Urolithiasis Drug Summary

Drug	Dosage	Remarks
Allopurinol	200-300 mg PO 12-24 hourly	Adverse Reactions Dermatologic effects (exfoliative dermatitis, pruritus, maculopapular rash); GI effects (nausea/vomiting); CNS effects (headache, vertigo, drowsiness); Hematologic effects (leukopenia, thrombocytopenia, hemolytic and aplastic anemia); Other effects (arthralgia, fever, visual and taste disturbances) Special Instructions Should be taken with meals Use with caution in patients with known hepatic/renal disease and those with poor uric acid clearance Contraindicated in patients with asymptomatic hyperuricemia
Febuxostat	Uric nephrolithiasis: 80 mg PO 24 hourly	Adverse Reactions Hypersensitivity, hematologic abnormalities, gout flares Special Instructions Use with caution in patients with hepatic and severe renal impairment Contraindicated in patients with ischemic heart disease or CHF, increased rate of urate formation
Pinene/Camphene/Cineol/ Fenchone/Borneol/Anethol	1-2 cap PO 8 hourly	Special Instructions Should be taken on an empty stomach Increase fluid intake during treatment Avoid use during first trimester of pregnancy Use with caution in patients taking oral anticoagulants and other drugs metabolized by the liver

Drug	Dosage	Remarks
Potassium citrate	Mild-moderate hypocitraturia: 10 mEq PO 8 hourly or 15 mEq PO 12 hourly or 30 mEq PO 24 hourly Severe hypocitraturia: 15 mEq PO 6 hourly or 20 mEq PO 8 hourly or 30 mEq PO 12 hourly or 60 mEq PO 24 hourly	Adverse Reactions GI effects (abdominal discomfort, nausea/vomiting, diarrhea) Special Instructions Should be taken with food Should follow a diet low in salt and is advised to increase intake of fluids Use with caution in patients with altered potassium excretion mechanism and renal insufficiency Contraindicated in patients with renal insufficiency, persistent alkaline urinary infections, obstruction of the urinary tract, hyperkalemia, adrenal insufficiency, respiratory or metabolic alkalosis, active peptic ulcer, intestinal obstruction, patients who have submitted to anticholinergic therapy and with slow gastric emptying
Sambong (Blumea balsamifera Leaf)	1,000 mg PO 8 hourly or 40-50 mg/kg/day PO in 3 divided doses	Adverse Reactions GI effects (abdominal discomfort, nausea/vomiting, diarrhea) Special Instructions Use with caution in patients with excretory urogram showing signs of renal obstruction
Tiopronin	Initial dose: 800 mg PO 8 hourly Average dose: 1,000 mg/day PO in 3 divided doses	Adverse Reactions CNS effects (chills, fatigue, fever); Dermatologic effects (bruising, pemphigus, pruritus, rash, skin friability/wrinkling, urticaria, warts); GI effects (abdominal pain, anorexia, bloating, diarrhea, flatulence, loss of taste perception, oral ulceration, nausea/vomiting); Hematologic effects (anemia, bleeding, eosinophilia, leukopenia, thrombocytopenia); Hepatic effects (jaundice, abnormal liver function tests); Neuromuscular and skeletal effects (arthralgia, myalgia, myasthenia gravis, weakness); Renal effects (Goodpasture’s syndrome, hematuria, nephrotic syndrome, proteinuria); Respiratory effects (bronchiolitis, dyspnea, hemoptysis, laryngeal edema, pharyngitis, pulmonary infiltrates, respiratory distress); Other effects (elastosis perforans serpiginosa, hypersensitivity, loss of smell, lupus-like syndrome, lymphadenopathy, positive ANA test) Special Instructions Patient should continue drinking at least 3 liters of fluid while taking this medication Contraindicated in patients with known agranulocytosis, aplastic anemia or thrombocytopenia that has developed from this medication

Drug	Dosage	Remarks
Orthosiphonis herba/Plantago major folium/Sericocalyx folium/Sonchus arvensis folium	1-2 cap PO 8 hourly	Special Instructions Should not be given in children, pregnancy and lactation
Phyllantus niruri/Rosmarinus officinalis/Ocimum basilicum	1 cap PO 24 hourly
Phytin/L-methionine/Vitamin A/Zinc	JJ catheter calcification: 3 capsules PO 24 hourly x 4 months Infectious lithiasis/struvite: 2 capsules PO 24 hourly x 4 months	Special Instructions Should not be used as a substitute for varied diet Should not be given in children, pregnancy and lactation
Theobromine/Vitamin A/Zinc	Uric acid lithiasis: 2 capsules PO 24 hourly x 4 months

All dosage recommendations are for non-pregnant and non-breastfeeding women, and non-elderly adults with normal renal and hepatic function unless otherwise stated.  
Not all products are available or approved for above use in all countries.  
Products listed in the Drug Summary are based on indications stated in the locally approved product monographs.   
Please refer to local product monographs in Related MIMS Drugs for country-specific prescribing information.