When to worry about dark urine with hepatitis B

Inflammation from hepatitis B can interfere with the liver's handling of bilirubin. Bilirubin entering the urine may produce a dark tea or cola shade, often alongside jaundice and pale stools. The infection may be short-term or long-lasting, and symptoms do not show how active liver inflammation is. Dark urine may also have unrelated causes, including dehydration, medicines, or urinary bleeding.

Contact your healthcare team for advice about a new or ongoing colour change. Keep taking prescribed hepatitis treatment unless the prescriber tells you otherwise, avoid alcohol, and check before using over-the-counter medicines or supplements. Drink regularly if you can and record urine colour, jaundice, pain, vomiting, and how often you pass urine. Do not share razors or toothbrushes, and follow advice about preventing transmission.

Go to urgent care for confusion, difficulty staying awake, fainting, unusual bleeding, severe abdominal pain, repeated vomiting, or inability to keep fluids down. Seek prompt review if jaundice is rapidly worsening, urine output falls noticeably, or you develop marked weakness. These changes can signal significant liver dysfunction or dehydration and should not wait for a routine appointment.

Ask whether the urine change could reflect active liver inflammation, which tests are needed, whether any current medicine needs review, how to protect household contacts, and what exact symptoms require emergency care.