Nitric Oxide Releasing Mouthwash (NORM) for the Management of Oropharyngeal Candidiasis

Sanotize Research and Development corp. (Industry)
Overall Status
Not yet recruiting ID

Study Details

Study Description

Brief Summary

Phase 1 Single Centre, open-labeled Clinical Trial to Evaluate the Safety and Tolerability of Topical Nitric Oxide Releasing Mouthwash (NORM) for the Management of Oropharyngeal Candidiasis.

Participants that meet all inclusion and exclusion criteria will be enrolled to receive open label NORM 3 doses/day for three weeks.

Condition or Disease Intervention/Treatment Phase
  • Drug: Nitric Oxide
Phase 1

Detailed Description

This is a single-center, open-label phase 1 clinical trial to evaluate NORM safety, tolerance and ability to eliminate Candida sp from the oropharyngeal cavity.

Adult volunteer patients with dry mouth and confirmed presence of candida (by oral smear due to any cause will be eligible, including autoimmune disease, idiopathic (aging, tobacco, approved inhaled recreational drug, or alcohol use), and medical management including chemotherapy-induced, radiotherapy-induced, bone marrow transplantation-induced, medication use including antibiotics, anti-inflammatories, etc.

Sufficient participants will be enrolled to achieve 10 evaluable participants. Participants who are currently pursuing other forms of treatment (within 2 weeks prior to enrollment) will be excluded from the study (unless participant agrees to a two weeks wash out period).

Study Design

Study Type:
Anticipated Enrollment :
10 participants
Intervention Model:
Single Group Assignment
Intervention Model Description:
Open labelOpen label
None (Open Label)
Primary Purpose:
Official Title:
Phase 1 Single Centre, Open-labeled Clinical Trial to Evaluate the Safety and Tolerability of Topical Nitric Oxide Releasing Mouthwash (NORM) for the Management of Oropharyngeal Candidiasis
Anticipated Study Start Date :
Dec 1, 2023
Anticipated Primary Completion Date :
Mar 31, 2024
Anticipated Study Completion Date :
May 30, 2024

Arms and Interventions

Arm Intervention/Treatment
Experimental: Nitric Oxide Releasing Mouthwash

Nitric Oxide Releasing Mouthwash (NORM) liquid producing NO at 266 ppm*min in 20mL

Drug: Nitric Oxide
Nitric Oxide Releasing Mouthwash will be self-administered by the participant three times throughout the day for 21 days. The intervention solution will be poured into their mouth from a medication cup containing 20 mL of the solution. Total exposure to study intervention will be a maximum of 63 treatments totaling 1,260 mL. All participants will be monitored for 7 days post-last treatment dose (to Day 28).
Other Names:
  • Nitric Oxide Releasing Mouthwash
  • Outcome Measures

    Primary Outcome Measures

    1. To assess the tolerability of NORM in participants with candidiasis. [21 days]

      Intolerance (i.e., oral cavity, dental, and/or lingual irritation or sensitivity (pain, swelling, erythema, discharge)), dysgeusia, or discoloration of oral cavity/teeth/tongue) as assessed by number of patients that terminate NORM treatment.

    Secondary Outcome Measures

    1. To assess the effectiveness of NORM to resolve oral fungal infection [21 days]

      Assess the number of participants who experience clearing of the infection by negative smear/culture

    2. To assess the effectiveness of NORM to resolve clinical symptoms of candidiasis [21 days]

      Mean time to achieve clearing of clinical infection (no symptoms [0] or mild [1]) from Baseline until Day 21

    3. To assess the effectiveness of NORM to reduce the need for an oral antifungal agent [21 days]

      Proportion of participants that require nystatin intervention

    Other Outcome Measures

    1. To categorize the major reasons impacting the tolerance of NORM during oral administration [21 days]

      Tolerance as assessed by number of patient reported outcomes (PRO) of irritation and dysgeusia of the rinse, dental sensitivity while willing to continue to use the rinse

