Chemicals, and Disease Induced Urine Discoloration

04/29/2019 Executive Officers Information Center Gujarat State Pharmacy Council

Concerned about your urine color? Know its meaning

Urine color and its shades, says lot about your body and overall health.

Color of urine and its shades may indicate various conditions ranging from “need not to worry” to “something really serious”. Observing and noting the color of the urine may help you to spot disease conditions ahead of time and get preventative treatments. For a pharmacist, this knowledge is crucial and may help in patient counseling. This article features the drugs, chemicals or disease condition responsible for the discoloration of urine. Keywords: DMCR= Disease & Medical condition related, DR= Drug Related, AC = acid urine, AL = alkaline, F = fluorescent, H = hematuria, M = metabolite, OS = on standing, C = contact with hypochlorite solution from prior use of chlorine toilet bowl cleaner

• DMCR • DR • Methyldopa • Acute hemolytic • Cascara (AL) Naphthalene (H) anemia (H) • Cotrimazine • Pamaquine (H) • Malaria (H) • Cotrimoxazole • Phenacetin (OS)

• Extensive burns (H) • Cresols (OS) • (OS)

• Hemoglobinuria • Fava bean (H) • Pyrogallol (OS) Black • Tyrosinosis (OS, AL) • Ferrous salts • Quinine (H) • Alcaptonuria (OS) • Iron Dextran (OS) • (AL) • Malignant melanoma • Levodopa (OS) • Sulfonamides (H)

(OS) • Melanin (OS) • (OS) • • (OS) •

• DMCR Carbolic acid Pseudomonas Blue diaper syndrome bacteriuria • DR Resorcinol Indigo blue Blue Anthraquinone Indigo carmine Tetrahydronaphthalene Methocarbamol (OS) Thymol Arbutin Methylene blue Tolonium

Azuresin Mitoxantrone Triamterene (pale, F) Bile pigments Nitrofurans

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• DMCR Blutene Methylene blue Chronic obstructive Boric acid Pseudomonas Blue- jaundice Carbolic acid bacteriuria DR Resorcinol Green Anthraquinone laxatives Indigo blue Tetrahydronaphthalene

Arbutin Indigo carmine Thymol Azuresin Indigotin sulfonate Tolonium Bile pigments salicylate Typhus

• DMCR Eosin dyes Phenols Acute febrile disease Danthron (OS)Phenylhydrazine Alcaptonuria Dipyrone Primaquine (H)

Black water fever Furazolidone Pyrogallol (OS) Hemoglobinuria Furoxone Quinine (H) Brown DR Hydroquinone Rhubarb (AL) Aminopyrine Levodopa (OS) Rifabutin Rifampin Aniline Methocarbamol (OS) Anthraquinone dyes Methyldopa Senna (AL) (AL) Metronidazole (H) Sodium Blood Naphthalene (H) Sulfonamides (H)

Cascara (AL) Nitrofurans Tannins Chloroquine Nitrofurantoin Thymol (OS) Cinchophen Pamaquine (H) Tiopronin

Cresols (OS) Phenacetin (OS) Tyrosinosis (OS, AL)

DR Methyldopa Povidone iodine Brownish Erythrityl tetranitrate Metronidazole Quinine (H) Black Isosorbide mono- or Nitrates Senna (AL) dinitrate Nitrofurans Tyrosinosis (AL) Methocabomol Phenacetin

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• DMCR • Hydroquinone • Primaquine

• Alcaptonuria • Iron sorbitex Levodopa• Pyrogallol (OS) (homogentisic acid) (OS) • Quinine (H) • Dehydration • Melanin (OS) • Resorcinol DR • Metronidazole • Rhubarb (AL) • Aniline dyes • Naphthol • Riboflavin Dark • Cadmium • • Santonin Yellow • Cascara (AL) • Nitrites • Senna • Chlorobenzenes • Nitrobenzene (OS) • Thymol (OS)

• Chloronaphthalene • P-aminosalicylic acid • Tolcapone • Dacium • Phenacetin (OS) • Trinitrotoluene • Furazolidone • (OS) • Trinitrophenol • Furoxone • Phenyl salicylate • Tyrosinosis (OS, AL)

• DMCR • Carbolic acid • Methocarbamol (OS) • Chronic obstructive • Chlorophyll, water • Methylene blue jaundice soluble Nitrofurans • Jaundice • Creosote • Phenols (OS)

