From the Guidelines
Cyclines can rarely cause gross hematuria, and if you develop gross hematuria while taking a cycline antibiotic, you should contact your healthcare provider immediately. This is not a common side effect of these medications, but it has been reported in some cases 1. The mechanism behind cycline-induced hematuria may involve direct irritation to the urinary tract or, in some cases, an immune-mediated reaction. Some key points to consider:
- Gross hematuria has a high association with malignancy of up to 30% to 40%, and therefore all patients with gross hematuria should have a full urologic workup 1.
- Other urinary symptoms that might accompany hematuria include painful urination, increased frequency, or lower abdominal pain.
- It's essential to distinguish medication-induced hematuria from other causes such as infection, kidney stones, or urinary tract malignancies, so proper evaluation is necessary 1.
- Clinicians should include gross hematuria in their routine review of systems and specifically ask all patients with microscopic hematuria about any history of gross hematuria 1. Never stop prescribed antibiotics without consulting your healthcare provider first. If you develop gross hematuria while taking a cycline antibiotic, your doctor may need to discontinue the medication and switch you to an alternative antibiotic. In any case, it is crucial to follow the healthcare provider's advice and undergo the necessary evaluation to determine the cause of hematuria.
From the Research
Causes of Hematuria
- Hematuria can be caused by various factors, including infection, malignancy, and urolithiasis 2, 3
- The risk of malignancy with gross hematuria is greater than 10%, and prompt urologic referral is recommended 2
Tetracyclines and Hematuria
- There is no direct evidence in the provided studies that links cycline (tetracycline) to gross hematuria 2, 3, 4, 5, 6
- Tetracyclines are a class of antibiotics used to treat various infections, including skin and skin structure infections 5, 6
Evaluation of Hematuria
- Clinical evaluation of patients with hematuria often involves urological consultation with urine cytology, urine culture, imaging studies, and cystoscopy 3
- Patients who have no identifiable cause after an extensive workup should be monitored for early detection of malignancy or occult renal disease 3