Listen to key opinion leaders about the importance of non-antibiotic rUTI prevention and the power of cranberry PAC.
36mg PAC (100% juice extract)
powerful non-antibiotic UTI management.
What makes Ellura clinically effective?
Unlike other cranberry supplements, the Ellura proprietary double extraction process results in high levels of soluble A-type PAC only found in concentrated cranberry juice extract, allowing the PAC to bind to the bacteria.
Whole berry and other products have little to no effect because the PAC in those products bind to the cellulose in the skin, seeds, and flesh of the berry rather than bacteria.4,6,7
Ellura contains only soluble A-Type PAC from concentrated juice extract.
Researchers have identified soluble A-type linkages in PACs as an important inhibitor of the adhesion of P-fimbriated uropathogenic bacterium to urothelial cells, establishing bacterial Anti-Adhesion Activity as the evidence-based mechanism of action.8,9
An Ellura dose-dependent, randomized, double-blind study determined that a minimum of 36 mg of highly soluble A-type PAC, only found in the concentrated juice of the berry, is required to promote bacterial Anti- Adhesion Activity and contribute to UTI prevention.10
Mechanism of action
The PAC in Ellura bind to the P-fimbriae and Type 1 pili, effectively neutralizing bacteria and allowing them to be washed away with the urine stream in a normal and healthy manner.
We lead with science.Learn more about Ellura’s studies.
- Catheter-associated urinary tract infections
Does cranberry have a role in catheter-associated urinary tract infections?
- Target dose for UTI prevention
36mg/72mg PAC identified and confirmed as target dose for UTI prevention
- Asymptomatic bacteriuria after cystoplasty
Effectiveness of a cranberry (Vaccinium macrocarpon) preparation in reducing asymptomatic bacteriuria in patients with an ileal enterocystoplasty
- Prophylaxis of rUTIs compared with antibiotic
Cranberry syrup vs. trimethoprim in the prophylaxis of recurrent urinary tract infections among children: a controlled trial
- AUA guidelines
Antimicrobial resistance is one factor that has led to an increasing interest in the scientific community to study non-antibiotic modalities in the prevention of rUTI, including the use of probiotics and the consumption of cranberry products.
- Non-antibiotic prevention
As a doctor, you may be prescribing a daily antibiotic to treat UTIs, but also as preventive therapy for recurrent infections. Multiple studies demonstrate that poor compliance, along with repeated antibiotic use leads to resistance and, therefore, makes it harder to prevent infection.
In early 2015 the World Health Organization endorsed a global action plan to tackle antibiotic resistance, the most urgent drug resistance trend compromising your ability to treat infectious disease.¹ On top of bacterial resistance, unwanted side effects of antibiotics beg a new solution for managing recurrent UTIs.
Now, you can feel confident in recommending ellura, a medical-grade, non-antibiotic alternative for preventing UTIs. ellura is a dietary supplement that contains a natural ingredient and has gone through complex extraction and extensive testing to harness the power of its bioactive ingredient, PAC (proanthocyanidins), to work on the offense, trapping and flushing out harmful bacteria before they can make themselves at home.
We recommend your patients take ellura with an antibiotic at the onset of infection and then continue taking ellura once daily to keep their urinary tract in check and to constantly flush out bad bacteria that could lead to future UTIs.
Hear from your peers.
Dr. Howell describes the action of proanthocyanidins preventing bacterial adhesion
Dr. Fletcher advocates patient self care for bladder and vaginal health
Dr. Cohen discusses getting UTI patients off antibiotic therapy
Dr. Brian Flynn – Antibiotic Stewardship and UTIs
That has been a significant part of my protocol, a medical-grade supplement that contains cranberry proanthocyanidins (PAC), specifically 36mg of soluble A-type PAC. I have never had a patient unable to tolerate the PAC approach.
Ellura has received traditional herbal medicine approvals worldwide
Ellura is an approved Traditional Herbal Medicine with the indication: Used in the prevention of recurrent uncomplicated acute urinary tract infections (cystitis) in women.
The choice of the cranberry-starting material is based on 15 years of experience with many cultivars and geographies. It takes into account the variety, extraction yield, PAC content, and Anti-Adhesion Activity (bioactivity), which are the main historical criteria.
The cranberry bogs are located in the Patagonia Lake Region near Lanco, Chile. The proximity to the equator provides extended hours of intense solar exposure and a long growing season. The duration and intensity of sun exposure increases the potency, quantity, and quantity of the PAC. PAC production is a direct response to the sun. Less than 4% of the total annual cranberry production comes from Chile. The cranberry harvest is March-May following the hot Chilean summer, December – February. The North American harvest is September – November following a much less intense summer. The Chilean bogs offer near-perfect acidic soil conditions for cranberry growth (pH 4.9-5.5).
Medical grade formulation
Our complex, proprietary manufacturing process extracts high levels of A-type PAC from pure concentrate cranberry juice extract which allows the PAC in ellura to bind to the bacteria. Whole berry products and other products have little to no effect because the PAC in those products bind to the skin, seeds, and flesh of the berry instead of the bacteria.
