7.4.3 Drugs used in urological pain
- 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
- 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 is required when using either potassium or sodium citrate in patients with cardiac disease or renal impairment.