Medications That Can Change the Color of Your Urine
Key takeaways:
Some medications and foods can cause the color of your urine (pee) to change from its usual clear or light-yellow color. Medications can turn your urine a whole range of colors, from orange and brown to pink, blue, and green.
Antibiotics, like metronidazole, can cause dark brown urine. And amitriptyline, an antidepressant, can change the color of your urine to green or blue.
Urine color typically returns to normal when you stop the medication.
Blood in your urine can look pink, red, or brown. When in doubt, get medical attention if you think you may have bloody urine.
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Table of contents
Urinating is your body’s way of getting rid of extra fluid and waste. Your kidneys filter your blood to make urine. Normally, urine (pee) is clear to light yellow in color. A waste product from bilirubin is what gives urine its yellow tint.
Taking certain medications can create new waste products in your urine. These can change the color of your urine to orange, brown, and red — and even blue.
Changes in the color of your urine can be alarming. But rest assured: It’s usually nothing to worry about. We’ll run through the different possible urine colors and their causes here, so read on to find out more.
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Medications that can turn urine orange
A thin line separates dark yellow and light orange on the color palette. So, it follows that urine can turn orange quite easily, sometimes even with dehydration. There are also more serious issues that can turn urine orange, like gallstones, liver problems, and even blood in the urine.
The following medications can also turn urine orange:
Phenazopyridine (Pyridium): This medication eases urinary pain in people with urinary tract infections (UTIs). Phenazopyridine turns urine a bright orange to a reddish-orange color.
Isoniazid: This antibiotic is part of the treatment for tuberculosis. Around half of people who take isoniazid notice that their urine turns a darker yellow-orange color.
Rifampin: This antibiotic is also part of tuberculosis treatment. And it can treat MRSA (methicillin-resistant staph aureus) infections. The pigment in rifampin can cause a color change from yellow and orange to brownish-red. It can also cause a similar color change in saliva and tears.
Sulfasalazine: This is an anti-inflammatory medication that can treat autoimmune conditions, like rheumatoid arthritis and ulcerative colitis. Sulfasalazine can turn urine, sweat, and tears orange.
Medications that can turn urine brown
Severe dehydration and other medical issues can cause brown urine. If your urine is dark and your skin or eyes look yellow, it’s a sign you may have a serious liver problem. And this needs urgent medical attention.
Here are a few medications that can lead to brown urine:
Metronidazole (Flagyl): This antibiotic is a common treatment for sexually transmitted infections (STIs), as well as gut and skin infections. Metronidazole can cause a dark brown urine color.
Nitrofurantoin (Macrobid): This antibiotic can treat and prevent UTIs. Nitrofurantoin can cause brown urine color as the drug dissolves and gets to work in the urine.
Senna: Senna, also known as sennosides, is a common over-the-counter laxative.
Phenytoin (Dilantin): Phenytoin is an anti-seizure medication.
Carbidopa / levodopa (Sinemet): This is a medication for people with Parkinson’s disease.
Chloroquine and Primaquine: Chloroquine and Primaquine are medications that can treat malaria.
Iron supplements: Ferrous sulfate can treat or prevent iron-deficiency anemia.
Causes of brown urine: A medication isn’t the only possible cause of brown urine. Learn why your urine is brown and when to get help.
What causes hematuria (bloody urine)? Blood can make your urine look pink, red, or brown. Here’s what can cause blood in the urine — and what to do about it.
Medications that can make you constipated: Medications may not just change the color of your urine. Some can change your bowel habits and lead to constipation.
Medications that can turn urine pink or red
Pink or red urine can be alarming. That's because, most often, it's a sign of blood. Some medications can turn your urine pink or red because they can actually cause you to have blood in your urine, and others simply cause it to change color as a harmless side effect.
Here are two examples of medications that can turn the urine pink or red:
Warfarin (Coumadin): This blood thinner treats and prevents blood clots, strokes, and heart attacks. Because Warfarin thins the blood, it makes bleeding more common. This can include blood in your urine.
Rifampin: As we noted above, rifampin is a tuberculosis treatment that can cause a reddish-brown urine color.
