The Medical Letter on Drugs and Therapeutics
Drugs for Kidney Stones
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Renal colic is a common problem in emergency departments. Stones <5 mm in diameter often pass spontaneously; stones >10 mm in diameter generally do not.1 The usual treatment for stones that do not pass is ureteroscopy with laser lithotripsy or shockwave lithotripsy.2 Some clinicians have suggested that off-label use of an oral alpha-adrenergic blocker such as tamsulosin (Flomax, and others) or calcium channel blocker such as nifedipine (Procardia XL, and others) could be tried first, with or without a corticosteroid. Both adrenoreceptors and calcium channels may have a role in the contractility of the ureter.3,4

CLINICAL STUDIES — A clinical trial in 210 symptomatic patients with distal ureteral calculi >4 mm in diameter compared phloroglucinol (an antispasmodic), tamsulosin 0.4 mg and slow-release nifedipine 30 mg, all given with ... more      

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Title: Drugs for Kidney Stones
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