What should you know about dark red colored urine?

Urine may look dark red, rust-colored, tea-colored, or cola-colored when blood or pigment is present. Concentrated urine after sweating, vomiting, diarrhea, or limited fluid intake can become much darker. Beets and some medicines can also change urine color. Blood may come from the kidneys, bladder, or urinary passage and can occur with burning, urgency, pain, or clots, although these symptoms are not always present. Liver inflammation can darken urine and may occur with yellowing of the skin or eyes, pale stools, nausea, or unusual tiredness. A color change alone cannot identify the cause.

Note when the change began, whether it followed exercise or heat, and whether you have pain, fever, urinary symptoms, or new medicines. Drink fluids normally if you can do so safely, but do not delay assessment if the urine remains red or dark. A clinician may ask for a urine sample and review medicines, food, hydration, and liver or kidney symptoms. Do not take leftover antibiotics or blood-thinning medicines without medical advice.

Seek urgent care for dark red urine with severe side or abdominal pain, inability to pass urine, visible clots, faintness, confusion, high fever, or repeated vomiting. Arrange prompt medical review for unexplained red urine, urine that persists after normal hydration, yellow skin or eyes, or swelling. Dehydration and heat exhaustion can need rapid attention when dark urine follows heavy sweating with weakness, dizziness, or headache.

Could this be blood, concentrated urine, a medicine effect, or a liver-related pigment? Which urine or blood tests are appropriate? Should I change any medicine or activity while the cause is being checked?