Medications to help pass kidney stones

If you are passing a kidney stone, your chances of successful stone passage are strongly related to stone factors including the size of the stone and its location. Small stones less than 4mm in size have an almost 80% chance of passage while larger stones measuring 8mm or greater have a less than 40% chance of spontaneous passage. Stones that are just starting to move out of the kidney have a 50% chance of passage while stones just about to drop into the bladder have an 80% chance of passage. 

Wouldn’t it be great if you could take something to improve your chances of passing your stone? It turns out there are medications your doctor can prescribe for you which may be effective. This treatment is known as “medical expulsive therapy”. The most commonly used medication for this purpose is tamsulosin (Flomax). Other similar medications used to facilitate stone passage include alfuzosin, nifedipine, doxazosin, and terazosin. These medications are known as alpha-blockers and are normally used to relieve prostate obstruction in men (by relaxing smooth muscle in the prostate) or to lower blood pressure in patients with hypertension (by relaxing smooth muscle in blood vessels). 

How do they work in stone passage?

The ureter is the hollow structure which transports urine from the kidney to the bladder. It has muscles which contract rhythmically in a process known as peristalsis. These movements normally help to speed the passage of urine down to the bladder. Medications to help pass stones may work by relaxing these ureteral muscles – resulting in a wider and less constricting ureter for stones to more easily pass through. 

Illustration showing how medications may help kidney stones pass.
How well do they work?

In initial studies of patients taking these medications or placebo (sugar pill), those on the medications were 1.45 times more likely to successfully pass their stone. They also required less pain medication and passed their stones more quickly with fewer return trips to the hospital than patients taking placebo. Most early studies however involved small numbers of participants which made their findings less reliable. 

Enthusiasm for this treatment approach waned when a large study from the UK published in July of 2015 cast doubt on effectiveness of medical expulsive therapy. The study included 1,167 participants who were given either placebo (sugar pill), tamsulosin, or nifedipine. The participants were then followed to see whether they passed their stone successfully. After 4 weeks, there were no differences seen, with 80% of those receiving placebo not needing further treatment, compared to 81% of those receiving tamsulosin and 80% of those receiving nifedipine. Pain scores, pain medication use, and time to stone passage also did not differ between the groups. Was this the end of medical expulsive therapy? Not quite – in medicine, more than one study is often needed to get a reliable answer and the question of whether medical expulsive therapy awaited additional research.

A subsequent analysis published by the Cochrane Library in 2018 pooled the findings from 15 studies with a combined total of 5,787 participants to try to get at a more definitive answer. In contrast to the UK study above, their combined results suggested kidney stone patients who took an alpha blocker medications were slightly more likely to pass their stones at a calculated relative risk of 1.16 (for each 1,000 patients who took an alpha blocker, 116 more passed their stones compared to those who took placebo (a sugar pill). Those who took an alpha blocker also seemed to more quickly pass their stones (3.4 days faster), have fewer hospitalizations (69 fewer hospitalizations per 1,000 patients), and take less pain medication. The effect of these medications seemed to be stronger for stones larger than 5mm. The downside of these medications was a slight increase in side effects (29 adverse events per 1,000 patients). These side effects included low blood pressure, fainting, racing heartbeat, and irregular heart beats.

The takeaway on medical expulsive therapy

The bottom line appears to be that medications used for medical expulsive therapy may modestly improve your chances of passing your stone and how quickly you pass your stone. They may also reduce the need for pain medications or hospitalization. They however may cause side effects in a small number of patients. The decision on whether to use these medications should ultimately be made with your medical provider and should take into account your chances of passing your stone spontaneously and whether you are at increased risk for serious consequences from any potential side effects.

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Teresa

OMG the stone’s are awful things ,must be a home remedy somewhere!!

Bernice ermis

I have seen that I have 10 stones in my left kidney and 11 in the left or vice versa. The largest one we saw yesterday again is 4 cms. I don’t think they will all pass and I’m hoping that my doctor will help me get them out. One medicine he said was an over-the-counter is called Theralith. Has anyone heard of this? I told him I couldn’t afford to get a drug. They are very expensive and would take a long time to get them all out I’m thinking. Most of them are very small. Thanks!

