7.4.3 Drugs used in urological pain
General Notes
- See NICE guideline NG118 on Renal and Ureteric stones: Assessment and Management.
- The acute pain of ureteric colic may be relieved with diclofenac by injection or as suppositories and compares favourably with pethidine; other NSAIDs are occasionally given by injection.
- Lidocaine gel is a useful topical application in urethral pain or to relieve the discomfort of catheterisation (see BNF Chapter 15).
- Tamsulosin is sometimes prescribed off-label [unlicensed indication] to hasten the passage of ureteral stones and decrease the severity and duration of renal colic.
Alkalinisation of urine
| Choice | Drug |
|---|
| 1st choice | Potassium citrate mixture BP (potassium citrate oral solution containing potassium citrate 30%, citric acid monohydrate 5% in a suitable vehicle with a lemon flavour) |
| |
Prescribing Notes
- Potassium citrate may relieve discomfort in mild urinary tract infections.
- Proprietary brands of potassium citrate and sodium citrate are on sale to the public for relief of discomfort in mild urinary tract infections.
- Sodium bicarbonate is used as a urinary alkalising agent in some metabolic and renal disorders.
Caution
- Caution is required when using either potassium or sodium citrate in patients with cardiac disease or renal impairment.
