Kidney Stones - Treatment

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Allopurinol. Allopurinol (Lupurin, Zyloprim) is very effective in reducing high levels of uric acid and may be helpful for patients with uric acid stones. Allopurinol will not prevent calcium stones from forming. There is also a slight risk for xanthine stones with this drug. Side effects include diarrhea, headache, and fever. More severe complications include blood disorders that may produce fatigue, bleeding, or bruising. About 2% of patients experience an allergic reaction to allopurinol that causes a rash. In rare cases, the rash can become severe and widespread enough to be life threatening. Allergic individuals who had experienced only a mild rash to sodium bicarbonate may be able to build up their tolerance for the drug by undergoing a desensitization process. The drug may also increase the risk for cataracts.

Allopurinol reduces uric acid levels rapidly, so it may trigger an attack of gout in susceptible people. To prevent this, patients taking allopurinol should also take a nonsteroidal anti-inflammatory (NSAID) for 2 or 3 months. Aspirin should not be taken, since it increases uric acid levels. Patients should discuss the appropriate drug with their doctor.

Medications for Struvite Stones

Before any medical treatment is given for struvite stones, the stones must be completely removed with surgery.

Antibiotics for Eliminating Infection. Persons with struvite stones are given on-going antibiotics to keep the urine free of the bacteria that cause urinary tract infections. Careful follow-up and urine testing is extremely important. (A high pH urine indicates low acidity and an increased risk of infection.)

Acetohydroxamic Acid (AHA). Acetohydroxamic acid (AHA or Lithostat) is beneficial when used with long-term antibiotics. AHA blocks substances that are released by bacteria and has been effective in preventing stones even when bacteria are present. Side effects, however, can be severe. The drug reduces iron in the body, so anemia is a common problem. Iron supplements may be needed. Other side effects include nausea, vomiting, depression, anxiety, rash, persistent headache, and, rarely, small blood clots in the legs. Experts recommend this drug only for patients with healthy kidneys who have chronic diseases caused by these specific struvite-causing organisms. Alcohol should be avoided. Pregnant women should not take acetohydroxamic acid.