Laci

My husband has passed stones before with flomax and tylenol 4… has anyone has success with flexiril and flomax together? As he woke up this an at 4 in the worst… alsonhas anyone tries the lemon juice olive oil to help ease the pain??? Any input back would be greatly appreciated

William F. Minshall

Does chanca powers really work????? I heard that it can help prevent stones and might actually break up stones?????

William F. Minshall

My urologist prescribed allopurinol ( a.k.a. Anti gout medication) and potassium citrate tablets in 2014…… The potassium citrate is expensive, but I bought 500 capsules on the internet for only $15…. The prescribed 30 pills were over $100….. I brought the pill container in and my urologist said I had to take ten of the less expensive potassium citrate tablets to equal one of the prescribed tablets……. I take 300 of the capsules a month vs. 30 of the prescribed pills… Still under $15 per month vs. $100 for the prescribed pills… The allopurinol is only about $10 for thirty pills, taken once a day…. I had the procedure where the large formation of stag horn calcium stone s in kidneys were removed in 2014 by going in (arthoscopically??) through a hole in my side….. They removed 90 plus percent of the stones in each kidney….. I have been lucky in that I haven’t experienced the excruciating pain that many speak of since 2014….. I have a yearly follow-up with an X-Ray and these medications have kept stone formation down….. Recently, a stone passed and is currently in my ureter….. One of the ones left from the 2014 proceedure possibly….I had a procedure where they try to break up the stone in the ureter with some kind of intense sonic/ laser waves…… This only got about 60%, and the stone is still there… We are waiting to see if it will pass on it’s own, and am taking tamsulosin (flomax) to relax my ureter in the hope that the stone will pass…. Like I said, I have not yet experienced the intense pain that others are experiensing…. If the stone doesn’t pass, I have to have the procedure where they go up through the penis to break up the stone… Just wanted to mention that the allopurinol and potassium citrate make work for some of you if your urologist prescribed it for you…..At least I won’t be gout with the allopurinol (lol)….

William F. Minshall

I have heard that there are other medications that might relax the ureter enough to pass a stone in the ureter… Any suggestions? I was wondering if strong coffee would help…. I heard it might keep down stone production ????? Hate to sound like a dummy….. Also have been drinking Synergy Kombucha drink as a stomach probiotic…. Was wondering if this would have effect on clearing kidneys…. It is fizzy and vinegar tasting….. I had my gall bladder out because of a stone in it in 2014, and when my stomach acts up, the drink really helps…..

Brian

What mg were the capsules?

Gayle

Have had many kidney stones since I was 29 got my first one when my daughter was 3 months old. Since I was nursing her the dr wouldn’t give me anything stronger than tylenol,talk about pain and the pain you go through so you can keep your baby happy. Have passed kidney stones every year since and sometimes 2 or 3 a year lots of surgeries for stuck kidney stones. This past September had another stuck kidney stone so was back in surgery. But this time had a specialist that was pro-active. When he went in to remove the kidney stone that was stuck he saw that I had 3 more in my right kidney so he went in and took them all out. Was sent ho e with a stint for a week and that side was fine. However he told me I had 5 stones in my left kidney and 2 were too large to pass. On December 23 he went in removed the 3 small stones and laser crushed the others. I am still wearing the stint and will for another week. The first time I can say I am stone free in 35 years and it feels good. My advice is get a dr that’s proactive. When they put a stint in it takes pretty much the same amount of time to remove the stones. They have the technology to do this but they get paid everytime you come into emergency so don’t want to remove all the stones.in 2018 I had a dr take an hour and half just to put a stint in so i could get it crushed 2 weeks later. The dr that removed all my stones in my left kidney only took 30 minutes. I have follow up appointments every 3 months to make sure I stay stone free.

pfwag

Whatever treatment you end up with, insist on hydro-morphine for the pain until treatment.

