Can Eliquis Cause Blood In The Urine? | What To Do Next

Yes, apixaban can lead to blood in urine by raising bleeding risk, so treat it as urgent and get checked soon.

Pink, red, or brown urine is alarming, and it deserves prompt medical attention when you’re on a blood thinner. Eliquis (apixaban) can be the reason, yet blood in urine can also signal a UTI, a stone, or a bladder issue that needs its own treatment. The safest move is to treat visible blood as a same-day problem and get checked.

Can Eliquis Cause Blood In The Urine? What The Label Says

Eliquis is an anticoagulant. It lowers clotting, which helps prevent stroke and other clots, but it also raises bleeding risk. The urinary tract has many small blood vessels, so bleeding may show up there when clotting is slowed.

The full safety warnings, interaction notes, and bleeding guidance are in the FDA-approved Eliquis label.

Eliquis And Blood In Urine: What Counts As Hematuria

“Hematuria” means blood in urine. It can be:

• Visible hematuria: urine turns pink, red, or tea-colored, sometimes with clots.
• Microscopic hematuria: urine looks normal, but a lab test finds red blood cells.

Visible blood usually needs same-day evaluation. Microscopic hematuria still needs follow-up, with timing shaped by symptoms and risk factors.

How Blood In Urine Can Look In Real Life

Not all scary color is true bleeding, yet you should treat new discoloration seriously until a test proves otherwise. Blood can tint urine light pink, turn it red, or make it look brown, like tea or cola. Small clots can look like soft, dark jelly.

Some foods and medicines can also change urine color. Beets, blackberries, and food dyes may turn urine red. Phenazopyridine (a urinary pain reliever) can turn urine orange. Even when you suspect a harmless cause, a simple urinalysis can confirm whether red blood cells are present.

If the color change comes with burning, fever, flank pain, or visible clots, don’t treat it as a food issue. Get checked the same day, especially while taking Eliquis.

Why Blood In Urine Can Happen While Taking Eliquis

Eliquis can turn a small bleed into one you can see. A minor scrape from a stone, irritation from an infection, or prostate bleeding may last longer. Sometimes the medication is the main driver. Sometimes it makes a separate issue easier to spot.

Doctors often check for:

• UTI: burning, urgency, fever, or cloudy urine.
• Kidney or bladder stones: sudden blood, often with flank or groin pain.
• Prostate enlargement: in men, bleeding with straining or a weak stream.
• Kidney disease: inflammation can leak blood into urine.
• Recent trauma or procedure: falls, catheters, scopes, or surgery.
• Medication interactions: some drugs raise bleeding risk with Eliquis.
• Urinary tract tumors: painless bleeding can be a clue.

For a patient-friendly list of bleeding signs and interaction cautions, see MedlinePlus: Apixaban.

What To Do Right Away When You See Blood

Don’t try to “wait it out” if blood is visible. Start with a quick check for danger signs, then get medical help.

1. Scan for severe symptoms. Fainting, chest pain, shortness of breath, severe back pain, or heavy bleeding mean urgent care or an ER.
2. Watch for clots or blockage. If you can’t pee, go in now.
3. Write down details. When it started, how the color changed, and whether it followed exercise, sex, or a fall.
4. List all meds. Include aspirin, ibuprofen, naproxen, and new prescriptions.
5. Don’t stop Eliquis on your own. Stopping suddenly can raise clot risk. A prescriber can decide the safest plan.

If you feel stable and can pass urine, call your prescribing office the same day. If you can’t reach them, urgent care or an ER can run the first tests.

Red Flags That Mean Go Now

• Bright red urine, rising bleeding, or clots
• Lightheadedness, weakness, sweating, or fainting
• Severe flank or belly pain, especially with vomiting
• Fever with shaking chills
• Inability to urinate or a painful, full bladder
• Recent fall, crash, or hit to the back or belly

How A Medical Team Checks The Cause

Evaluation usually starts by confirming hematuria, checking for infection, and looking for anemia or kidney strain. Then clinicians narrow down where the blood is coming from.

Tests that often come first

• Urinalysis: checks red blood cells, protein, and signs of infection.
• Urine bacteria test: lab test that checks for bacteria when infection is suspected.
• Blood tests: a blood count and kidney function panel.
• Medication review: dose timing, missed doses, and interacting drugs.

Imaging and bladder checks

Imaging can spot stones and many other causes. Persistent hematuria may also need cystoscopy, where a urologist uses a thin camera to view the bladder lining.

The American Urological Association describes a risk-based approach to hematuria evaluation in the AUA Microhematuria Guideline.

