What is the role of Rowatinex (Phenylbutazone, Papaverine, and other ingredients) in the treatment of urolithiasis (kidney stones)?

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Last updated: February 27, 2025View editorial policy

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From the Guidelines

Rowatinex should not be considered a first-line treatment for urolithiasis, but rather as a complementary approach to primary treatments like adequate hydration, medical expulsive therapy, or surgical interventions. The American College of Physicians (ACP) recommends management with increased fluid intake spread throughout the day to achieve at least 2 L of urine per day to prevent recurrent nephrolithiasis, as well as pharmacologic monotherapy with a thiazide diuretic, citrate, or allopurinol to prevent recurrent nephrolithiasis in patients with active disease in which increased fluid intake fails to reduce the formation of stones 1. Some key points to consider when using Rowatinex include:

  • Typical dosage: 1-2 capsules taken three times daily with meals for several weeks during active stone management
  • Mechanism of action: potentially increasing urine flow, reducing urinary tract spasms, and providing mild anti-inflammatory effects that may ease stone passage
  • Safety profile: relatively good with minimal side effects, typically limited to occasional gastrointestinal discomfort or allergic reactions in sensitive individuals
  • Efficacy: appears most beneficial for small stones (less than 7mm) in the lower urinary tract It is essential to note that Rowatinex should not replace primary treatments, and its use should be considered on a case-by-case basis, taking into account the individual patient's needs and medical history.

From the Research

Role of Rowatinex in Urolithiasis Treatment

  • Rowatinex is a combined drug based on plant terpenes, providing diuretic, anti-inflammatory, and antispasmodic effects 2.
  • The use of Rowatinex in patients with urinary stone disease after extracorporeal shock-wave therapy (ESWL) has been analyzed, showing that it contributes to effective and rapid passage of stone fragments 2.
  • Rowatinex allows for a reduction in the time to spontaneous passage of fragments after ESWL, intensity of pain syndrome, and leukocyturia, as well as an increase in daily diuresis 2.
  • The effect of Rowatinex does not depend on the stone composition 2.

Comparison with Other Treatments

  • Other studies have explored the use of thiazide diuretics, allopurinol, and other medications in the prevention and treatment of urolithiasis 3, 4, 5, 6.
  • These treatments have shown varying degrees of effectiveness in preventing stone recurrence and reducing symptoms 3, 4, 5, 6.
  • However, Rowatinex has been specifically studied in the context of ESWL and has shown promise in facilitating the passage of stone fragments and reducing symptoms 2.

Mechanism of Action

  • The exact mechanism of action of Rowatinex in the treatment of urolithiasis is not fully understood, but its diuretic, anti-inflammatory, and antispasmodic effects are thought to contribute to its effectiveness 2.
  • The increase in diuresis caused by Rowatinex may help to flush out stone fragments and reduce the risk of further stone formation 2.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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