Diana L

Anyone who has experienced an allergic reaction to sulfa drugs (topical creams or pills) should make sure the hospital/doctor knows about this, as Tamsulosin is a sulfa analog. If this is the case, go with Alfusozin instead. Any side effects or other indications are similar to Tamsulosin but without the risk of anaphylactic reaction. I agree with Anonymous that most of what you eat or drink won’t matter if you are prone to stones, but I have found that higher than average intake of citrus does lessen chances of getting stones and their severity when included with regular liquid intake.Hydrate, hydrate, hydrate! Especially if you like salty fatty snacks like me. ;-}

Ray ali

Can you please advice me on the types of tablets name I can used to crushed my kidney stones

Sheldaine

There isn’t anything you can take by mouth that will crush stones. Most stones are *extremely* hard; that’s why it takes shockwaves or lasers to blast them.
Think about it: anything you could take that would, indeed, affect a stone would also maim or kill you en route to the renal system!
The so called “stonebreaker” pills are, basically, a diuretic. You are instructed to take them with a glass of water. If you do pass a stone while using these pills, it’s the water that’s responsible. So save your money and keep up with the water, at *least* 2 litres / 64 oz. a day.
Usually you can pass a stone that’s 5 mm or smaller, depending on its shape and how you’re built inside. The ureter is 3 to 4 mm in diameter but stretches. I know some who’ve passed 7 mm stones. It wasn’t painless but they did avoid surgery!
Wishing you stone-free days. And, hopefully, that by the time you’ve seen this, you are still stone-free!

Dale W Robison

I have had four “sonic boom” treatments (lithotripsies) over a decade. None of them
have have blasted all kidney stones to bits. I still have one in my lower left abdomen
and its accompaniment — lower left back.

My last lithotripsy left me in terrible pain, caused a painful bladder backup in the recovery room, required a stent and catheter attached to a bag. This all reduced me
a bed with a collection bag on the floor for three weeks..

In the end, after bleeding disappeared from my urine the stent was removed through
my ureter and penis without anesthetic. Talk about medieval torture!

Right now I’m living with a modest amount of kidney pain and taking an OTC named
Stonebreaker. I’m not hoping for a miracle cure. I’ll suck on lemons.

Sheldaine

So-called stonebreaker pills are, at best, a diuretic.
There’s no evidence they’re really effective. Besides, you have to take them with a glass of water and, if anything, it’s the water that’s moving the stone.
Stones that are about 5 mm and smaller will likely pass on their own, depending on their shape.
So, go ahead and buy the so-called remedy, but I’d say save your money.
P.S. As for the lemons, they help deter new (calcium oxalate) stones from forming and current stones from growing.

Tom

I’ve had hundreds of kidney stones since the age of 20. I’m in my 60’s now and with the kidney condition called Medullary Sponge Kidney I know there really is no 100% cure for recurrence. My suggestion is to limit coffee and alcohol as they are diaretics and the other foods that are problems are peanuts, broccoli, chocolate ;o( . Nothing works 100% as I said, but when I do have a stone bothering me I use AZO and Flomax (tamsilosin) to help it once it’s out of the kidney. Drinking plenty of water and moving around helps with the pain. Also heat on my back or groin if the stone is “on the move”. Good luck.

fdzm

i have 6mm stone in my kidney. can it pass through?

Sam NazareneG

Hello there all kidney stoners,
I am told that I was born with kidney substance that would develop into either stones or sand (dust). I was admitted first time when I was five years of age. I know that this runs in my family and there is nothing we can do about it except take it one stone (or two ) at a time. One of my uncles had 36 such stones removed in the course of over 50 years. You won’t believe the size of these stones. kept them in two glass jars (big ones). they reached the size of a baseball ball.
i had one such stone back in 1986 that was 40*30*20 MM and the other was one cubic centimeter. both were removed in Haddasah Jerusalem by Extra-corporeal shock wave lithotripsy (ESWL).
Now I have many small stone in both my kidneys, and every now and then i feel pain for couple days then I pass one or two.
my current stone that is really bothering me is 14 MM, the Dr.s Implanted a Stent that will be removed after two and a half weeks in order to crack the stone and remove it.
In SHORT, I am writing to you in order to share my description of natural herbs that i received from my late Grandmother.
Rosemary branches plus Bay Leaves, and I add a stick of cinnamon, and few leaves of Sage. Boil them on three gallon pot and once done I cool them and drink then in the course of three-four days. This tastes a little bitter but the bitterness goes away in 3-4 seconds. I am in the early stages of this recipe but will keep on it even after the removal for I have many more small ones.
My friend lost his 8 MM kidney stone in 7-8 months.
God luck and God Bless You
Sam

I am in horrible pain from kidney stone shock wave treatment 2 weeks ago today. The pain today is worse than before procedure. What to do???

