From the Guidelines
For kidney stone pain, NSAIDs such as ibuprofen (Advil, Motrin) or naproxen (Aleve) are recommended as first-line treatment, as they are at least as effective as opioids and can decrease ureteral smooth muscle tone and ureteral spasm, according to the CDC clinical practice guideline for prescribing opioids for pain - United States, 2022 1. When choosing an NSAID for kidney stone pain, it's essential to consider the potential risks and benefits.
- Ibuprofen (Advil, Motrin) is typically taken at 400-600mg every 6-8 hours as needed, not exceeding 3200mg daily.
- Naproxen (Aleve) is another effective option, taken at 220-440mg every 8-12 hours, with a maximum of 660mg daily for over-the-counter use. These medications work by reducing inflammation and blocking pain signals, which helps manage the severe pain caused by kidney stones moving through the urinary tract. However, it's crucial to note that NSAIDs can cause renal complications, particularly in individuals with preexisting renal disease, congestive heart failure, or cirrhosis, as they can cause volume-dependent renal failure, as well as renal failure from interstitial nephritis and nephritic syndrome 1. Therefore, it's essential to stay well-hydrated while taking these medications, drinking 2-3 liters of water daily to help pass the stone, and to consult a healthcare provider before using NSAIDs if you have kidney disease, stomach ulcers, or heart conditions. If pain is severe or persists despite NSAIDs, seek medical attention as stronger prescription medications may be needed.
From the Research
NSAID Options for Kidney Stone Pain
- There is no direct evidence in the provided studies to recommend a specific NSAID for kidney stone pain.
- However, according to 2, nonsteroidal anti-inflammatory drugs (NSAIDs) are preferred for alleviating pain during an episode of renal colic.
- The studies focus on the management of kidney stones, including medical expulsive therapy with alpha-blockers 3, 2, and lifestyle modifications to prevent recurrence 2.
- Other studies discuss the diagnosis and management of nephrolithiasis 4, but do not provide information on specific NSAIDs for pain management.
- One study is unrelated to the topic of kidney stones and NSAIDs, focusing on the genome of coxsackievirus B3 5.