Can drugs change your urine? Understanding Medication-Induced Color Shifts

October 12, 2025 •

4 min read

Numerous medications, from antibiotics to anesthetics, can alter urine color [1.5.1]. So if you're asking, can drugs change your urine?, the answer is a definitive yes, with colors ranging from orange and red to even blue and green [1.5.3, 1.3.6].

Quick Summary

Many common medications alter urine color as a side effect. This discoloration is often harmless, but certain changes, like red or brown urine, can signal underlying health issues requiring medical attention.

Key Points

Common Side Effect: Many medications, including antibiotics, antidepressants, and anesthetics, can change urine color as a common and often harmless side effect [1.5.1, 1.5.3].
Red and Brown are Warning Colors: While many color changes are benign, red, pink, or dark brown urine should be reported to a doctor as it can indicate blood or liver problems [1.6.2, 1.6.5].
Orange is Frequent: The urinary tract analgesic phenazopyridine (Pyridium) and the antibiotic rifampin are well-known for causing a distinct orange-red discoloration [1.3.6].
Blue/Green is Rare but Striking: Medications like amitriptyline and the anesthetic propofol can cause a surprising but typically harmless blue or green urine color [1.2.1, 1.4.2].
Hydration Matters: Dehydration concentrates urine, which can make its color appear darker, including orange or dark yellow, separate from any medication effects [1.3.2].
Temporary Effect: For most drug-induced color changes, the urine will return to its normal color shortly after the medication is discontinued [1.3.4].
When in Doubt, Ask: If a urine color change is unexpected, persistent, or accompanied by other symptoms like pain or fever, consulting a healthcare provider is essential [1.6.4, 1.6.2].

Why Do Medications Change Urine Color?

Noticing an unexpected change in your urine color can be alarming, but it's a relatively common side effect of many medications [1.5.3]. The normal color of urine ranges from pale yellow to a deep amber, depending on your hydration level [1.3.2]. This yellow hue comes from a pigment called urochrome [1.4.6]. When you take certain drugs, your body processes and breaks them down into substances called metabolites. These metabolites, or sometimes the drug's original pigments, are filtered by the kidneys and excreted in your urine [1.3.4, 1.5.6]. Depending on their chemical properties and concentration, they can mix with the natural urochrome and produce a surprising spectrum of colors [1.4.6]. For instance, the anesthetic propofol contains phenolic compounds that, when excreted, can turn urine green [1.5.7, 1.4.8]. Similarly, the antibiotic rifampin has a reddish-orange pigment that directly discolors urine [1.3.6]. While most of these changes are harmless and temporary, they underscore the complex ways medications interact with the body's metabolic processes [1.5.3].

Common Urine Color Changes and The Medications Behind Them

A wide array of medications can cause urine to change color. These changes are typically harmless and resolve after the medication is discontinued [1.3.4].

Red or Pink Urine

This is often the most concerning color because it can indicate the presence of blood (hematuria), which may signal a urinary tract infection (UTI), kidney stones, or other serious conditions [1.4.2, 1.6.2]. However, several drugs can also cause a benign red or pink hue:

Rifampin (Rifadin): An antibiotic for tuberculosis that can turn urine a reddish-orange color [1.4.2].
Phenazopyridine (Pyridium): A medication used to relieve pain from UTIs, which commonly turns urine bright orange or reddish-orange [1.3.6, 1.4.4].
Senna-based laxatives: Over-the-counter laxatives like Senokot can impart a red or pink color [1.4.2].
Chemotherapy drugs: Certain agents like doxorubicin can cause red or pink urine for a couple of days post-treatment [1.4.3, 1.7.4].

Orange Urine

Similar to red, orange urine can be caused by medications or be a sign of dehydration or liver and bile duct issues, especially if accompanied by light-colored stools [1.4.2]. Drugs known to cause this include:

Sulfasalazine (Azulfidine): An anti-inflammatory drug for conditions like ulcerative colitis and rheumatoid arthritis [1.4.1].
Isoniazid: An antibiotic used to treat tuberculosis [1.3.4].
High-dose B-Vitamins: Specifically, vitamin B2 (riboflavin) can turn urine a bright, almost fluorescent, yellow-orange [1.4.5].
Phenazopyridine (Pyridium): As mentioned, this drug produces a distinct orange-red color [1.3.4].

Blue or Green Urine

This is a less common but visually striking change. It is rarely a sign of a serious medical condition and is almost always linked to medications or medical dyes [1.4.6].

Amitriptyline: A tricyclic antidepressant [1.4.2].
Indomethacin (Indocin): An NSAID used for pain and arthritis [1.2.1].
Propofol (Diprivan): A powerful anesthetic used for sedation and surgery can result in green urine [1.2.1, 1.5.7].
Cimetidine (Tagamet): An acid reducer that can sometimes cause a blue or green tint [1.2.1].
Methylene Blue: A dye used in some diagnostic tests and as a medication itself [1.4.6].

