From the FDA Drug Label
Manifestations of acute overdosage with amphetamines include ... rhabdomyolysis ... Acidification of the urine increases amphetamine excretion, but is believed to increase risk of acute renal failure if myoglobinuria is present. The answer is yes, amphetamines can cause hematuria indirectly, as it can lead to rhabdomyolysis, which in turn can cause myoglobinuria, a condition that can increase the risk of acute renal failure.
- Rhabdomyolysis is a serious syndrome due to direct or indirect muscle injury.
- It results in the death of muscle fibers and release of their contents into the bloodstream, which can lead to myoglobinuria and renal failure. 1
From the Research
Yes, amphetamines can cause hematuria (blood in the urine), as evidenced by their potential to raise blood pressure and cause vasoconstriction of blood vessels in the kidneys, which may lead to kidney damage or other serious conditions 2.
Mechanisms of Amphetamine-Induced Hematuria
Amphetamines can lead to hematuria through several mechanisms, including:
- Vasoconstriction of blood vessels in the kidneys, potentially damaging the glomeruli that filter blood
- Raising blood pressure significantly, which may cause small blood vessels in the urinary tract to rupture
- Association with rhabdomyolysis (muscle breakdown), which can release myoglobin that damages kidneys and causes bloody urine
Clinical Implications
If you experience hematuria while taking amphetamines, you should seek medical attention promptly as it could indicate kidney damage or other serious conditions. Your healthcare provider may need to adjust your medication dosage, switch to an alternative treatment, or address any underlying complications. Persistent or recurrent hematuria requires thorough evaluation regardless of its suspected cause.
Evidence-Based Recommendation
Based on the most recent and highest quality study available, amphetamines increase blood pressure, heart rate, and withdrawals due to adverse effects, with these effects observed across all time points, including shorter and longer durations of use 2. Therefore, it is essential to monitor patients taking amphetamines for signs of hematuria and other cardiovascular complications.