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Case Reports
. 2023 Jun 29:50:102481.
doi: 10.1016/j.eucr.2023.102481. eCollection 2023 Sep.

Bilateral nephrolithiasis following ingestion of guaifenesin and dextromethorphan

Elizabeth Kim  1 , Michael Perlmutter  2 , Haley Zweber  3 , Joseph Resch  3
Affiliations
Case Reports

Bilateral nephrolithiasis following ingestion of guaifenesin and dextromethorphan

Elizabeth Kim et al. Urol Case Rep. .

Abstract

Both guaifenesin and dextromethorphan are routinely available nonprescription medications that are also common drugs of abuse amongst young adults. We describe a presentation of guaifenesin and dextromethorphan misuse resulting in acute renal failure due to bilateral nephrolithiasis. The patient underwent placement of bilateral ureteral stents but again formed small renal stones bilaterally. While most renal calculi are not drug-induced, this case highlights the potential for nephrolithiasis after guaifenesin and dextromethorphan ingestion. It suggests that in this combination ingestion multiple mechanisms lead to a prolonged period of nephrolith formation.

Keywords: Acute renal failure; Dextromethorphan; Guaifenesin; Nephrolithiasis.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Computed tomography scan of the abdomen and pelvis without IV contrast demonstrating hyperdense material in the inferior poles of the right and left kidneys and calcified phleboliths in the right and left hemi pelvises.
Fig. 2
Fig. 2
Urine mass spectrometry with presences of dextromethorphan, dextromethorphan metabolite levorphanol, and guaifenesin.
See this image and copyright information in PMC

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