Throwing up blood after drugs: what to know

The blood may be bright red, dark brown, or mixed with material that looks like coffee grounds. It can come from irritation or a tear in the throat or stomach after repeated retching. Drug effects can also alter alertness, breathing, blood pressure, or the way blood clots. It may be difficult to tell vomiting blood from coughing up blood or swallowing blood from the nose or mouth. Conditions such as bronchiectasis, pneumonia, tuberculosis, pulmonary embolism, or lung cancer can cause coughing up blood rather than vomiting it, so describe exactly what happened. The symptom alone does not identify its cause.

Stop taking the suspected substance and do not take alcohol, aspirin, ibuprofen, or another drug to mask the symptom unless a clinician has specifically told you to do so. Do not drive if you feel drowsy, confused, faint, or impaired. Keep the packet, label, or a photo of the substance and note when it was taken, how much was used, and whether anything else was taken. Do not induce more vomiting. If possible, have someone stay with you while arranging urgent medical help.

Call emergency services now for ongoing or large-volume bleeding, fainting, severe chest or abdominal pain, black stools, confusion, seizures, slow or difficult breathing, blue lips, or inability to stay awake. Seek same-day urgent assessment even if the bleeding has stopped, because internal bleeding or drug toxicity can worsen after a delay. Tell clinicians the substance, route, timing, and any prescribed medicines; accurate information helps them choose safe tests and treatment.

Could this be vomiting blood or coughing up blood? Do I need blood tests, imaging, or an examination of the upper digestive tract? Which medicines and substances should I avoid while this is being assessed? What warning signs mean I should return immediately?