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.
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.
hi, I am 27 yrs old, and I am having a 5 mm kidney stone can i pass it out using some medicine. Can i avoid Sergeiery ??
If i can use some medicine then can you please help me which medicine to take?
Im a 50 yr old male. Two stones, one on each kidney.
Measure 7.8mm and 5.5mm. Taking Tamulson.
Pain can be unbearable, so much i go emerg. For IV pain relief.
Yes, rather chew my foot off.it then eases.
I had one 5 years ago and passed itnok.
Rule is 7-8 mm is about a 50% chance it wont get stuck.
Waiting on followup.
Hi.I m 26 years male.I have 0.6cm stone in right ureter from 4-days.extremely pain occured .I m using tamsulin and citral syrup.any one have best experience
I have a 10.5 mm stone just beyong the UP junction. So suggest to remove it.
I am a 52 year old woman, I was just advised that I have an 8mm kidney stone in my right kidney, I don’t feel any pain but blood showed up in my urine test. I was advised by my doctor that it is just sitting in my kidney and is not passingCan medications break this up or is surgery needed
Hello Ellen, I see you wrote your question 2 weeks ago, and perhaps you already have your answer, but if your gp is not giving you the info you need, you should consider getting him to refer you to a urology specialist. That is getting into a good sized kidney stone, and yes it can and probably will be passed. It won’t be nice.
There are 3 ways a kidney stone is going to come out. One way is by surgery, but that is only when it is threatening your life. Another is to target the stone with a form of shock or sound waves to break it up into much smaller pieces, but then you have 2 more potential problems. The sound waves can make more damage to your surrounding kidney tissue because it is very soft and delicate, also, then you will have many smaller pieces of kidney stone to pass instead of just one.
The third way is to just go though it the old fashioned way. He can prescribe to you certain drugs that will ‘open’ or loosen the tube that the stone has to pass through to help you pass it.
The problem with a kidney stone is that they can sit in there sometimes for years, you don’t even know you have one and suddenly you have this incredible pain, so bad you think it would hurt less if you cut off one of your arms or leg.
I’m sorry to tell you this, good luck, and keep positive by thinking once it’s done, you’ll feel better within moments.
I am a 39 year with a 5mm stone… Had it for over almost 3 weeks. The pain comes and goes. I am taking flomax and almost out. The pain started up again. Should I worry?
I had a stone and it passed successfully ax my urologist prescribed me 3 medicines ( Rowanix , Catafast and Prosta Tab pro).It took one month to pass stone which obstructed my left ureter.
Hi. What was the size of the stone?
I’m a 26 year old women .. I have a 4mm stone .. Took flowmax .. Took all my pills already .. And still have pain .. Does that mean I need to get it surgically removed??
Probably because I had stone of 4.5 mm in ureter. I was operated for the same just last week. Consult your clinician.
Look up this stuff calles Stone Breaker. It has chanca piedra in it which helps get rid of stones.
hi, I am 27 yrs old, and I am having a 5.7 mm kidney stone can i pass it out using some medicine. Can i avoid Sergeiery ??
If i can use some medicine then can you please help me which medicine to take?
Please consult your nearby urologist to avoid medical emergency.
Look up this stuff called Stone Breaker. It has chanca piedra in it which helps get rid of stones.
Sir,Can I use Cystone medicine for removing the 5.8 mm of stone or it can be remove by water or not?
Several of my relatives are having kidney stone. Cyston works for them. They have it even they feel slight pain. But the still stone did not pass. It reduces the sensation of pain. For effective therapy for stone, it’s better to consult a good urologist.
Sir a calculas of 8.9mm is found in lower calyx of my left kidney. Can it be pass through urine? & How?
Sir, a calculus of 9.9 mm is found in upper calyx of my right kidney. can it be pass through urine ? and How ?
hi, I am 27 yrs old, and I am having a 5 mm kidney stone can i pass it out using some medicine. Can i avoid Sergeiery ??
