Pills for kidney pain

There are no special tablets for pain relief in the kidneys: medicinal products of the group of antispasmodics, analgesics or non-steroidal anti-inflammatory drugs (NSAIDs) are usually used to relieve pain of different localization and origin. And in emergency medical care with renal colic, you should not use pills for kidney pain, but more powerful painkillers that are injected parenterally. 

[1], [2], [3], [4], [5]

Indications for the use of tablets against kidney pain

The main indications for the use of pills from kidney pain are the relief of pain attacks with pyelonephritis (inflammation of the renal pelvis) and glomerulonephritis (inflammation of the renal glomeruli); acute and chronic renal failure; hydronephrosis or polycystic kidney, as well as nephrolithiasis (renal calculi).

Pharmacodynamics

Since these drugs belong to different pharmacological groups, their pharmacodynamics are different.

The basis of the analgesic action of Drotaverin hydrochloride is the blocking of the regulating passage of nerve impulses of the enzyme cAMP-phosphodiesterase, which changes the biophysical processes of the introduction of Ca 2+ ions into muscle cells and relieves their spasms causing pain. A similar mechanism of action in mebeverin of the active substance Meurerin, but in this case the transport of Na + ions through cell membranes is blocked.

Neurotropic spasmolytic Hyoscine has only peripheral action, and its active component (a synthetic analogue of belladonna alkaloid hyoscine butyl bromide), blocking the muscle receptors of the neurotransmitter acetylcholine, inhibits the transmission of parasympathetic nervous system impulses.

Pharmacodynamics of Spazmolgon is associated with the combined action of its components: metamizole sodium, pituophenone hydrochloride and fenpiverinium bromide. Their total effect is expressed in inhibition of cyclooxygenase (COX) and a decrease in the production of anti-inflammatory lipid mediators-prostaglandins and a decrease in the tone of smooth muscles, resulting in the withdrawal of the pain syndrome.

All non-steroidal anti-inflammatory drugs (Ibuprofen, Ketorolac, Dexalgin) also inhibit COX, which leads to a reduction in the synthesis of anti-inflammatory cytokines.

Pharmacokinetics

After taking a therapeutic dose of Drotaverine hydrochloride, it is partially absorbed, enters the bloodstream and binds to plasma proteins. The maximum concentration of the drug in the blood is noted about an hour after application.

Biotransformation of these tablets from kidney pain occurs in the liver, and metabolites are excreted from the body by the kidneys and intestines for two days.

The active substance of the Meverin preparation undergoes a metabolism before entering the systemic circulation and is excreted by the liver and kidneys.

Absorption of Hyoscine after ingestion is insignificant (not more than 8%), and binding to blood proteins is low (about 5%), but this is enough to relieve pain in the kidneys (the therapeutic effect of a minimum single dose lasts from 6 to 10 hours). Metabolism occurs in the liver, the products of decay are excreted through the intestine.

Spazmolgon after absorption in the gastrointestinal tract forms active metabolites, which are found in the blood for 1-1.5 hours. The drug is partially cleaved by acetylation in the kidney and is excreted in the urine.

Once in the stomach, all NSAIDs (Ibuprofen, Ketorolac, Dexalgin) are absorbed and enter the systemic blood stream with a maximum plasma concentration in 60-120 minutes. Binding with blood proteins reaches 98-99%. The therapeutic effect lasts an average of 4-5 hours. Biotransformation of NSAIDs occurs in the liver by conjugation with glucuronic acid, and metabolic products are quickly removed (through 4 hours) through the kidneys. More than half of the Ketorolac drug delivered to the digestive tract is excreted unchanged. Preparations of this group do not have a cumulative effect.

Names of pills for kidney pain

Painful syndrome in the kidneys is removed:

• myotropic antispasmodics: Drotaverina hydrochloride (other trade names - Drotaverin, No-shpa, Spasmol), Meverin (Duspatalin, Niaspam);
• antispasmodics of neurotropic action: Hyoscine (Buskopan, Spanil);
• combined analgesic preparations: Spazmolgon (other trade names - Spazgan, Revalgin, Baralgetas);
• nonsteroidal anti-inflammatory drugs: Ibuprofen (Ibupen, Ibuprex, Nurofen, etc.), Ketorolac (Ketanov, Ketorol, Toradol), Dexalgin (Dexketoprofen).

The diuretic preparation of vegetable origin Kanefron N (Canephron N) contains in its composition the powder of the root of lovage, herbs of gold-bearing and leaves of rosemary; analgesic is not, but is used as an auxiliary phyto-drug in uncomplicated cystitis and irritable bladder syndrome - to reduce the intensity of the inflammatory process and the activation of urodynamics.

Method and dosage of tablets for kidney pain

Tablets from pain in the kidneys are taken inside (not liquid, squeezed with water). Drotaverina hydrochloride (tablets of 40 mg) is recommended to take 1 tablet one or two times 2-3 times a day. The maximum daily dose is 6 tablets (240 mg). Single dose for children under 12 years - 20 mg.

Meverin (Duspatalin, Niaspam) is prescribed at 200 mg, between the intervals an interval of 12 hours is necessary.

Tablets Hyoscine  take 2-3 times during the day for 1-2 tablets. The same dosage of tablets from pain in the kidney Spazmolgon, while this drug is not used for more than three days in a row.

Ibuprofen (tablets of 200, 400 and 600 mg) adults are recommended to take 200-800 mg three times a day (after meals). Ketorolac tablets are taken one at a time of 6 hours between doses. Use this drug to relieve pain more than 5-6 days, doctors do not recommend.