DR • Gadolinium • Phenyl salicylate • Acriflavine (F) texaphyrin • • Guaiacol • Pyrogallol (OS) • Anthraquinone • Hydroquinone • Resorcinol (OS) Green • Indigo blue • Arbutin • Santonin • Azuresin • Indigo carmine • Suprofen • Bile pigments • Indomethacin • Tetrahydronaphthalene • Bromoform (hepatotoxicity) • Thymol (OS)

• •

Green Orange Milky Purple Yellow Yellow

• DMCR -Diffuse DR-Bromoform • DR-Fluorescein DMCR -Indwelling DeWitts Pills glomerulonephritis, sodium, urinary catheters Methylene Blue Bacteria Rifampin (long-term), DR - Nitazoxanide DR- Chloroguanide • Sulfasalazine

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• DMCR • • Rhubarb (AL)

• Dehydration in mesylate Entacapone • Rifabutin Orange children • Ethoxazene • Rifampin • DR • Heparin sodium • Salicylazosulfapyridine • Anisindione (AL) • Mannose • Sulfasalazine • Canthaxanthines • Paprika • Warfarin • Chlorzoxazone • Phenindione

• Chrysophanic acid • Phenzaopyridine (AL) •

• DR • Dipyrone • Porphyrins

• Aminopyrine • Emodin (H) • Propofol Pink • Anisindione • Eosin dyes (H) • Rhodamine • Anthraquinone dyes • Ethoxazine • Salicylates (H)

(AL) • Merbromin (F) • Santonin (AL) • Aspirin • Methyldopa • Senna • Benorilate • Phenazopyridine (AC) • Serenium 1. Amitriptyline• Cascara • Phenindione • Thiazolsulfone

• Chrysophanic acid • Phenolphthalein (A) • Urates • Cinchophen • Phenothiazines • 1,8- • Danthron (AL) • Phensuximide • Deferoxamine • • •

Red- DMCR - Bile Doxidan with PSP Phenindione (AL) Orange • DR Ethoxazene Rifampin Anisindione (AL) Furazolidone Rifapentine

-Brown Chlorzoxazone Phenazopyridine Warfarin Congo red (AL)

Drug Information Center- Gujarat State Pharmacy Council DMCR Dimethylsulfoxide • Beets Danthsone (AL) • Oxyphenbutazone

Blackberries Daunorubicin • Phenacetin (M, H) Bile pigments Deferiprone • Phenazopyridine (AC) Blood Deferoxamine • Phenolphthalein (AL)

Diffuse – Dihydroergotamine • Phenolsulfonphthalein glomerulonephritis mesylate (AL) Hematuria Dipyrone • Phenothiazines Hemoglobinuria DMSO • Phensuximide • Infectious - • Doxorubicine • Phenylbutazone

mononucleosis • Emodin (AL) • Phenytoin • Myoglobinuria • Eosin dyes (H) • Propyphenazone • DR • Ethoxazene • Porphyrins

Acetanilid • Fava bean (H) • Rhodamine Acetophenazine • Fuscin • Rifampin Aminopyrine • Heparin • Santonin Red Aniline • Homogenistic acid • Senna (AL) Aniline dyes • Ibuprofen • Serenium

Anthraquinone (AL) • Iron sorbitol • Sulfonal Antipyrine • Logwood • Tolcapone Azo dye • Madder • Thiazolsulfone

Cardiografin • Melanin • Trional Cascara (AL) • Methemoglobin • Tyrosinosis Chloroquine • Methyldopa (OS, in • Urates the presence of • Uro-Erythrin Chrysarobin (AL) hypochlorite) • 1, 8- Chrysophanic acid • Naphthalene (H) Dihydroxyanthraquinone Cinchophen • Nitrofurantoin

Red • DR • Methemoglobin • Porphyrins

Purple • Chlorzoxazone • Phenacetin • Senna (AL) • Ibuprofen • Phenolsulfonphthalein •

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DMCR • Chloroquine • Quinacrine • Acute febrile disease • Furazolidone (AC)Rhubarb (AC) • Dehydration • Furoxone • Riboflavin

• DR • Metronidazole • Santoin Rust • Acetanilid • Nitrofurantoin • Senna (AC) • Acetophenazine • Pamaquine (H) • Sulfonal

• Acriflavine • Phenacetin (OS) • Sulfonamides (H) • Trinitrophenol • Aloin • Picric acid • Bromoform • Primaquine • Trional • Carrots • Pyrogallol (OS) • Urates • Cascara (AC, AL) •

Bright Brown Brown Dark Red Yellow Green Orange Brown yellow

Acute febrile Flavin • Hydroquinone Entacapone disease Urates

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