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Blood in urine
Pink or red urine can be more worrisome than other colors. This is because it can be a sign of hematuria (bleeding in the urinary tract). Common causes of blood in your urine are menstruation, UTI, and kidney stones. But hematuria can also be a sign of something more serious, like prostate cancer.
You should always see a healthcare professional if you notice blood in your urine.
Medications that can turn urine blue or green
It’s hard to miss blue or green urine. Blue or green urine can be the result of food dye. Two medical conditions that lead to this color urine are liver disease and certain bacterial UTIs (caused by Pseudomonas aeruginosa). If you’re concerned about either of these potentially serious conditions, you should contact a healthcare professional.
Certain medications can also make your urine look blue or green:
Amitriptyline (Amitril): Amitriptyline is a tricyclic antidepressant medication that treats depression and neuropathy.
Cimetidine (Tagamet): Cimetidine is an acid blocker that can lessen acid reflux and heartburn symptoms.
Indomethacin (Indocin): Indomethacin is an anti-inflammatory medication that can provide pain relief from different types of arthritis, including gout.
Methocarbamol (Robaxin): Methocarbamol is a muscle relaxant that treats neck and back pain.
Metoclopramide (Reglan): Metoclopramide can help treat nausea.
Promethazine (Phenergan): Promethazine is an antihistamine that treats allergies and nausea.
Propofol (Diprivan): This anesthetic is common in surgery.
Methylene blue: This water-based dye is used in scans and surgery. Methylene blue is also used to treat methemoglobinemia, a rare blood disorder.
What foods can change urine color?
Certain foods can change urine color, too. Usually this is a temporary change in color that normalizes after 12 to 24 hours.
Here are some foods that can change urine color:
Carrots can tint urine orange.
Red foods, like beets or blackberries, can turn urine pink or red.
Rhubarb, asparagus, and fava beans can turn urine brown.
Foods rich in vitamin B can color urine bright yellow or green.
Any foods that have artificial food dyes can change the color of urine.
What should I do if my urine color is abnormal?
If you notice a change in the color of your urine, first take a moment to think about any recent changes you’ve made. Have you recently updated your medications or varied your diet? Have you been drinking enough water?
If you haven’t changed anything recently and your urine doesn’t return to its normal color, let your primary care provider know. They can check to see if you’re experiencing any other symptoms and help figure out the cause.
Frequently asked questions
Some antibiotics can make your urine look brown or dark. For example, darker urine is a known side effect of nitrofurantoin and happens when the medication gets concentrated in your pee. Your urine should return to its normal color after you finish your treatment.
Urine color often doesn’t change with a UTI. But your urine may look cloudy. If there’s blood in your urine, then it may look pink. It’s more likely that you’ll notice a strong smell to your urine. Other symptoms of a UTI include:
Experiencing abdominal pain
Peeing more often than usual
Feeling a burning sensation when you pee
Cloudy urine can look thick, hazy, foggy, or milky. Medications aren’t a common cause of cloudy urine. But your pee may look cloudy due to kidney stones, STI (such as chlamydia or gonorrhea), UTI, or a purine-rich diet. Get medical attention if your urine is cloudy for more than a day or two.
The bottom line
The color of your urine can change due to what you drink and eat. Urine color changes can also happen when you take certain medications. If you recently started a new medication, this very well may be the cause. Usually this isn’t dangerous, especially if you have no other symptoms. If the color change persists, connect with your primary care provider so they can help you figure out what’s causing the color change.
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References
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Foley, C. (2020). ‘Normal’ urine color comes in many different shades. University Health News.
Lupin Pharmaceuticals, Inc. (2023). Rifampin [package insert].
Moss, P. (2018). Deconstructing the threat of the fava bean. The Hematologist.
National Institute of Diabetes and Digestive and Kidney Diseases. (2016). Hematuria (blood in the urine).
Pearcy, R. M., et al. (1992). Beetroot and red urine. Biochemical Society Transactions.
Simerville, J. E., et al. (2005). Urinalysis: A comprehensive review. American Family Physician.
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