    2. Determine incidence and severity of adverse reactions [21 days]

      Safety as assessed by number and severity of adverse events

    3. To assess reoccurrence of candidiasis [28 days]

      Proportion of participants with reemergence of candidiasis infection

    4. To assess of exacerbation of candidiasis [28 days]

      Proportion of participants with an increased Candida sp. associated with their lesions (determined as an increase of 2 or more semi-quantitative steps (e.g., scant to moderate or light to heavy))

    Eligibility Criteria


    Ages Eligible for Study:
    19 Years and Older
    Sexes Eligible for Study:
    Accepts Healthy Volunteers:
    Inclusion Criteria:
    1. At least 19 years old at the time of consent.

    2. Participants must be diagnosed with clinical candidiasis.

    3. Have no acute illnesses or hospitalizations within 30 days prior to enrollment, no planned procedures during the anticipated study participation, and no newly diagnosed chronic illnesses that are not deemed stable by the participant's primary care physician), in the opinion of the Investigator, based on medical history (i.e., absence of any clinically relevant abnormality) during Screening.

    4. Participants must not have been part of any clinical trial for the past 30 days and may not be taking any other investigational therapy related to treatment of candidiasis.

    5. If female, be surgically sterile or post-menopausal (no menses for at least 12 months), or if of childbearing potential, must be using an acceptable method of contraception such as a combination estrogen/progestin hormonal contraceptive (oral or injected) for at least 1 month prior to Day -14, or such items as an intrauterine device (IUD), intrauterine system (IUS), transdermal hormonal implant, vaginal hormonal ring, or 2 forms of the following: diaphragm, cervical cap, patch, condom, spermicide, or sponge. Total abstinence is permitted. If local regulations deviate from the previously listed contraception methods to prevent pregnancy, local requirements will apply. In addition, females of childbearing potential must agree to continue to use their method of birth control for the duration of the study.

    6. If male, be surgically sterile, or agree to use appropriate contraception (latex condom with spermicide) when engaging in sexual activity and agree to not donate sperm for the duration of the study.

    7. Be able to understand and provide written, informed consent.

    8. Must be willing and able to manage a treatment regimen and attend assessment study visits.

    Exclusion Criteria:
    1. Participants with mucosal/oral ulceration

    2. No prior antifungal therapies for a minimum 2-week prior to enrollment

    3. Participants with other conditions considered by the investigator to be reasons for disqualification that may jeopardize patient safety or interfere with the objectives of the trial (e.g., acute illness or exacerbation of chronic illness, lack of motivation, history of poor compliance, neurologically or mentally disabled)

    4. Females who are breastfeeding, pregnant, or attempting to become pregnant.

    5. Participants with hypersensitivity to any of the product's ingredients.

    Contacts and Locations


    Site City State Country Postal Code
    1 Atlantis Dental Cambie Vancouver British Columbia Canada V5Z 4T1

    Sponsors and Collaborators

    • Sanotize Research and Development corp.


    • Study Director: Keith Moore, PHARMMD, SaNOtize R&D Corp
    • Principal Investigator: Joel Epstein, Atlantis Dental Cambie

    Study Documents (Full-Text)

    None provided.

    More Information


    None provided.
    Responsible Party:
    Sanotize Research and Development corp. Identifier:
    Other Study ID Numbers:
    • NORM-POC-01
    First Posted:
    Nov 7, 2023
    Last Update Posted:
    Nov 7, 2023
    Last Verified:
    Nov 1, 2023
    Individual Participant Data (IPD) Sharing Statement:
    Plan to Share IPD:
    Studies a U.S. FDA-regulated Drug Product:
    Studies a U.S. FDA-regulated Device Product:
    Keywords provided by Sanotize Research and Development corp.
    Additional relevant MeSH terms:

    Study Results

    No Results Posted as of Nov 7, 2023