Can Eliquis (apixaban) cause blood in urine?
Eliquis is an anticoagulant, so one of the main concerns with it is bleeding. Blood in the urine (hematuria) can happen when a blood thinner like Eliquis increases the tendency to bleed, including bleeding from the urinary tract. If you notice red or tea-colored urine after starting or while taking Eliquis, treat it as a potentially serious symptom and contact a clinician promptly.
If you have heavy bleeding, clots, severe pain in the side/back, dizziness/fainting, or you cannot urinate, seek urgent care or emergency help.
What kind of urine color change counts as “blood in urine”?
People describe hematuria in a few common ways:
- Pink, red, or brown urine
- “Tea-colored” urine
- Visible clots or sediment
Even if the bleeding seems mild (for example, only a small pink tinge), it still warrants medical evaluation because the source could range from irritation/inflammation to stones, infection, or other problems.
When should you call a doctor urgently vs. wait?
Because Eliquis can increase bleeding risk, the safest approach is to call your prescriber promptly if you see any blood in urine. Go urgently if you have any of the following:
- Large amount of blood, clots, or urine that is visibly red throughout
- Trouble urinating or severe lower abdominal pain
- Flank pain with fever (possible kidney infection)
- Dizziness, weakness, shortness of breath, or fainting (possible significant blood loss)
Could blood in urine be from something other than Eliquis?
Yes. Urinary tract causes are common and can also occur while taking Eliquis, which may make them more noticeable or heavier. Typical causes include:
- Urinary tract infection
- Kidney stones
- Bladder or kidney irritation
- Prostate bleeding issues (in people with a prostate)
- Less common causes that still require evaluation
Clinicians generally won’t assume it’s “just the Eliquis” because hematuria can have non-drug causes that need diagnosis.
What should you do if you notice hematuria while on Eliquis?
- Contact your prescriber as soon as possible for guidance on next steps.
- Do not stop Eliquis on your own unless a clinician tells you to. Stopping suddenly can increase the risk of clotting depending on why you take it.
- Ask whether you should get urine testing (urinalysis/culture) and whether you need bloodwork or imaging to look for stones, infection, or other causes.
Are there other drugs that raise the bleeding risk with Eliquis?
Yes. Bleeding risk is higher if Eliquis is combined with other medications that affect clotting or the stomach lining, such as:
- Other anticoagulants or antiplatelet drugs (for example, aspirin or clopidogrel, depending on your regimen)
- Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen/naproxen
- Some antidepressants and other medicines that increase bleeding risk
If you’re taking other medications (including over-the-counter pain relievers), it’s important to review them with your clinician.
What tests might doctors order for blood in urine on a blood thinner?
Doctors often assess both bleeding risk and the urinary tract source. Common next steps can include:
- Urinalysis and urine culture
- Blood counts and kidney function tests
- Imaging (often ultrasound or CT, depending on symptoms and risk factors)
- If appropriate, evaluation by a urologist, especially in recurrent or unexplained hematuria
Is hematuria ever “expected” on Eliquis?
It’s not considered a normal or expected side effect. Any visible blood in urine should be treated as abnormal and evaluated.
If you tell me:
1) your age/sex,
2) whether the urine is pink/red/brown or tea-colored,
3) whether you have pain, burning, fever, clots, or trouble urinating, and
4) your Eliquis dose and how long you’ve been taking it,
I can help you think through how urgent it might be and what to ask your clinician.