Updated September 26, 2013.
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
Question: Is red urine following chemotherapy normal?
I have received CHOP-R chemotherapy for non-Hodgkin lymphoma. Now this evening, I notice my urine looks red! Is this normal?
Answer:
There are a couple of reasons why your urine may look red after receiving CHOP-R chemotherapy.
The most likely reason for this is the medication doxorubicin, the “H” in the CHOP protocol. It contains a red dye that is excreted in your urine, making it look red.
While it may be alarming at first, this is completely normal. You can expect that this will clear up in the next day or so.
Doxorubicin is not the only chemotherapy medication that can turn your urine red. Other medications used in the treatment of blood and marrow cancers that can turn your urine red are daunorubicin and idarubicin.
Think that’s strange? Mitoxantrone, another medication used in the treatment of blood cancers, can actually turn your urine a blue-green color!
Blood in the urine can also cause it to look red. There are many causes for blood in the urine, including a condition called hemorrhagic cystitis. While it is highly unlikely that this would occur on the day of your chemo, the medication cyclophosphamide, the “C” in the CHOP protocol, can cause hemorrhagic cystitis.
Hemorrhagic cystitis from chemotherapy occurs when a byproduct of the medication called acrolein irritates the lining of your bladder and causes ulceration and bleeding. Ifosphamide is another chemotherapy medication used to treat hematologic cancers that can cause hemorrhagic cystitis.
Hemorrhagic cystitis is a serious side effect of cancer treatment. If you think that you may have blood in your urine, you should contact your healthcare provider right away.
How can you tell what is causing the redness? It can be difficult to distinguish. Blood in the urine may appear pink, red or a brownish hue, like the color of tea. You may even pass small clots. It only takes a small amount of blood in the urine for it to be visible. This type of red urine usually looks like a bloody color. It will usually persist for more than a few bathroom trips, and is often accompanied by other symptoms, such as bladder discomfort and a frequent sensation of “needing to go.”
Red urine caused by dyes in the chemotherapy is usually an orange or pinkish red, like the color of the medication in the syringe when your nurse gave it to you. It will typically fade after a few times going to the bathroom. You will not have any other bladder symptoms in addition to the red color if this is the cause.
If you are unable to tell the difference, it is a good idea to call your healthcare provider for further advice. Meanwhile, drink lots of water and void often to help clear out your bladder.
Sources:
Camp- Sorrel, D. Chemotherapy: Toxicity Management. In Yarbro, C., Frogge, M., Goodman, M., Groenwald, S.(eds.) (2000) Cancer Nursing: Principles and Practice. Jones and Bartlett: Sudbury, MA. (pp.444-486.)
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
Question: Is red urine following chemotherapy normal?
I have received CHOP-R chemotherapy for non-Hodgkin lymphoma. Now this evening, I notice my urine looks red! Is this normal?
Answer:
There are a couple of reasons why your urine may look red after receiving CHOP-R chemotherapy.
The most likely reason for this is the medication doxorubicin, the “H” in the CHOP protocol. It contains a red dye that is excreted in your urine, making it look red.
While it may be alarming at first, this is completely normal. You can expect that this will clear up in the next day or so.
Doxorubicin is not the only chemotherapy medication that can turn your urine red. Other medications used in the treatment of blood and marrow cancers that can turn your urine red are daunorubicin and idarubicin.
Think that’s strange? Mitoxantrone, another medication used in the treatment of blood cancers, can actually turn your urine a blue-green color!
Blood in the urine can also cause it to look red. There are many causes for blood in the urine, including a condition called hemorrhagic cystitis. While it is highly unlikely that this would occur on the day of your chemo, the medication cyclophosphamide, the “C” in the CHOP protocol, can cause hemorrhagic cystitis.
Hemorrhagic cystitis from chemotherapy occurs when a byproduct of the medication called acrolein irritates the lining of your bladder and causes ulceration and bleeding. Ifosphamide is another chemotherapy medication used to treat hematologic cancers that can cause hemorrhagic cystitis.
Hemorrhagic cystitis is a serious side effect of cancer treatment. If you think that you may have blood in your urine, you should contact your healthcare provider right away.
How can you tell what is causing the redness? It can be difficult to distinguish. Blood in the urine may appear pink, red or a brownish hue, like the color of tea. You may even pass small clots. It only takes a small amount of blood in the urine for it to be visible. This type of red urine usually looks like a bloody color. It will usually persist for more than a few bathroom trips, and is often accompanied by other symptoms, such as bladder discomfort and a frequent sensation of “needing to go.”
Red urine caused by dyes in the chemotherapy is usually an orange or pinkish red, like the color of the medication in the syringe when your nurse gave it to you. It will typically fade after a few times going to the bathroom. You will not have any other bladder symptoms in addition to the red color if this is the cause.
If you are unable to tell the difference, it is a good idea to call your healthcare provider for further advice. Meanwhile, drink lots of water and void often to help clear out your bladder.
Sources:
Camp- Sorrel, D. Chemotherapy: Toxicity Management. In Yarbro, C., Frogge, M., Goodman, M., Groenwald, S.(eds.) (2000) Cancer Nursing: Principles and Practice. Jones and Bartlett: Sudbury, MA. (pp.444-486.)
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