Lenette

I have a 8 mm Kidney stone on the left and I had The shockwaves surgery It did not work at All I keep drinking is water lemon juice they say put honey in water so am going to keep trying the natural way .

Anonymous

Lemon juice deters the formation of calcium oxalate stones and the growth of current stones.
It will NOT help you pass stones – and sugar (honey) won’t either. Considering the amount of sugar in most diets, if honey worked to pass stones we’d virtually never get kidney stones.

Anonymous

Hi I know an over the counter med which my dad took for his UTI but his kidney stone popped out while urinating because that medicine urges fast urination. The name in AZO urinary pain relief maximum strength.

Jac

After having lithotripsy 3 times with stints and basket surgery for stones I do feel I’m my own worst enemy. Water water water is honetly the best answer. I do believe that daily apple cider in small portions as well as lemon juice can prevent the stones from enlarging. If the stones like mine are in lower pole of kidney you may not be successful no matter what you chose to treat your stones with. My stones are made of calcium oxalate, I admittedly do not drink enough water. Indigestion would win over if I used pineapple juice but the other seems to prevent forming new stones. Good luck 🍀

Anonymous

These home “remedies” may, at best, DETER a stone. And oil is processed as a food, not a liquid, so it will not affect stones AT ALL. It passes through your digestive tract like solid waste. Why do you think oil can give you diarrhea?
If anything these “remedies” work because they’re consumed with lots of water. WATER..
Whether or not a stone passes depends on its size and shape and how you are internally, e.g. size of ureter and if there’s scarring in your renal system.
Not chanca piedra. Not apple cider vinegar. Not corn husks. Not oil.

Your early reply is awaited.

I have 3mm stones in right kidney.It came in my notice when went for Preventive Health Checkup on 3rd of June 2018. Since then I have been taking lemon juice and pineapple regularly two weeks. Green virgin olive oil also taken 5 days. But no benefits seems to me. Kindly suggest for 100% cure.

Anonymous

Lemon juice helps DETER calcium oxalate stones, not hasten their exit from your body.
And oil won’t help. It’s processed by the digestive tract to your bowels. It does NOT lubricate your kidneys or stones.
Drink at least 2 L (64 oz) of water a day. Your 3 mm stones may be bothering you but they will likely leave your body without intervention as they’re quite small.

Jiri TICHY

The best way to remedy kidney stones is prevention….Do not eat food, which contain hi amount of oxalates(search internet), avoid breathing dust from calcium used in making mortar and /or dust from dry gypsum or dust of smoothing out “mud” on drywalls., avoid coffee, and coffeinated drinks or any sodas*contains phosphoric acid as preservative).
Drink tea from Cola de Calaballo or herbmix called Chunkapiedra(South America). Drink water with lemon…especially in the morning -15 minutes before food. Pinaple, orange, grape or lemon with pinch of salt and green virgin olive oil (about 1/3 of cup). For salads make vinagrette from apple cider vinegar or white wine vinegar and Virgin olive oil and never waste the liquid…always drink it!. Put vinegar(small spoon) in cup of your tea…..

Anonymous

Not helpful if you already have one!

Anonymous

Most of what you’ve recommended will either do nothing or increase stone growth.
And, by the way, when you consume oil it goes to your stomach and is processed in the small intestine. It will not go to your kidneys and it will not go to your ureters or your bladder. Ever see oil in your urine? Exactly..

People are just trying to help. No need to be snarky

Trust Science, not the crowd

It’s not “snarky” when someone has to pound the mental doors people create when following herbal/homeopathic/internet cures from on-line strangers. While many think they are helping, they may cause folks to ignore sound, proven, scientific medical advice and treatments.

My grandfather once told me to get a jackass out of a mud pit you had to use a 2×4: “Hit it over the head with the board to get the jackass’s attention, then lead it out by the reins.”
Now THAT is snarky!