chronic

Recurrent Urolithiasis (Kidney Stone Prevention)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources4 sources

DailyMed Allopurinol Tablet Package Insert (DailyMed, NLM) · DailyMed Hydrochlorothiazide Tablet Package Insert (DailyMed, NLM) · DailyMed Urocit-K (Potassium Citrate Extended-Release Tablets) Package Insert (DailyMed, NLM) · EAU Guidelines on Urolithiasis 2023

Verified against4 documents

DailyMed Allopurinol Tablet Package Insert (DailyMed, NLM)
DailyMed Hydrochlorothiazide Tablet Package Insert (DailyMed, NLM)
DailyMed Urocit-K (Potassium Citrate Extended-Release Tablets) Package Insert (DailyMed, NLM)
Urolithiasis - disease-level clinical article (urolithiasis-prevention-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (5)

Unilateral, colicky flank or abdominal pain that comes and goes is the classic stone presentation [abdominal pain]
Pain shifts toward the groin, scrotum, or labia as a stone moves toward the bladder junction [groin pain]
Nausea, vomiting, and fever can accompany the pain of a stone [fever · nausea · vomiting]
Constant shifting and inability to stay still, rather than lying motionless, is typical of stone pain
A child with a stone may present with irritability and crying rather than describing pain [irritability]

Signs — what you find (2)

The abdomen is usually soft and not distended on exam despite the degree of pain
Hemodynamic instability can develop when a stone leads to obstruction with sepsis [sepsis]

Tests (6)

Microscopic blood on urinalysis is found in about 90% of stone patients
Renal ultrasound is the preferred initial study in pregnant and pediatric patients to avoid radiation
Non-contrast CT of the abdomen and pelvis is the most accurate study, at 95% sensitivity and 98% specificity
A stone under 3 mm can be missed on CT because it may fall between the imaging slices
A low-dose CT protocol is avoided once the patient's BMI is above 30
The STONE score combines sex, symptom timing, nausea, and hematuria to gauge how likely a stone is

If not this — what else fits (4)

Pelvic inflammatory disease is a differential to weigh against suspected renal colic
A spontaneous abortion should be excluded as a cause of pelvic pain in a pregnant patient
A renal artery aneurysm is a vascular differential for flank pain
Small bowel obstruction can cause colicky abdominal pain that resembles renal colic

SourceStatPearls "Urolithiasis" - disease-level clinical article

Presentation findings are traced to the source above.

Rx: Alkalinisation | If hyperuricosuria | If hypercalciuria | Main treatment

ALKALINISATION

POTASSIUM CITRATE

Alkalinisation

1st line

Strength1080 mg

Formoral.solid

Adult dose and duration

1080 mg (10 mEq) three times daily with meals, titrate to maintain urinary pH between 6.2 and 6.8 - long-term

Paediatric dose

Under pediatric urology/nephrology supervision only

Dose source

DailyMed Urocit-K (Potassium Citrate Extended-Release Tablets) Package Insert (DailyMed, NLM)

Why

Alkalinizes urine to prevent hypocitraturic calcium oxalate, uric acid, and cystine stones

Cautions

CONTRAINDICATED in hyperkalemia, severe renal impairment, and peptic ulcer disease.
Monitor serum potassium and renal function regularly.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
KALEMAPEX 10 MEQ (1080 MG) 30 XR TABS.	MULTI-APEX	187.50 EGP
CITRO-K 1.102G/5ML 120ML SYRUP? strength differs? different route - not oral solid	EUROPEAN EGYPTIAN PHARM. IND.	9.00 EGP

IF HYPERURICOSURIA

ALLOPURINOL

If hyperuricosuria

1st line

Strength100 mg

Formoral.solid

Adult dose and duration

200 mg to 300 mg orally daily in divided doses or as the single equivalent. - long-term

Paediatric dose

Specialist pediatric use only

Dose source

DailyMed Allopurinol Tablet Package Insert (DailyMed, NLM)

Why

Indicated when 24-hour urine demonstrates hyperuricosuria (>800 mg/day in men, >750 mg/day in women)

Cautions

Discontinue immediately if skin rash occurs (risk of severe cutaneous adverse reactions).
Advise them to increase fluid intake during therapy (i.e., for adults, at least 2 liters of liquids per day) and to stay well hydrated to prevent kidney stones.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
NO-URIC 100 MG 50 TABS.	EIPICO	12.00 EGP (0.24/unit)
URIC PURE 100MG 50 TAB.	MEPACO	13.50 EGP (0.27/unit)
LESSURIC 100MG 20 TAB.	ALEXANDRIA	6.00 EGP (0.30/unit)
ZYLORIC 100 MG 30 TABS.	GLAXO SMITHKLINE > ASPEN PHARMA TRADING LIMITED	39.00 EGP (1.30/unit)

IF HYPERCALCIURIA

HYDROCHLOROTHIAZIDE

If hypercalciuria

1st line

Strength25 mg

Formoral.solid

Adult dose and duration

25-50 mg once daily in the morning for hypercalciuric calcium stone formers - long-term

Paediatric dose

Specialist pediatric nephrology use only

Dose source

DailyMed Hydrochlorothiazide Tablet Package Insert (DailyMed, NLM)

Why

Thiazide diuretic that lowers urinary calcium excretion by increasing distal renal tubular calcium reabsorption; used to prevent recurrent calcium stone formation in patients with hypercalciuria.

Cautions

Reduces urinary calcium excretion by enhancing distal nephron calcium reabsorption.
Monitor serum potassium (hypokalemia risk) and serum uric acid.
Restrict dietary sodium intake to optimize hypocalciuric efficacy.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
HYDROZIDE 25 MG 30 SCORED TABS.	EPCI	8.00 EGP

MAIN TREATMENT

REFERRAL & SAFETY-NETTING (NO DRUG THERAPY)

1st line

Dose source

Urolithiasis - disease-level clinical article (urolithiasis-prevention-clinical.txt)

Why

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

Cautions

RED FLAG - Struvite stones largely require surgical intervention rather than the medical/preventive drug therapies on this page, and need close urology follow-up.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.