Which Medications Are Used For Kidney Stones?

Did you know that each year more than 5,00,000 people go to the emergency room because of kidney stones? And about 1 out of every 10 people will get a kidney stone at some point in their life. This data has been shared by the National Kidney Foundation. Since it is a very common condition, this makes it even more important for us to become aware of what kidney stones are and which medications can be taken for it. This article will explore this in depth. 

To get a better understanding of this, we reached out to Dr Shalabh Agrawal, Director, Urology and Andrology, CK Birla Hospital, Gurugram and Dr Sudeep Singh Sachdev, Senior Consultant and Director, Nephrology, Narayana Hospital Gurugram.

Which Medicines Are Prescribed For Kidney Stones?

According to the National Institutes of Health (NIH), professionals prescribe medicines depending on the type of stone. The report mentioned that one may have to take medicines for a few weeks, several months, or longer. “For example, if you had struvite stones, you may have to take an oral antibiotic for 1 to 6 weeks, or possibly longer. If you had another type of stone, you may have to take a potassium citrate tablet 1 to 3 times daily. You may have to take potassium citrate for months or even longer until a healthcare professional says you are no longer at risk for kidney stones,” mentions NIH.

Shedding more light on this, Dr Sachdev shares, “Pain relief comes from painkillers like paracetamol, tramadol or ultracet (relatively kidney safe), prescribed commonly in India. Alpha-blockers such as tamsulosin or silodosin aid kidney stone passage by relaxing ureteric smooth muscles. Potassium citrate syrup prevents calcium stone recurrence by alkalising urine and also helps in dissolving uric acid stones. In case of severe inflammatory pain caused by ureteric stones, short courses of steroids like Deflazacort (to reduce inflammation) can also be given.”

Non-surgical Medical Treatments For Kidney Stones

Small kidney stones can be treated at home and do not need invasive treatments, according to Mayo Clinic. Their report mentions the following tips for the same:

• Drinking1.8 to 3.6 litres daily may keep urine dilute and prevent stones from forming.
• Doctors may recommend pain killers to deal with kidney stone aches at home.
• Doctors may even recommend medicines which can help pass kidney stones. This type of medicine is called an alpha-blocker. 

Explaining this further, Dr Agrawal shares, “Non-surgical treatment is often recommended for small to moderately sized stones that are likely to pass on their own.” On this note, he lists down some common approaches that include:

• Medical Expulsive Therapy (MET): Use of medications such as alpha blockers can relax the ureter and aid stone passage.
• Pain management: Analgesics are given to manage the severe pain associated with stone movement.
• Hydration therapy: Increased fluid intake helps flush the urinary system and promote stone passage.
• Urine alkalinisation therapy: Medications like potassium citrate help dissolve certain stones such as uric acid stones.
• Dietary modification: Reducing sodium intake, limiting oxalate-rich foods, and maintaining adequate calcium intake can help prevent stone growth.

“Many small stones (usually less than 5–6 mm) can pass naturally with these measures,” he adds.

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Surgical Medical Treatments For Kidney Stones

While medical treatments may be inevitable for severe cases of kidney stones, it may come with possible complications, depending on the size and position of the stones. According to the National Health Service (NHS), these complications include:

• Sepsis.
• A blocked ureter caused by stone fragments.
• An injury to the ureter.
• Urinary tract infection (UTI).
• Bleeding during surgery.
• Pain.

Elaborating on this, Dr Sachdev says, “ESWL uses high-energy shock waves to break down stones and is usually ideal for upper ureteric or kidney stones under 20 mm in size. Laser lithotripsy techniques like URSL or RIRS target ureteric and renal stones precisely. PCNL removes large kidney stones through skin incision. Such procedures are performed under anaesthesia in equipped government or private sector hospitals. The choice of surgery depends on location and size of the stone in the urinary tract.”

Small Stones Vs Large Stones – How Medical Treatment Differs For Each 

Treatment strategies for kidney stones differ based on their size. Dr Agrawal lists some important points for the same:

• Small stones (less than 5–6 mm): These often pass naturally. Treatment focuses on hydration, pain control, and medications such as alpha-blockers to help the stone move through the ureter.
• Moderate stones (6–10 mm): Medical therapy may still be attempted, but there is a higher likelihood that procedures like ureteroscopy or shock wave therapy may be needed if the stone does not pass.
• Large stones (greater than 10 mm): These typically require interventional procedures such as ESWL, ureteroscopy, or PCNL, as spontaneous passage is unlikely.

When To Seek Medical Treatment For Kidney Stones?

Dr Agrawal shares that medical evaluation and treatment are needed for kidney stones, if a person experiences symptoms such as:

• Severe pain in the lower back or side (renal colic).
• Pain during urination.
• Blood in urine.
• Frequent urge to urinate or difficulty passing urine.
• Nausea, vomiting, or fever that may indicate infection.

“If these symptoms occur, it is important to seek medical attention. Doctors typically confirm the diagnosis through ultrasound, CT scan, or urine tests before deciding on the most appropriate treatment approach. Early diagnosis and timely treatment can help prevent complications such as infection, kidney damage, or recurrent stone formation,” concludes Dr Agrawal.

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The Final Word

Most common medications for kidney stones include painkillers such as paracetamol, tramadol, or ultracet (relatively kidney safe). These are prescribed commonly in India. Apart from these, there are other medications such as alpha blockers. In short, professionals prescribe medications depending on the type of stone.