See the DrugPatentWatch profile for Apixaban
Is it typical to have blood in urine while taking apixaban?
Apixaban (Eliquis) is a blood thinner. It helps prevent clots, but it can also make bleeding more likely. Blood in urine (hematuria) can happen with apixaban, even if the amount is small enough that it only shows up once or was noticed briefly.
That said, hematuria is also a common warning sign of other issues (such as a urinary tract infection, kidney stones, bladder irritation, or problems in the urinary tract). Because of this, doctors usually still take it seriously and do tests rather than assuming the medication is the only cause.
How could a urine sample “come back OK” if you saw blood?
A urine test can be “OK” in a few different ways:
- It may not show red blood cells on the specific day the sample was collected, especially if the bleeding was brief.
- The blood you saw could have come from irritation that had already settled by the time the sample was taken.
- Some causes of visible blood are intermittent (for example, a stone moving in and out of the bladder can bleed off and on).
Also, if the urine test results say there was no infection or no significant blood cells detected, it often points away from an active infection or ongoing bleeding at that moment—but it does not always rule out intermittent problems.
When is blood in urine “not usual” and needs urgent care?
Even on apixaban, you should treat visible blood in urine as a red flag. Seek urgent care or ER evaluation if you have any of these:
- Clots or a lot of blood (urine looks red/pink consistently or you cannot pee normally)
- Severe flank or lower belly pain (possible stone or serious bleeding)
- Dizziness, weakness, fainting, or shortness of breath
- Fever or chills with urinary symptoms
If none of those apply but you noticed blood once, you should still follow up with the prescriber who ordered the test.
What are common causes doctors look for after hematuria?
Clinicians often check for:
- Urinary tract infection (UTI) or inflammation
- Kidney stones
- Irritation of the bladder
- Less commonly, other urinary tract conditions that need evaluation (especially in higher-risk ages or smokers)
A single “normal” urine test reduces the chance of an active UTI, but it doesn’t always eliminate the need to reassess if the blood was visible.
What should you do next with your apixaban?
Follow your prescribing clinician’s instructions. Do not stop apixaban on your own, because that can raise the risk of clot/stroke depending on why you’re taking it.
Because you had visible blood, it’s reasonable to ask your doctor:
- Do you need a repeat urine test?
- Do you need a urine culture (if infection wasn’t fully checked)?
- Do you need imaging or a urology evaluation (depending on your age, risk factors, and whether blood recurs)?
Quick questions that change the advice
If you answer these, I can tailor what “usual” means for your situation:
1) How old are you, and do you smoke or have a history of bladder/kidney issues?
2) Was the urine visibly red/pink, or was blood found only on testing?
3) Any burning, urgency, fever, or back/flank pain?
4) Is this the first time, and has it happened again since?
5) Why are you on apixaban (atrial fibrillation, clot, etc.)?