Monograph highlights importance of standardized cranberry supplements to initiate bacterial anti-adhesion
The American Herbal Pharmacopoeia (AHP) released a 96-page review for dietary supplements made from cranberry. Studies referenced in the monograph were conducted by leading authorities of all things cranberry and were initiated by Trophikos, the makers of ellura, and our European partners. These studies have shined a spotlight on the importance of standardized PAC (proanthocyanidins) in promoting bacterial anti-adhesion. ellura remains the only supplement in the U.S. standardized to the recommended 36 mg PAC delivered in one capsule and proven to reduce the adhesion of E.coli and other bacteria to the urinary tract wall – the first stage in development of a UTI. Click here for the UTI section of the monograph. For a copy of the complete monograph, please email email@example.com.
French company Pharmatoka petitions AFSSA (the French food safety agency) to confirm that PAC (proanthocyanidins) can inhibit bacteria from sticking to the urinary tract – known as the anti-adhesion effect.
AFSSA issues a health claim based on studies using supplements with 36 mg PAC.
French DGCCRF (Directorate General for Competition, Consumer Affairs and Fraud Control) requires commercial products listing the claim to use the DMAC method [4-(dimethylamino) cinnamaldehyde] to measure PAC.
The French food safety agency (now called ANSES) reviews additional studies and reaffirms that cranberry supplements with 36 mg PAC perform as claimed.
Click here to learn more about the DMAC/A2 method now considered the gold standard in measuring PAC content.
After the 2004 confirmation, Pharmatoka launches urell®, the only cranberry product to contain 36 mg PAC measured by DMAC/A2. Urell gains in popularity and is rolled out worldwide, entering the U.S. market as ellura in late 2010. Today, a rapidly growing base of physicians and patients all over the globe trust ellura to maintain a clean urinary tract.
In the past, several measuring methods were used to quantify PAC (proanthocyanidins) in cranberry supplements. However, these methods factored in additional compounds within the cranberry. Scientific and government agencies sought for one validated and standardized measuring method and agreed on the DMAC/A2 assay method (dimethylamino/cinnamaldehyde), developed by Brunswick Laboratories, Southborough, MA. See the story at dmac-asso.org¹.
1″The dosage of cranberry proanthocyanidins (PACs) in food supplements: challenges and latest developments” by G. Haesaerts in: Phytothérapie (France), Springer-Verlag, August 2010.
The BL-DMAC method was published in 2010 after an international lab validation backed by the US cranberry industry, the Cranberry Marketing Committee of the USA (who financed the study) and the Cranberry Institute.
- 1. Uberos J et al. “Cranberry syrup vstrimethoprim in the prophylaxis of recurrent urinary tract infections among children: a controlled trial.” Open Access Journal of Clinical Trials. Published online 5/21/2012.
- 2. Jepson RG et al. “Cranberries for preventing urinary tract infections.” Cochrane Database of Systematic Reviews. Published online 10/17/2012.
- 3. Howell AB et al. “Dosage effect on uropathogenic Escherichia coli Anti-Adhesion Activity in urine following consumption of cranberry powder standardized for proanthocyanidin content: a multicentric randomized double blind study.” BMC Infectious Diseases. Published online 4/14/2010.
- 4. Upton R, Brendler T, eds. American Herbal Pharmacopoeia: Cranberry Fruit. Scotts Valley, CA: American Herbal Pharmacopoeia; 2016:17, 20, 22, 39, 31.
- 5. Chugtai B, Thomas D, Howell A. Variability of commercial cranberry dietary supplements for the prevention of uropathogenic bacterial adhesion. American Journal of Obstetrics & Gynecology. 2016;215(1):122-123.
- 6. Advantages of DMAC method for quantifying total cranberry PACs (A-type and B-type together) over other methods. DMAC Association website. https://www.dmac-asso.org/advantages-of-dmac- method/#. Accessed March 2, 2021.
- 7. Roopchand DE et al. Food-compatible method for the efficient extraction and stabilization of cranberry pomace polyphenols. Food Chem. 2013;141(4):3664-3669.
- 8. Howell AB et al. “A-type cranberry proanthocyanidins and uropathogenic bacterial Anti-Adhesion Activity” Phytochemistry. 2005;66(16):2281-2291.
- 9. Lavigne JP et al. “In-vitro and in-vivo evidence of dose-dependent decrease of uropathogenic Escherichia coli virulence after consumption of commercial Vaccinium macrocarpon (cranberry) capsules.” Clinical Microbiology and Infection. 2008;14(4):350-355.
- 10. Howell AB et al. “Dosage effect on uropathogenic Escherichia coli Anti-Adhesion Activity in urine following consumption of cranberry powder standardized for proanthocyanidin content: a multicentric randomized double blind study.” BMC Infectious Diseases. (Apr 2010).