Abuse of guaifenesin-containing medications generates an excess of a carboxylate salt of beta-(2-methoxyphenoxy)-lactic acid, a guaifenesin metabolite, and results in urolithiasis. Urology 1999 Jul;54(1):23-7
Date
07/22/1999Pubmed ID
10414721DOI
10.1016/s0090-4295(99)00031-xScopus ID
2-s2.0-0033169109 (requires institutional sign-in at Scopus site) 32 CitationsAbstract
OBJECTIVES: Several urinary calculi were submitted to our institution for compositional analysis. The typical techniques of analysis, polarized light microscopy, electron microprobe analysis, and infrared spectroscopy proved inadequate for a definitive identification. As a result, a more detailed organic analysis was conducted to determine the exact chemical structure of the material.
METHODS: Infrared spectroscopy and mass spectrometric analysis were carried out on the solid material, providing information concerning the functional groups and the molecular mass of the organic constituent and its components. The stone was solubilized in deuterated solvents and analyzed by nuclear magnetic resonance spectroscopy, which resulted in a definitive chemical structure.
RESULTS: The spectroscopic analysis indicated that the stones were composed of a calcium salt of beta-(2-methoxyphenoxy)-lactic acid, a metabolite of the pharmaceutical guaifenesin, which is used as an expectorant.
CONCLUSIONS: Guaifenesin, an expectorant common in over-the-counter cold and allergy remedies, can cause urolithiasis if taken in excess. Discussions with physicians and their patients confirmed that most patients admitted to taking large doses of guaifenesin-containing medications.
Author List
Pickens CL, Milliron AR, Fussner AL, Dversdall BC, Langenstroer P, Ferguson S, Fu X, Schmitz FJ, Poole ECAuthor
Peter Langenstroer MD Professor in the Urologic Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Carboxylic Acids
Female
Guaifenesin
Humans
Male
Middle Aged
Salts
Urinary Calculi
