Stones in the kidney and urinary tract are hard masses that form from crystals that separate from the urine. Those that develop in the kidney are called kidney stones. Those that are found in the ureters — the long tubes that carry urine from the kidneys to the bladder — are called ureteral stones. Stones usually contain chemicals, most commonly calcium, that are a normal part of our diet. Less commonly, they are caused by urinary tract infection or uric acid.

Cystinuria

Cystinuria is an inherited disorder. The kidneys filter the body’s blood, keeping some substances (a process called reabsorption) and filtering out others for excretion. In cystinuria, certain important amino acids are not adequately reabsorbed, resulting in excess excretion. These amino acids may form crystals or stones in the kidneys, ureters, or bladder. Cystinuria is the least common cause of kidney stone formation, accounting for 3% or less of kidney stones.

Commonly Prescribed (On-Label) Drugs: Penicillamine, Tiopronin

Off-Label Prescription Drug Breakthrough Option: Captopril

Hypercalciuria

Hypercalciuria is the presence of an excessive amount of calcium in the urine. It is the most common cause of kidney stones caused by calcium that physicians have been able to identify. Medications used to reduce hypercalciuria include diuretics, bisphosphonates, vitamin D suppressors, and urinary macromolecules, alone or in combination in difficult cases. They should be used in conjunction with dietary therapy.

Commonly Prescribed (On-Label) Drugs: Phosphates

Off-Label Prescription Drugs Breakthrough Options: Amiloride, Indapamide, Trichlormethiazide, Ketoconazole. Pentosan Polysulphate, Risedronate

Kidney Stones

Kidney stones are one of the most common disorders of the urinary tract. Most pass with no problem. But when larger ones get stuck in the ureter, they can cause enormous pain. The four main types are: stones that contain calcium that your kidneys have failed to flush out normally; struvite stones that may form after an infection; uric acid stones that may arise if you have too much acid in your urine; cystine stones, which are rare but tend to run in families.

Commonly Prescribed (On-Label) Drugs: None

Off-Label Prescription Drugs Breakthrough Options: Ibuprofen, Ketorolac, Nifedipine, Prednisone

Renal Colic

Renal colic is intermittent, but often very severe, pain felt on the side of the abdomen that is most commonly caused by a tiny kidney stone passing down the ureter — the tube that connects the kidney to the bladder. Sometimes the stone gets stuck and remains in one place in the ureter. Another medical term for the condition is nephrolithiasis. It has been called one of the most severe types of pain. Treatment options are aimed at reducing the severity of pain.

Commonly Prescribed (On-Label) Drugs: Dezocine

Off-Label Prescription Drugs Breakthrough Options: Ibuprofen, Ketorolac

Ureteral Stones

Ureteral stones are those that form in the ureters — the long tubes that carry urine from the kidneys to the bladder. When a stone is in the ureters, as opposed to the kidneys, you may feel the need to urinate more often.

Commonly Prescribed (On-Label) Drugs: None

Off-Label Prescription Drugs Breakthrough Options: Ibuprofen, Ketorolac, Nifedipine, Prednisone, Tamsulosin

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