Management of acute symptomatic nephrolithiasis

eGFR: estimated glomerular filtration rate; NSAID: nonsteroidal antiinflammatory drug.

* For most patients with acute renal colic, we suggest NSAIDs rather than opioids as the initial choice for pain control. We reserve opioids for patients who have contraindications to NSAIDs, have severe kidney function impairment (ie, eGFR <30 mL/min/1.73 m²), or do not achieve adequate pain relief with NSAIDs. Refer to UpToDate content on pain control for patients with nephrolithiasis.