed 35788049), 2022

    Kaußner et al.: 3,524 women in eight trials; non-antibiotic strategies raised incomplete recovery (OR 3.0), later antibiotics (OR 3.5), and pyelonephritis (OR 5.6) but cut antibiotic use by 63%; funded by the German Federal Ministry of Education and Research.

  4. EAU Guidelines on Urological Infections (limited update March 2026)

    European Association of Urology, 2026

    Strong recommendation for non-antibiotic options with shared decision-making in non-geriatric women; warning of higher symptom burden and slightly increased pyelonephritis risk; weak recommendation for the centaury, lovage, and rosemary combination to reduce recurrences; F. Wagenlehner on the panel.

  5. S3-Leitlinie Epidemiologie, Diagnostik, Therapie, Prävention und Management unkomplizierter, bakterieller, ambulant erworbener Harnwegsinfektionen bei Erwachsenen (AWMF 043-044), Version 3.0

    Deutsche Gesellschaft für Urologie, via AWMF, 2024

    Recommendation 9.4: antibiotics should be recommended, non-antibiotic treatment alone may be considered in non-geriatric patients; BNO 1045 saved antibiotics in 84%; no valid long-term prevention studies for lovage root with rosemary and centaury; early antibiotics for pyelonephritis.

  6. Canephron N in the treatment of recurrent cystitis in women of child-bearing age: a randomised controlled study

    Clinical Phytoscience (Springer Nature), 2017

    Sabadash and Shulyak: open-label, 90 women aged 18–45, ofloxacin with or without 3 months of Canephron N; recurrences 8.9% versus 17.8% at 6 months and 15.5% versus 35.5% at 12 months; no competing interests declared.

  7. Bladder infection: Do herbal remedies help with recurrent bladder infection? IQWiG Reports, Commission No. HT20-01

    Institute for Quality and Efficiency in Health Care (PubMed 37023241), 2022

    Hint of added benefit for lovage, rosemary, and centaury with antibiotics versus antibiotics alone for recurrence, from isolated study results; no hint of benefit on specific symptoms; no adverse event data; indication of benefit for cranberry versus placebo.

  8. Multicenter open prospective randomized study on the efficacy and safety of Canephron N in preventing recurrences of uncomplicated lower urinary tract infection in women

    Urologiia (PubMed 41399819), 2025

    Amdiy et al.: open-label, 72 women randomized, 67 analyzed; antibiotics plus Canephron N then 1 month alone versus antibiotics alone; recurrence within 12 months 13.9% versus 38.7%.

  9. Treatment of Urinary Tract Infections with Canephron in Germany: A Retrospective Database Analysis

    Antibiotics (PubMed 34201264), 2021

    Höller et al.: 2,320 Canephron versus 158,592 antibiotic patients, 2016 to June 2019; fewer recurrences and later antibiotics; no difference in pyelonephritis (HR 1.00); funded by Bionorica, three company-employed authors.

  10. A Randomized Clinical Trial to Evaluate the Effect of Canephron N in Comparison to Ciprofloxacin in the Prevention of Postoperative Lower Urinary Tract Infections after Midurethral Sling Surgery

    Journal of Clinical Medicine (PubMed 33105885), 2020

    Rechberger et al.: 562 women; ciprofloxacin 500 mg 3 times daily for 3 days versus Canephron 5 ml 3 times daily for 3 weeks; UTI within 6 months 10.98% versus 13.64%, not significant; funded by the Medical University of Lublin.

  11. Postoperative Prevention of Urinary Tract Infections in Patients after Urogynecological Surgeries: Nonantibiotic Herbal (Canephron) versus Antibiotic Prophylaxis (Fosfomycin Trometamol)

    Pathogens (PubMed 36678373), 2022

    Wawrysiuk et al.: 125 women; single 3 g dose of fosfomycin versus Canephron 3 times daily for 14 days; UTIs in 6.4% overall with no significant difference.

