What are the first-line pharmacological treatments for managing pain in patients with renal colic?

First-line pharmacological treatment for pain in patients with renal colic is a nonsteroidal anti-inflammatory drug (NSAID) offered by any route. If NSAIDs are contraindicated, not tolerated, or insufficient for pain relief, intravenous (IV) paracetamol should be offered if available. If both NSAIDs and IV paracetamol are contraindicated or ineffective, or IV paracetamol is unavailable, an opioid analgesic such as tramadol may be considered. Antispasmodics should not be offered for pain relief in renal colic.