Kidney stone medications, such as diclofenac, acetaminophen, or tamsulosin, are commonly prescribed to relieve renal colic pain, prevent new episodes, or make it easier to pass stones.
These treatments must always be prescribed by a doctor, after evaluating symptoms, the size and location of the stone, and the type of stone, which may be made of calcium, uric acid, cystine, or struvite.
Treatment should start as soon as symptoms appear, under the care of a nephrologist, a primary care doctor, or at the nearest hospital, to prevent complications such as blocked urine flow, kidney swelling, or kidney infection. In some cases, surgical treatment may also be recommended.
Main kidney stone medications
Medications your doctor may prescribe to treat kidney stones include:
1. Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs are usually the first kidney stone medications prescribed by doctors. They work by lowering the production of inflammatory substances like prostaglandins and thromboxanes, which helps ease the pain from kidney stones and discomfort when urinating. Common NSAIDs used for kidney stones include:
-
Ketorolac
These drugs should only be taken under medical supervision. They are not recommended during pregnancy or breastfeeding, and should be avoided by people with stomach ulcers, gastritis, severe kidney disease, chickenpox, or suspected dengue fever.
2. Pain relievers
Pain relievers such as acetaminophen are often recommended to reduce the pain caused by kidney stones. They work by blocking the production of pain-related substances in the brain, such as prostaglandins and cyclooxygenases.
Although available without a prescription, they should ideally be used under medical guidance, as they are not safe for people with liver problems. Taking acetaminophen in higher-than-recommended doses can seriously damage the liver, cause drug-induced hepatitis, and even be life-threatening.
3. Opioids
Opioids like morphine or tramadol are stronger pain relievers that may be prescribed when the pain is severe, acute, or does not improve with regular painkillers. These medications are usually prescribed for short periods and must be closely monitored by a doctor.
4. Alpha-blockers
Alpha-blockers are normally used to treat benign prostatic hyperplasia in men, but they may also be prescribed for kidney stones between 4 and 10 mm located in the ureter. These medications relax the ureter muscles, making it easier for the stone to pass while also reducing pain and the risk of recurrent colic episodes.
The most commonly prescribed alpha-blocker is tamsulosin, which should only be taken if recommended by a doctor.
5. Thiazide diuretics
Thiazide diuretics, such as hydrochlorothiazide or chlorthalidone, may be prescribed to help prevent calcium-based kidney stones, especially when lifestyle changes like drinking more fluids or adjusting the diet are not enough. These medications reduce calcium levels in the urine, which lowers the chance of new stone formation.
6. Potassium citrate
Potassium citrate may be prescribed to prevent recurrent kidney stones made of calcium, uric acid, or cystine. It works by making the urine more alkaline, which reduces the likelihood of stones forming. However, it should only be used if prescribed by a doctor, as in some cases it may worsen symptoms depending on the type of stone.
Medications to dissolve kidney stones
Allopurinol is the main medication prescribed to help dissolve uric acid stones and prevent new ones from forming. It may also be used for people with recurrent calcium stones, since high uric acid levels can contribute to their development.
Home remedies
Some herbal teas, such as hibiscus tea, have mild diuretic effects that may help pass small stones. These options can complement treatment with kidney stone medications but do not replace medical therapy.
Which doctor to see
The best specialist to prescribe kidney stone medications is a nephrologist, as they focus on kidney health. The nephrologist will assess the type of stone, the severity of the condition, and medical history to determine the most effective medication for fast pain relief and stone elimination. If needed, the doctor may also recommend additional treatments, such as laser therapy or surgery.