Bilateral guaifenesin ureteral calculi

Area of Science:

• Nephrology
• Pharmacology
• Analytical Chemistry

Background:

• Ureteral calculi (kidney stones) can cause significant patient morbidity.
• Guaifenesin is a commonly used expectorant, often found in over-the-counter cold and cough preparations.
• The popularity of certain preparations containing ephedrine has increased.

Observation:

• A patient presented with bilateral ureteral calculi.
• Infrared spectroscopy was utilized for stone analysis.

Findings:

• The ureteral calculi were composed of a guaifenesin metabolite.
• This finding suggests a potential link between excessive guaifenesin consumption and stone formation.
• The increased popularity of ephedrine preparations may indirectly contribute to this phenomenon.

Implications:

• This case highlights a potential adverse effect of high-dose or chronic guaifenesin use.
• Further research is warranted to investigate the prevalence and mechanisms of guaifenesin-induced nephrolithiasis.
• Clinicians should consider medication history, including over-the-counter drugs, in patients with unexplained kidney stones.