Table 1: Possible Causes Of Blood In Urine While On Eliquis And What Usually Happens Next

What You Notice	What It Can Point To	Typical Next Step
Burning, urgency, cloudy urine	UTI or bladder irritation	Urine test; antibiotics if infection confirmed
Sudden blood with flank or groin pain	Kidney or ureter stone	Imaging; pain relief; stone plan based on size
Painless red urine that repeats	Bladder source, including tumor	Imaging plus cystoscopy with urology
Blood after strenuous exercise	Exercise-triggered bleeding, but other causes still possible	Rest; repeat urine test; work-up if it returns
Blood after catheter, scope, or surgery	Procedure-related bleeding	Follow post-op plan; call surgeon if bleeding rises
Foamy urine, swelling, high blood pressure	Kidney disease with protein leak	Blood and urine tests; kidney referral
Fever, back pain, feeling ill	Kidney infection	Same-day care; antibiotics; possible IV fluids
Clots and trouble urinating	Prostate bleeding or blockage risk	Bladder scan; catheter care; urology review
New bruising plus gum or nose bleeding	Higher overall bleeding tendency	Medication review; labs; adjust the plan

Does Dose, Age, Or Kidney Function Affect Bleeding

Yes. Apixaban levels can rise when kidney function drops, and dosing depends on factors like age and weight. Acute illness and dehydration can also shift kidney function over a short time. After hematuria, clinicians often re-check kidney tests to see if the dose still fits your current status.

Drug Combinations That Can Raise Bleeding Risk

Bleeding risk goes up when another medication also affects clotting or irritates the urinary tract. Common examples include NSAIDs like ibuprofen and naproxen, antiplatelet drugs like aspirin or clopidogrel, and some medicines that change apixaban levels through CYP3A4 or P-gp systems.

If you started a new drug in the last week or two, bring it up during your evaluation, even if it feels unrelated.

Can You Stay On Eliquis After Hematuria

Many people can. The decision hinges on how much bleeding occurred and why. A treatable cause like a UTI may clear quickly once therapy starts. A stone may need pain control and a plan to pass or remove it. If bleeding is heavy or the source is unclear, a clinician may pause the drug, use reversal in an emergency, or change the anticoagulation plan.

The safest rule is simple: visible blood calls for medical review before any dose change.

What A Same-Day Visit Often Includes

Bring your dose schedule and a full medication list. Expect urine testing, basic blood work, and an exam. Imaging may be done if stone, trauma, or persistent bleeding is suspected. If clots block urine flow, staff may place a catheter and flush the bladder.

If you can, bring any recent lab results, your latest kidney test numbers, and the name of the doctor who manages your anticoagulation. If you track blood pressure or have diabetes, note recent readings. These details help the team decide which tests are safest, whether imaging needs contrast, and how to plan follow-up.

Table 2: Triage For Blood In Urine While On Eliquis

When To Seek Care	What It Looks Like	Why It Matters
Go now (ER)	Clots, can’t urinate, fainting, severe pain, heavy bleeding	Risk of shock, blockage, or internal injury
Same day	Visible pink/red urine, burning, fever, worsening symptoms	Needs tests and a plan to stop ongoing bleeding
Within 1–3 days	Microscopic hematuria on a lab test, no severe symptoms	Still needs a work-up for urinary tract causes
Scheduled follow-up	Bleeding resolved after a clear cause was treated	Confirms healing and checks for recurrence

Questions To Ask So You Leave With A Clear Plan

• What is the most likely source based on my results so far?
• Do I need imaging, cystoscopy, or both?
• Should my Eliquis dose change based on kidney tests, age, or weight?
• Are any of my other meds raising bleeding risk?
• If blood returns, what steps should I take the same day?

Steps At Home While You’re Waiting For Evaluation

If you’re stable and already arranging care, these steps help you avoid surprises:

• Drink enough fluids unless you were told to limit fluids for a medical reason.
• Skip heavy lifting and intense workouts until you’re checked.
• Avoid NSAIDs unless a prescriber has told you they’re OK with Eliquis.
• Note color changes and whether clots appear.

When Hematuria Is Not Mainly From Eliquis

Blood thinners can be part of the story, but persistent hematuria still needs evaluation for stones, tumors, kidney inflammation, and other urinary tract causes. Don’t assume the medication is the whole answer just because you take it.

For another patient-facing overview of apixaban side effects and when to seek medical care, see NHS: Apixaban.

A Checklist You Can Save

• Visible blood in urine while on Eliquis: same-day medical evaluation.
• Clots, severe pain, fainting, fever with chills, or can’t pee: go to an ER.
• Bring dose timing, a medication list, and notes on when bleeding started.
• Don’t stop Eliquis without a prescriber-directed plan.