Which medications are used to treat various stone-forming conditions
Oral Drug Therapy for Renal Stones.
| DISORDER | DRUG | DOSAGE |
|---|---|---|
| Absorptive type I | Hydrochlorothiazide Potassium citrate Cellulose sodium phosphate Magnesium gluconate Magnesium oxide | 12.5–25 mg twice daily 10–30 mEq three times daily 5 g 1–3 times/day with meals 1–1.5 g twice daily 400 mg twice daily |
| Absorptive type II | Hydrochlorothiazide | 12.5–25 mg twice daily |
| Renal phosphate leak | Neutral sodium phosphate | 500 mg three times daily |
| RH | Hydrochlorothiazide | 12.5–25 mg twice daily |
| Hypocitraturia | Potassium citrate | 10–30 mEq two to three times daily |
| Hyperuricosuria | Potassium citrate Allopurinol | 10–30 mEq two to three times daily100–300 mg/day |
| Enteric hyperoxaluria | Potassium citrate Magnesium gluconate Calcium citrate Calcium carbonate Cholestyramine Pyridoxine | 10–30 mEq three times daily 1–1.5 g twice daily 950 mg four times daily 250–500 mg four times daily 4 g three times daily 100 mg/day |
| Cystinuria | Potassium citrate Tiopronin Penicillamine Pyridoxine | 10–30 mEq three times daily 100 mg 2–4 tablets three times daily 250–500 mg four times daily 50 mg once daily |
| Struvite stones | Acetohydroxamic acid | 250 mg 1–2 tablets three times daily |
| Antispasmodic therapy | Tamsulosin Nifedipine ER | 0.4 mg once daily 30 mg once daily |
Note: All medications are given orally. Dosages are estimated ranges and not absolute recommendations. Each drug must be adjusted according to the patient’s tolerance. Use the lowest dosage necessary to attain the desired effect and avoid side effects. Always use drug therapy in addition to appropriate dietary changes and fluid input. Potassium citrate is better tolerated in lower dosages taken three times a day with meals. However, twice-daily dosing of extended-release potassium citrate may improve compliance. Potassium citrate is often required to correct thiazide-induced hypokalemia and hypocitraturia.
