Canephron® N in Type 2 Diabetes Mellitus: Use in Kidney and Urinary Tract Diseases
Canephron® N is a herbal medicinal product manufactured in Germany that contains dry extracts of three plants: centaury herb, lovage root, and rosemary leaves. In type 2 diabetes mellitus, it has a specific area of use related to the high risk of kidney and urinary tract damage.
Why can Canephron be relevant in type 2 diabetes?
The main reason is the prevention and comprehensive treatment of diabetic nephropathy and urinary tract infections (UTIs), which are common and serious complications of diabetes.
Main purposes of use:
Support of kidney function. Diabetic nephropathy—damage to the small blood vessels of the kidneys (glomeruli)—is one of the most dangerous complications. Canephron has mild anti-inflammatory and antioxidant effects, which may help protect renal tissue.
Enhancement of the effect of basic therapy. The drug is often prescribed as an adjunct to the main medications that protect the kidneys in diabetes: ACE inhibitors (enalapril, lisinopril) or angiotensin II receptor blockers (losartan, valsartan). It does not replace them but may potentiate their effects.
Prevention and treatment of infections. People with diabetes often have elevated glucose levels in the urine, creating a favorable environment for bacterial growth. Frequent, recurrent cystitis and pyelonephritis are a serious problem. Canephron has antibacterial (due to rosemary and lovage) and anti-inflammatory properties, helping prevent bacteria from adhering to the bladder wall.
Diuretic effect. The drug provides a mild diuretic effect, promoting the excretion of excess fluid and reducing edema that may occur with kidney problems. Unlike some synthetic diuretics, it does not cause potassium loss.
Important precautions and principles of use:
DOES NOT REPLACE BASIC DIABETES OR NEPHROPROTECTIVE THERAPY. Canephron is an adjunctive agent. It does not lower blood glucose, does not replace insulin or glucose-lowering tablets, and is not an alternative to medications for blood pressure control and kidney protection (ACE inhibitors/ARBs).
Use only as prescribed by a physician. The decision to use it should be made by a general practitioner, endocrinologist, or nephrologist based on test results:
Urinalysis (general, Nechiporenko test) to detect protein (albuminuria), leukocytes, and bacteria.
Blood tests for creatinine and calculation of the glomerular filtration rate (GFR) to assess kidney function.
Risk in severe nephropathy. In cases of marked renal impairment (CKD stages 4–5, high creatinine levels), the use of any medications, including herbal ones, requires special caution and dose adjustment. Self-medication is unacceptable.
Possible side effects and contraindications:
Allergic reactions to the components of the drug.
Exacerbation of gastric or duodenal ulcer disease (due to alcohol in the drops and bitter components).
Lactose intolerance (for tablets, as they contain lactose monohydrate).
Alcoholism (drops are contraindicated because they contain 16–19.5% ethanol).
Interactions with other medications. Canephron may enhance the effect of diuretics, so their combined use requires medical supervision.
Dosage forms and dosing (approximate; must be specified by a physician):
Drops: usually 50 drops 3 times a day. It is important to remember the alcohol content.
Dragees (tablets): usually 2 dragees 3 times a day.
The course of treatment is generally long—from 2–4 weeks to several months—depending on the goal (treatment of an acute infection or long-term nephroprotection).
Key takeaway:
Canephron in type 2 diabetes is a medication for protecting the urinary system, not for treating diabetes itself.
Main indications: combination therapy and prevention of cystitis and pyelonephritis, as well as adjunctive nephroprotection in the early stages of diabetic nephropathy (microalbuminuria).
It is an addition, not the basis of treatment. Its effectiveness increases only with good diabetes control (target HbA1c levels) and blood pressure control.
The decision to prescribe is made by a physician after assessing kidney function. Self-administration “for prevention” without indications is not recommended.
Thus, Canephron can become a useful component of a comprehensive approach to the management of type 2 diabetes aimed at preventing one of its most serious complications—kidney damage.