What Pill Breaks Up Kidney Stones? A Guide to Medical Therapies

October 12, 2025 •

4 min read

Kidney stones are a prevalent condition, affecting approximately 1 in 11 people in the United States [1.8.1, 1.8.2]. While many wonder, 'What pill breaks up kidney stones?', the answer is nuanced, as most medications help stones pass rather than breaking them apart.

Quick Summary

While no single pill instantly breaks up all kidney stones, certain medications can dissolve specific types like uric acid stones. More commonly, drugs called alpha-blockers help stones pass by relaxing the urinary tract.

Key Points

No 'Magic Pill': Most medications for kidney stones don't 'break them up', but rather help them pass through the urinary tract. This is called Medical Expulsive Therapy (MET) [1.10.1].
Alpha-Blockers for Passage: The most common prescription is an alpha-blocker like tamsulosin (Flomax), which relaxes the ureter muscles to facilitate stone passage [1.9.3, 1.10.1].
Dissolving Specific Stones: Uric acid stones are a unique type that can be dissolved over time with medications like potassium citrate, which makes the urine less acidic [1.4.1, 1.6.4].
Prevention is Critical: After passing a stone, doctors may prescribe preventative medications like thiazide diuretics (for calcium stones) or allopurinol (for uric acid stones) [1.5.5, 1.7.4].
Pain Management: Pain is managed with NSAIDs like ibuprofen, though a doctor's guidance is important. Stronger medications may be used for severe pain [1.2.1, 1.9.4].
Diagnosis is Key: The correct medication depends entirely on the type and size of the kidney stone, which requires a medical diagnosis [1.2.4].

The Misconception: Breaking Up vs. Passing Stones

Many people experiencing the intense pain of renal colic hope for a magic pill that can shatter a kidney stone into dust. However, for the majority of stones, this isn't how medication works. The primary role of the most commonly prescribed pills is not to break up the stone itself, but to make its journey out of the body quicker and less painful [1.9.3]. This process is known as Medical Expulsive Therapy (MET) [1.10.1].

Procedures like shock wave lithotripsy (SWL) or laser ureteroscopy are used to physically break up large stones, but this is different from taking a daily pill [1.2.2]. The exception to this rule is for stones made of uric acid, which can sometimes be dissolved over time with specific medications that change the chemistry of your urine [1.4.1, 1.4.2].

Medical Expulsive Therapy (MET): Pills That Help Stones Pass

MET is the first-line approach for smaller stones (typically under 10mm) that are likely to pass on their own but are causing significant pain [1.2.3, 1.10.4]. The goal is to relax the ureter—the tube connecting the kidney and bladder—to create a wider, more relaxed pathway for the stone.

Alpha-Blockers: The Most Common Choice

Alpha-blockers are the most-prescribed and most-studied class of drugs for MET [1.2.3, 1.10.4]. These medications work by relaxing the smooth muscles in the ureter and at the base of the bladder [1.3.1, 1.3.3]. This relaxation reduces spasms and helps the stone move through the urinary tract more easily, often reducing the time it takes to pass and the need for pain medication [1.3.5, 1.9.3].

Common Example: Tamsulosin (brand name Flomax) is frequently prescribed for this purpose [1.2.1, 1.9.3]. Other alpha-blockers like doxazosin and silodosin may also be used [1.2.3, 1.10.4].
Effectiveness: Studies have shown that alpha-blockers can significantly increase the chances of passing a stone. One analysis found that with alpha-blockers, about 73 out of 100 people passed their stones within four weeks, compared to 50 out of 100 without the medication [1.4.1].

Pills That Can Dissolve Specific Kidney Stones

While most stones are made of calcium oxalate and cannot be dissolved by medication, uric acid stones are a key exception [1.4.1, 1.6.3]. These stones form in acidic urine. Therefore, medications that make the urine more alkaline (less acidic) can slowly dissolve them.

Alkalinizing Agents

Potassium Citrate: This is a primary treatment used to raise the urine pH [1.6.1, 1.6.4]. By making the urine less acidic, it can prevent new uric acid stones from forming and can help dissolve existing ones [1.6.4]. It is a prescription medication available as an extended-release tablet [1.6.1].

Uric Acid Reducers

Allopurinol: This medication is a xanthine oxidase inhibitor that works by reducing the body's overall production of uric acid [1.7.1, 1.7.3]. It is used to treat gout and to prevent uric acid stones from forming in the first place, and it can be part of a dissolution therapy regimen [1.7.1, 1.4.2].