  12. Femistina versus Canephron as a prevention of urinary tract infections after midurethral sling surgery: non-inferiority study

    European Journal of Obstetrics, Gynecology, and Reproductive Biology (PubMed 36027670), 2022

    Rechberger et al.: 320 women; UTI within 6 months in 6.25% with Femistina versus 15.63% with Canephron drops 5 ml 3 times daily for 4 weeks.

  13. Efficacy and safety of the phytotherapeutic drug Canephron N in prevention and treatment of urogenital and gestational disease: review of clinical experience in Eastern Europe and Central Asia

    Research and Reports in Urology (PubMed 24400233), 2013

    Naber: 17 studies with 3,115 patients; one adverse effect (skin rash); no teratogenic effects reported in pregnancy; some studies not well designed.

  14. The Effect of Canephron N in Preventing Urinary Tract Infection: A Systematic Review and Meta-Analysis

    Neurourology and Urodynamics (PubMed 42781758), 2026

    Ak et al.: 12 studies (8 randomized), 3,821 patients; bacteriuria clearance RR 1.34 with high heterogeneity (I² 72%); concludes Canephron N is an effective and safe alternative to antibiotics.

  15. A case of hepatic injury suspected to be caused by Canephron N, a Centaurium Hill containing phytotherapeutics

    International Journal of Risk & Safety in Medicine (IOS Press), 2011

    Sychev et al.: 66-year-old woman with jaundice (bilirubin 369.2 µmol/L) after one week of Canephron N 2 tablets 3 times daily; also taking risperidone and clomipramine long term.

  16. Canephron N Dragees: Gebrauchsinformation (package leaflet)

    Bionorica SE, 2017

    Traditional herbal medicine; 18 mg each of centaury herb, lovage root, and rosemary leaf; from 12 years, 2 tablets 3 times daily; contraindications (Apiaceae and anethole allergy, stomach ulcers, edema from heart or kidney impairment); red flags; pregnancy and breastfeeding; 0.2 g carbohydrate per tablet.

  17. Canephron N Tropfen: Fachinformation (summary of product characteristics)

    Bionorica SE, via Rote Liste Service (fachinfo.de), 2023

    Drops: 1:56 extract of a 1:1:1 herb mixture; 5 ml 3 times daily from 12 years; 760 mg alcohol per 5 ml (19% v/v) with blood alcohol example; avoid in pregnancy as a precaution; not while breastfeeding; experimental pharmacology.

  18. Canephron Uno: Fachinformation (summary of product characteristics)

    Bionorica SE, via Rote Liste Service (fachinfo.de), 2024

    36 mg of each herb per tablet, 1 tablet 3 times daily from 12 years; see a doctor after about 3 days without improvement, maximum 2 weeks of self-medication; 300–1,000 pregnancy outcomes without malformation risk; sugar intolerance warnings.

  19. Public Assessment Report: Canephron, coated tablet

    Läkemedelsverket (Swedish Medical Products Agency), 2015

    Traditional-use registration approved 18 December 2014; no HMPC monograph on the fixed combination; mechanism not clarified; not recommended under 18, for men with urinary symptoms, or in pregnancy and lactation.

  20. Community herbal monograph on Levisticum officinale Koch, radix

    European Medicines Agency (EMA/HMPC/524621/2011), 2012

    Traditional use of lovage root tea, 4–6 g daily, for urinary flushing; contraindicated with Apiaceae or anethole hypersensitivity; not recommended under 18 or in pregnancy and lactation.

  21. Assessment report on Levisticum officinale Koch, radix

    European Medicines Agency (EMA/HMPC/524623/2011), 2012

    Notes a UK traditional herbal registration for a lovage, centaury, and rosemary tablet for minor urinary complaints associated with cystitis in women only.

  22. Traditional Herbal Registrations granted, with indication and quantitative composition (27 October 2025)

    Medicines and Healthcare products Regulatory Agency (MHRA), 2025

    Current UK list of traditional herbal registrations; no product containing lovage root or centaury is listed.

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