Oct 19, 2007

A Theory on Kidney Stones and Pseudoephedrine

As mentioned previously, I have been a long-time sufferer of kidney stones, which are also known by the formal name of nephrolithiasis. I currently have a stone lodged in my left ureter, causing me a considerable amount of discomfort.

While reading up on the topic, I came across an article on Medscape Today that suggests a link between kidney stones and pseudoephedrine use. I am also someone who consumes Sudafed for sinus congestion, so I was intrigued by this link.

Given the fact that the kidney stone pain has been most fierce in the late morning, I began to wonder about the effects that pseudoephedrine might have on kidney stones stuck in the ureter. I usually take Sudafed between nine and ten in the morning (one or two 30 mg tablets), and the pain becomes more severe between eleven and twelve o'clock. My theory is that - since pseudoephedrine narrows blood vessels - it might also narrow the ureter, making any stones lodged therein even more painful.

I read that pseudoephedrine is used to treat urinary incontinence, as it causes the sphincter muscles at the bladder neck to contract and tighten. Would it not follow that a similar mechanism is at work on the ureter in people taking pseudoephedrine?

At any rate, now that I have read a few warnings about pseudoephedrine and kidney disease, I shall cease taking said decongestant. Should my symptoms subside, I will gladly trade stuffy sinuses for searing kidney stone pain.

If such a medical study examining the relationship between pseudoephedrine use and kidney stone pain has been completed, feel free to link to it in the comments section of this blog. If not, and you are a researcher in urinary medicine, be sure to cite this blog as inspiration for your future award-winning experiments proving or disproving the link.



Roo said...

Mike - pseudoephedrine is a great drug - but like many great drugs it has its downfalls. The vasoconstriction is one that interferes with many organs - not just the kidneys/ureters.

If you have trouble with sinus and allergy issues I would suggest checking into something like Claritin or Allegra. They come in generic form as loratadine and can be purchased anywhere. While they are not strictly for stuffy noses, they certainly alleviate that issue and you only need take 1 tablet every 24 hours.

Hope you are feeling better. Kidney stones are no laughing matter.

historymike said...

Hi Roo:

Thanks for the word "vasoconstriction." I knew that there was a medical term for what I was describing, but I could not dredge it up.

Amy said...


I'm drawn to all things kidney stone related, as I am 8 days out from having a partial nephrectomy (removal of 40% of the kidney) due to complications from stones. Your ureter has my sympathies. Kick the pseudophedrine to the curb and get a 24 hour urinalysis. Other than that, drink water, pop percocet, and pray for passage.

Pee well, my friend.

Smthree said...

Hi Mike,

Very interesting article. I'm also a long-time sinus sufferer and also have problems with urethral stenosis. I've never had kidney stones but have had urethral dialation (I'm female) many time.

To help reduce my dependence on decongestants, I bought a Grossan Hydropulse nasal irrigation system. I use a product called Breatheze to make a non-drying saline solution to use with it. It can take time to see results but it does work! I got mine from achooallergy.com.

The Screaming Nutcase said...

As roo pointed out, Claritin or Allegra might be less bothersome for you if you're taking them for allergies. I also recommend nasal steroid sprays like Flonase (now available in a cheaper generic), Rhinocort, etc, as they don't have systemic side effects.

Also, the 24-hour Sudafed (sorry, generic not yet available) doesn't have quite the blood level peak that the quick-release ones do; that may also bother you less.

Anonymous said...

At present I am suffering from a cold. I was congested so I took Sudafed. I also took it the other night before going to sleep. I did not get a good nights sleep because of pains around my kidney area. I now have pain in the same place. I have 5 kidney stones kicking around in me and I thought it might be worth looking for any related issues.
Well, at least I now know why I'm in pain, and what you say seems to make sense.
Thanks for the info!

Kidney Stone Pain Center said...

Hi Mike

The answer to your question is in your own statement : I read that pseudoephedrine is used to treat urinary incontinence, as it causes the sphincter muscles at the bladder neck to contract and tighten.

As the Ureter and Urethra are tubes with muscular walls it is possible that the pseudoephedrine is causing your ureter to contract more than normal during peristalsis. This would increase the pain from your kidney stone.

Anonymous said...

Sudafed - very bad to take it when wanting to sleep. Insomnia is one of the most common side effects. It can also cause increases in blood pressure, which is bad for those of us with kidney issues. I have had kidney cancer and have one kidney. I've wondered if my chronic sinus issues which caused me to use sudafed and antihistamines frequently (along with a bad habit of under drinking water) didn't contribute to my kidney tumor. I've had kidney stones as well. The antihistamines are very drying. They don't help with sinus/nasal congestion, though, and that's what I need because the congestion often leads to sinus infections for me as trapped bacteria starts to grow.

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