Tamsulosin was found to improve passage of larger, but not smaller, kidney stones compared to placebo, according to a study in the Annals of Emergency Medicine.

The randomized, double-blind, placebo-controlled, multicenter trial of adult participants with calculus on computer tomography assigned 403 patients to 0.4mg of tamsulosin or placebo for 28 days. The primary outcomes were stone expulsion on CT at 28 days and time to stone expulsion. The median stone size was 4.0mm in the tamsulosin group and 3.7mm in the placebo group.

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Of the 316 patients who received CT at 28 days, stone passage occurred in 87% of the tamsulosin group and in 89.1% of the placebo arm. Among those with large stone (5–10mm), 83.3% of patients receiving tamsulosin had stone passage vs. 61% of those receiving placebo. There were no differences in urological interventions, time to self-reported stone passage, pain, or analgesia requirements between both groups.

Lead study author Jeremy Furyk, MBBS, MPH, added that tamsulosin should be considered for patients with larger kidney stones but that time may be best for patients with small kidney stones.

For more information visit AnnEmergMed.com.