Dark Brown or Black Urine

Dark brown urine can be a sign of severe dehydration, liver disease, or muscle injury from extreme exercise (rhabdomyolysis) [1.2.2, 1.4.1]. However, it is also a known side effect of several medications:

Metronidazole (Flagyl): An antibiotic used for various bacterial infections [1.2.2].
Nitrofurantoin (Macrobid): Another antibiotic commonly prescribed for UTIs [1.2.2, 1.7.6].
Senna or Cascara Laxatives: Can darken urine to a brown color [1.2.2].
Chloroquine and Primaquine: Antimalarial drugs [1.2.2].
Methocarbamol (Robaxin): A muscle relaxant [1.4.1].
Iron Supplements: Can make urine dark brown [1.3.4].

Medication-Induced Urine Color Comparison


Color Change	Common Medication Causes	Other Potential Causes
Red / Pink	Rifampin, Phenazopyridine, Senna-based laxatives, Doxorubicin [1.4.2, 1.7.4]	Blood (hematuria), Beets, Blackberries [1.4.2]
Orange	Sulfasalazine, Isoniazid, High-dose B-Vitamins, Chemotherapy drugs [1.4.1, 1.3.4]	Dehydration, Liver/Bile duct problems, Carrots [1.4.2]
Blue / Green	Amitriptyline, Indomethacin, Propofol, Cimetidine, Methylene blue [1.2.1, 1.4.6]	Food dyes, Pseudomonas UTI (rare), Familial benign hypercalcemia (rare) [1.4.1]
Dark Brown / Black	Metronidazole, Nitrofurantoin, Chloroquine, Methocarbamol, Iron supplements [1.2.2, 1.4.1]	Severe dehydration, Liver disease, Rhabdomyolysis, Fava beans, Rhubarb [1.2.2, 1.4.1]

When to Be Concerned and Consult a Doctor

While most medication-related urine color changes are harmless, it's crucial to distinguish them from signs of an underlying health problem [1.6.4]. You should contact a healthcare provider if:

You see a pink, red, or dark brown color, as this could indicate blood in the urine or liver problems. This is especially urgent if you also have pale stools or yellowing of the skin and eyes (jaundice) [1.6.2, 1.6.4].
The color change is not explained by a new medication you've started [1.6.4].
The discoloration persists for more than a few days after you've finished the medication [1.6.1].
The change is accompanied by other symptoms like fever, pain during urination, vomiting, or severe back pain [1.6.2].

Always inform your doctor about any new medications you are taking, including over-the-counter drugs, vitamins, and supplements. They can help you determine if a change in urine color is an expected side effect or a reason for further investigation [1.3.2].

Conclusion

The answer to "Can drugs change your urine?" is a clear yes. Numerous medications can alter the color of urine, a phenomenon that is usually a benign and temporary side effect caused by the excretion of drug pigments or metabolites [1.3.1, 1.5.3]. Understanding which medications cause which colors can provide reassurance and prevent unnecessary alarm. However, it's vital to remain vigilant. Red, pink, or dark brown urine should always prompt a discussion with a healthcare professional to rule out more serious conditions like internal bleeding or liver dysfunction [1.6.5]. By being aware of these potential changes and knowing when to seek medical advice, patients can better manage their health while on medication.

Mayo Clinic

Frequently Asked Questions

Yes, several antibiotics can change urine color. For example, rifampin can turn it reddish-orange, while metronidazole (Flagyl) and nitrofurantoin (Macrobid) can make it dark brown [1.4.1, 1.3.6].

Bright yellow or yellow-orange urine is often caused by taking B vitamins, particularly vitamin B2 (riboflavin). This is a harmless side effect [1.4.5].

The medication phenazopyridine (Pyridium), often prescribed to relieve pain from urinary tract infections (UTIs), contains a reddish-brown powder that, when processed by the body, turns urine a bright orange or reddish-orange color [1.4.4, 1.3.4].

Usually, it is not dangerous and is a known side effect. However, if your urine turns red, pink, or dark brown, you should contact a doctor to rule out blood in the urine or liver issues [1.6.2, 1.6.4].

In most cases, urine color should return to its normal shade within a few days after you stop taking the medication causing the change [1.6.1].

Yes, some antidepressants, most notably amitriptyline, are known to cause blue or green urine. This is a rare but generally harmless side effect [1.2.1, 1.4.2].

You should see a doctor if a color change can't be explained by a new medication or food, if it persists, or if it is red, pink, or dark brown. Accompanying symptoms like pain, fever, or vomiting also warrant a doctor's visit [1.6.2, 1.6.4].

Yes, some over-the-counter (OTC) medications can change urine color. For example, laxatives containing senna can turn urine reddish or brown, and certain vitamins can make it bright orange or yellow [1.4.1, 1.4.5].