Comparison of Common Kidney Stone Medications


Medication	Type / Class	Primary Action	Commonly Used For	Common Side Effects
Tamsulosin (Flomax)	Alpha-Blocker	Relaxes the ureter muscles to help a stone pass (MET) [1.3.1, 1.3.3]	Passing ureteral stones (<10mm) [1.2.3]	Dizziness, headache, retrograde ejaculation [1.10.4]
Potassium Citrate	Alkalinizing Agent	Makes urine less acidic (raises pH) to dissolve and prevent stones [1.6.1, 1.6.4]	Dissolving/preventing uric acid & preventing calcium stones [1.6.3]	Abdominal discomfort, nausea, diarrhea [1.6.3]
Allopurinol	Xanthine Oxidase Inhibitor	Reduces the body's production of uric acid [1.7.2, 1.7.3]	Preventing uric acid & recurrent calcium oxalate stones [1.7.2, 1.7.3]	Rash, nausea, diarrhea, drowsiness [1.7.3]
Hydrochlorothiazide	Thiazide Diuretic	Reduces the amount of calcium excreted into the urine [1.5.5]	Preventing recurrent calcium stones [1.5.5]	Dizziness, increased glucose levels, low potassium [1.5.4]

Managing Pain and Preventing Future Stones

Effectively managing a kidney stone episode involves more than just passing the stone; it also requires controlling the often severe pain and taking steps to prevent recurrence.

Pain Relief

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Medications like ibuprofen (Advil, Motrin) are often the first choice for pain relief as they can be more effective than opioids for renal colic [1.2.3, 1.9.4]. However, you should consult a provider before taking them during an acute attack, as they can carry risks for kidney function [1.2.1].
Opioids: For severe pain not controlled by NSAIDs, stronger prescription painkillers may be necessary [1.9.2, 1.9.5].

Medications for Prevention

Once a stone has passed and its composition is analyzed, a doctor may prescribe medication to prevent future stones.

Thiazide Diuretics (e.g., Hydrochlorothiazide): These are 'water pills' that are effective for people with recurrent calcium stones because they reduce the amount of calcium released into the urine [1.5.5, 1.2.4].
Allopurinol and Potassium Citrate: As mentioned, these are crucial for preventing uric acid stones and are also used to prevent certain types of calcium stones [1.4.5, 1.6.3].

Conclusion

To answer the question, "What pill breaks up kidney stones?": very few pills actually "break up" or dissolve stones. The main exception is uric acid stones, which can be dissolved by medications like potassium citrate that make the urine less acidic [1.4.1, 1.6.4]. For the most common types of kidney stones, medications like the alpha-blocker Tamsulosin do not break the stone but instead relax the ureter to help it pass more quickly and with less pain [1.9.3]. Prevention is also a key part of medical management, with drugs like thiazide diuretics and allopurinol used to stop new stones from forming [1.5.5, 1.7.4]. The correct treatment always depends on the stone's size, location, and type, so consulting with a healthcare professional is essential.

For more information on kidney health, you can visit the National Kidney Foundation.

Frequently Asked Questions

The most common medication is an alpha-blocker called tamsulosin (brand name Flomax). It doesn't break up the stone, but it relaxes the muscles in your ureter to help the stone pass more quickly and with less pain [1.2.1, 1.9.3].

Yes, but only specific types. Uric acid stones are the only common type of kidney stone that can sometimes be dissolved with medication, typically potassium citrate or allopurinol, which work by making the urine less acidic or lowering uric acid levels [1.4.1, 1.4.2].

Tamsulosin begins to work by relaxing the ureter muscles shortly after you start taking it. This can help speed up the natural process of passing the stone, potentially reducing the time from weeks to days [1.3.1, 1.5.5].

Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are often recommended as the first choice for pain relief [1.2.3, 1.9.4]. However, it is important to speak with a healthcare provider before taking them during an acute attack [1.2.1].

There are no over-the-counter pills that can break up or pass a kidney stone. While OTC pain relievers like ibuprofen can manage symptoms, the medications that facilitate stone passage (like tamsulosin) or dissolve stones (like potassium citrate) are available by prescription only [1.6.4, 1.9.3].

Medical Expulsive Therapy (MET) is the use of medication, such as an alpha-blocker, to help facilitate the spontaneous passage of a ureteral stone. It is a non-invasive treatment option for smaller stones [1.10.1, 1.10.2].

Depending on the type of stone you form, a doctor might prescribe thiazide diuretics for calcium stones, allopurinol for uric acid stones, or potassium citrate for both uric acid and some calcium stones [1.2.5, 1.5.5, 1.6.3].