If i can use some medicine then can you please help me which medicine to take?
I see a naturopath. She sent me home with an herbal tincture of Ulmus and colinsonia. I also take magnesium citrimate and L-glutamine powder. I have avoided surgery with four stones this way.
i have tested the urine and small crystals found, i have burning pain in my left kidney , i have consulted so Many times with different medication but no difference since early 2014. I also made the scan this year april but nothing found, no blood in the urine but am burning left kidney. I also consulted the traditional healers but said my left kidney is week and pain because it cant pass the waiste . So m hopeless i dont know where to go. M writting dis on bed i cant even wakeup my kidney is burning like Fire.
I m 48 yrs male. I have 13 mm stone in left ureter. Can it b pass by urine? Sugest me pls.
A 13 mm stone is very big. Lithotripsy may help you have you asked your dr?
I m 48 hrs male. I have 13 mm stone in left ureter. Can it b pass by urine? Sugest me pls.
1 gokharu powder or seeds boil 20 mg in 250ml for 30 minutes water drink for one month early in the morning
2 boil barly seeds 20 mg in 250 ml water for 30 minutes drink it early in the morning
3 Take powder pashanbhedi one taspoon with 250 ml warm water early in morning
4 drink tendour coconut water for one month early in morning
5 drink 100 to 200 ml water after every one hour
I have 7mm of stone on my kidney, how can I brake it and pass it out without surgery, please help me, its painful. thanks.
Most Drs would tell you that you have a 50/50 chance to pass one that size. Flomax, ketorolac & pain meds are usually prescribed.
i have a stone in uthera of 10 mm , though it is not paining , can it be removed by medicines
No, lithotripsy or surgery usually. I’ve had one embed in my ureter before so make sure you don’t wait long for it to pass so that same thing doesn’t happen to you.
can lemonade or sodium carbonate water drinks reduce kidney stones? can passing clear transparent urine by drinking enough water melt stones? if I pass my urine always in yellow colour lead to stones,so drink much water?
Yes my doc recommends lemonade
I have two stones stuck in urinary tube.one is medium, other small stone.how to melt them or pass them without operation.
i’m trying Tamsulosin…i also have a stone in my uterers. i hope it works
Try an herb called Stone Breaker, which has the main herb Chanca Piedra, as well as several others. My husband had an extremely painful kidney stone episode, and we think it dissolved the stone by the time it got to the bladder. We would get a prescription next time for a muscle relaxant like Flomax.
I didn’t take the prescribed tamsulosin when the ER advised that I had kidney stones on my right kidney. I took it once and it made me dizzy and I couldn’t take off work. I came to the ER because of blood in my urine. Also on doxycycline for urine infection. Don’t know if stones passed. Still bleeding. Should I still continue tamsulosin until I finish the bottle?
it makes me dizzy also let me know the answer to your question plz
When you look up flomax it says it’s not recommended for women or children. Doesn’t say why but I stopped taking it when I read that.
Flomax is a med for the male prostate. But woman can use it. It just relaxes the uretur. It will make you dizzy etc. I take it right before I go to bed. Helps me sleep when I’m in severe pain from stones.
I have a 6 mm calculus in the floor of my bladder. What is the best way to pass this.
Lt renal sinus calculus 6.0 mm in lower calyx
Sir i am 26 year s old i have my left kidney 16 mm stone how treatment and pass with out Sergeiery please sir help me
16mm won’t pass with medication that will have to be done surgically however I have had the surgery many times and it’s painless
Hi aim 28 years old and I have a 13 mm stone in my left kidney renal pelvic of it possible to out or treat without any operation aim from Afghanistan please help me thanks
I hv two stones one is 11.3mm and the other 13.6mm, what should I do
Lithotripsy or surgery for one that big
I have a 13 mm kidney stone in the right kidney.is possible to treatment without surgery
do to UROLOGIST YO GIVE YOU POTASSIUM CITRTATE AND FLOMAX