Lexapro and Tea-Colored Urine
Lexapro (escitalopram) is not known to cause tea-colored urine based on available evidence. Tea-colored urine is not listed as a recognized adverse effect in the pharmacological profile of escitalopram, and no clinical studies or case reports document this association.
Known Urinary Side Effects of Escitalopram
- Urinary retention is the only documented urinary adverse effect associated with escitalopram, though it occurs rarely 1
- One case report describes acute urinary retention developing after escitalopram initiation, which resolved upon discontinuation of the medication 1
- This urinary retention effect is uncommon and often overlooked due to limited reporting in the literature 1
Escitalopram's Safety Profile
- Escitalopram demonstrates a predictable tolerability profile with generally mild to moderate and transient adverse events 2
- The medication has low protein binding (56%) and is widely distributed throughout tissues 3
- Common adverse effects include gastrointestinal symptoms, sexual dysfunction, and CNS effects, but urine discoloration is not among them 2
Important Clinical Considerations
Tea-colored urine warrants immediate evaluation for other causes, including:
- Hepatobiliary disease (elevated bilirubin causing dark urine)
- Hemolysis or rhabdomyolysis (myoglobin or hemoglobin in urine)
- Severe dehydration (concentrated urine)
- Other medications that can cause urine discoloration
Medication-induced urine discoloration is well-documented with certain drugs (e.g., rifampin causes orange-red urine, mesalamine can cause red-brown discoloration when mixed with toilet cleaners) 4, but escitalopram is not among these agents
Clinical Recommendation
If a patient on Lexapro presents with tea-colored urine, investigate alternative etiologies rather than attributing it to the medication. Obtain urinalysis, liver function tests, and assess for signs of hemolysis or muscle breakdown. The temporal association with escitalopram initiation is likely coincidental rather than causal based on the drug's known pharmacological properties 3.