Renal Colic (Acute Nephrolithiasis)

The usual dose of Ketoprofen Capsules, USP recommended for mild-to-moderate pain and dysmenorrhea is 25 to 50 mg every 6 to 8 hours as necessary.

Specialist pediatric emergency referral required

DailyMed Ketoprofen Package Insert (DailyMed, NLM)

NSAIDs beat opioids for renal colic - they reduce the ureteric spasm as well as the pain.

Acute Renal Colic - disease-level clinical article (renal-colic-full.txt)

Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.

0.4 mg once daily after breakfast as medical expulsive therapy (MET) for distal ureteric stones <10 mm

Specialist pediatric urology use only

DailyMed Tamsulosin Hydrochloride Capsule Package Insert (DailyMed, NLM)

Helps a stone in the lower ureter pass. It is not an analgesic and does not replace the NSAID.

1000 mg every 6 hours as needed, maximum 4000 mg in 24 hours

10-15 mg/kg/dose [child max 500 mg]

(Child under 1 month: 10 mg/kg 3 or 4 times daily (max. 40 mg/kg daily))

MSF Essential Drugs 2024 - paracetamol (oral)

Two jobs. Given alongside ketoprofen it improves the analgesia; given instead of it, it is what the patient who cannot have an NSAID gets - renal failure, active ulcer, or late pregnancy, all listed on the ketoprofen row above.

75 mg as one deep intragluteal IM ampoule; a second ampoule may follow after 30 minutes if the pain persists, up to 150 mg in a day - Injections for no more than two days, then continue with tablets or suppositories if still needed

Not for children - the ampoule is not recommended in the paediatric population.

Voltarol Ampoules SmPC (emc, 1043), section 4.2 Posology - renal colic entry

The card's only NSAID is an oral one, and vomiting is part of the presentation. This is the injection a Cairo GP gives in the clinic when the patient cannot swallow or keep tablets down.

4 mg to 8 mg by mouth

No paediatric dose for renal colic in the sources opened.

Acute Renal Colic - StatPearls - NCBI Bookshelf (NBK431091) - the article states the dose for this indication

Nausea and vomiting define the presentation and are why oral analgesia fails; the article names ondansetron as the preferred antiemetic here.

8 mg once daily with a meal

No paediatric dose in the sources opened.

Egyptian National Drug Formulary - Cardiovascular Chapter 2024 (silodosin monograph) - verbatim: "Oral: 8 mg once daily with a meal."

The card offers tamsulosin for medical expulsive therapy; the article reports silodosin beat both tamsulosin and alfuzosin in systematic reviews, so it belongs on the card as the stronger option.

800 mg a day in three divided doses, on top of fluids and alkali. US label verbatim: "Adults: The recommended initial dosage in adult patients is 800 mg/day. In clinical studies, the average dosage was about 1,000 mg/day." and "Administer THIOLA EC in 3 divided doses at the same times each day, with or without food. Maintain a routine pattern with regard to meals." The dose is then set by a urine test, verbatim: "Measure urinary cystine 1 month after starting THIOLA EC and every 3 months thereafter. Adjust THIOLA EC dosage to maintain urinary cystine concentration less than 250 mg/L." A patient who has had severe toxicity to penicillamine starts lower. - Indefinite, because cystinuria is a lifelong inherited transport defect. There is no course to finish - the review points are the three-monthly urinary cystine and the three- to six-monthly urine protein.

15 mg/kg/day

(Licensed from 20 kg, and cystinuria is one of the few stone diseases that starts in childhood. US label verbatim: "Pediatrics: The recommended initial dosage in pediatric patients weighing 20 kg and greater is 15 mg/kg/day. Avoid dosages greater than 50 mg/kg per day in pediatric patients", given in three divided doses. The reason for that ceiling is in the cautions: "Pediatric patients receiving greater than 50 mg/kg of tiopronin per day may be at increased risk for proteinuria." A child with a stone belongs with paediatric nephrology, not on a prescription written in a primary-care clinic.)

Not for children under 20 kg

THIOLA EC (tiopronin) delayed-release tablets US prescribing information, section 1 Indications and Usage, section 2.1 Recommended Dosage, section 2.3 Monitoring and section 5 Warnings and Precautions (DailyMed SetID 20298a52-a194-a161-8632-d84b6f26e23c)

The disease article names the drug in its section on preventing the next stone by stone type: a cystine-stone former needs a large urine output, 3000 mL a day or more, and a urine pH kept at 7.5 or above so cystine stays dissolved; potassium citrate is the preferred alkaliniser, and tiopronin or another thiol drug lowers urinary cystine. The US label's licensed use covers the same disease and the same three supporting measures: it is indicated, combined with high fluid intake, alkali and diet change, for preventing cystine stones in adults and children 20 kg and over with severe homozygous cystinuria not controlled by those measures alone. Cystine stones make up roughly 1% of stones but recur relentlessly, present in childhood or adolescence, and resist lithotripsy. The row is marked adjunct and third line because it does nothing for the colic in front of you - the analgesics and tamsulosin on the card handle that. Egypt has no registered tiopronin product, so no local brand or price can be shown.

No Egyptian brand matched — prescribe by generic name.