Fluorescent Yellow

• Fluorescein Dye
  • Used During Surgical Procedures

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Green Urine

• FD&C Blue Dye in Tube Feedings
• Metoclopramide (Reglan) (see Metoclopramide)
• Promethazine (Phenergan) + Cimetidine (see Promethazine and Cimetidine)
• Propofol (see Propofol): propofol is metabolized and excreted as phenolic metabolites, which cause the green discoloration
  • Green urine is a benign side effect of propofol infusion
  • It has been reported with both short-term and long-term use of propofol

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Blue Urine

• Methylene Blue (see Methylene Blue)

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Red-Brown Urine (May Be “Coca Cola”-Colored)

Beet Ingestion

• xxx

Hemoglobinuria (Urine Hemoglobin) (see Hemoglobinuria)/Hemosiderinuria (Urine Hemosiderin) (see Hemosiderinuria)

• Hemolytic Anemia (see Hemolytic Anemia)
  • Hemoglobin Binds to Haptoglobin: imparts a red color to plasma

Myoglobinuria (see Myoglobinuria)

• Rhabdomyolysis (see Rhabdomyolysis)
  • Myoglobin is a Low Molecular Weight (17kDa) Heme Pigment, Which Does not Bind to Haptoglobin: therefore, it is not present to any significant extent in the plasma

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Purple Urine

• Klebsiella pneumoniae UTI (NEJM, 2019) [MEDLINE]

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Red Urine

Beet Ingestion

• xxx

Hematuria (see Hematuria)

• xxx

Hemoglobinuria (Urine Hemoglobin) (see Hemoglobinuria)/Hemosiderinuria (Urine Hemosiderin) (see Hemosiderinuria)

• Hemolytic Anemia (see Hemolytic Anemia)
  • Hemoglobin Binds to Haptoglobin: imparts a red color to plasma

Hydroxocobalamin (see Hydroxocobalamin)

• Epidemiology
  • Hydroxocobalamin Treatment Results in Bright Red Urine (CMAJ, 2009) [MEDLINE]

Myoglobinuria (see Myoglobinuria)

• Rhabdomyolysis (see Rhabdomyolysis)
  • Myoglobin is a Low Molecular Weight (17kDa) Heme Pigment, Which Does not Bind to Haptoglobin: therefore, it is not present to any significant extent in the plasma

Porphyrinuria

• xxx

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Orange Urine

• Phenazopyridine (Pyridium) (see Phenazopyridine): with associated orange secretions
• Rifampin (see Rifampin): with associated orange secretions

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References

• Intravenous medications and green urine. JAMA 1981; 246: 216 [MEDLINE]
• Clinical significance of rare and benign side effects: propofol and green urine. Pharmacotherapy 2000;20(9):1120-1122
• Green urine after motorcycle accident. Nephrol Dial Transplant 2000;15:725-726
• Green urine in a critically ill patient. Am J Kidney Dis 2002; 39: E20 [MEDLINE]
• Green urine: an association with metoclopramide Nephrol Dial Transplant. 2004 Oct;19(10):2677 [MEDLINE]
• Discoloration of skin and urine after treatment with hydroxocobalamin for cyanide poisoning. CMAJ. 2009 Jan 20; 180(2): 251 [MEDLINE]
• Purple Urine After Catheterization. N Engl J Med. 2019 Oct 31;381(18):e33. doi: 10.1056/NEJMicm1905446 [MEDLINE]