A single dose of Dexalgina depends on the intensity of the pain: 1/2 (12.5 mg) or whole tablet (25 mg). The next dose can be taken only after 8 hours, and the allowable daily dose is 75 mg. The administration of this drug is also limited in duration.

Using tablets against kidney pain during pregnancy

Myotropic antispasmodics (Drotaverin, Meverin and their generics) with kidney pain during pregnancy should be prescribed by a doctor who, as written in all instructions, should evaluate the benefit to the mother and the possible danger to the development of the fetus.

The same principle of application of the spasmolytic Hyoscine, however, these drugs penetrate through the GPB and give side effects (they will be discussed below). This raises questions about their safety for pregnant women. Moreover, the lack of data from manufacturers on the negative effects of these drugs does not mean the absence of such effects.

When pregnancy is used, Spazmolgon is not recommended for kidney pain, and all non-steroidal anti-inflammatory drugs are prohibited.

Contraindications for use

All pills for kidney pain have these or other contraindications to the use. Drotaverina hydrochloride is contraindicated in cardiovascular pathologies (elevated blood pressure, coronary and cerebral atherosclerosis, tachycardia or impaired electrical impulse from the atria to the ventricles), kidney or liver failure, in the treatment of children under 12 years. This antispasmodic is not prescribed if there is a closed-angle glaucoma and an enlargement of the prostate gland.

Meverin contraindications include poor individual tolerability of the drug and age up to 14 years, and Hyoscine tablets are not prescribed if there are: hypertrophy of the large intestine, neuromuscular autoimmune diseases, closed-angle glaucoma, swelling of the lung tissue, and also if the patient is younger than 7 years.

Spazmolgon is contraindicated with sensitivity to aspirin, blood diseases with a decrease in the level of leukocytes, partial dysfunction of the liver or kidneys, pronounced atony of the bile or bladder and prostate adenoma.

Contraindications to the use of all non-steroidal anti-inflammatory drugs include allergy to acetylsalicylic acid, gastric ulcer, coagulopathy, arterial hypertension, severe heart failure, and kidney and liver failure.

[6], [7], [8], [9]

Side effects of tablets against kidney pain

The main side effects of tablets against kidney pain are as follows:

• Drotaverina hydrochloride can cause nausea, vomiting, bowel problems, headache, increased heart rate, arrhythmia, decreased blood pressure, bronchospasm and breathing difficulties, hives, hyperhidrosis, sleep disorders.
• Meverin and its synonyms can lead to allergic skin rash and angioedema.
• Hyoscine can cause dryness of the skin and oral cavity, skin rashes, heart rhythm disturbances, dyspnea, ishuria (urinary retention) and anaphylactic shock.
• Reception of tablets Spazmolgon can be accompanied by nausea and vomiting, epigastric pains and exacerbation of existing gastrointestinal diseases; headache, dizziness and discomfort; malfunctions in the urinary system, as well as negative changes in blood composition.
• Ibuprofen and other NSAIDs often cause heartburn, bloating, ulcers of the stomach mucosa, edema, hypertension, urticaria and bronchospasm. In the process of taking these tablets, there is a headache, shortness of breath, weakness, sleep disturbance, as well as rapid heart rate and blood pressure.

Overdose

Exceeding the dosage of Drotaverine hydrochloride may result in paralysis of the respiratory center and cardiac arrest. At the same time, there is no specific antidote, and heart stimulation and artificial ventilation of the lungs in conditions of resuscitation may be required.

The overdose of Meverine is expressed in the increased nervous excitability of the central nervous system. In such a situation, you should take activated charcoal and rinse the stomach.

Symptoms of an overdose of Hyoscine are dryness and hyperemia of the skin, as well as visual anomalies that quickly pass after washing the stomach and taking sorbents.

Spazmolgon in high doses can lead to intoxication and allergic syndrome. The usual measures are taken to accelerate the excretion of the drug from the body, and in more severe cases they perform enhanced hydration and hemodialysis.

With an overdose of NSAIDs, their side effects increase, which can be stopped by washing the stomach and following symptomatic therapy.

Interactions with other drugs

Presented in the review tablets from kidney pain interact with other drugs as follows:

• Drotaverina hydrochloride enhances the effect of concomitantly taking antispasmodics, and also reduces BP with the parallel use of certain antidepressants. Barbiturates potentiate the effects of drotaverine.
• Hyoscine with simultaneous use of drugs blocking the adrenaline receptors (and lowering blood pressure) increases tachycardia. The effect of tricyclic antidepressants and antihistamines is also increasing.
• Spazmolgon is incompatible with preparations containing ethyl alcohol, anticoagulants of the coumarin group and immunosuppressant Cyclosporin. The therapeutic effect of spasmolgonum reduce barbiturates, and NSAIDs, hormonal oral contraceptives and antidepressants increase the intensity of its side effects.
• Ibuprofen, Ketorolac, Dexalgin reduce the effect of diuretics and potentiate the effect of anticoagulant drugs. In addition, it is impossible to combine cardiac glycosides and NSAIDs, as this leads to an aggravation of heart failure. Tablets from kidney pain Dexalgin is inadmissible to be used simultaneously with drugs for the treatment of diabetes mellitus because of a decrease in the effectiveness of the latter.

Storage conditions and shelf life

The drug should be stored at room temperature, out of the reach of children.

Shelf life of most drugs is 3 years; Hyoscine tablets - 5 years.