What Causes Blood Clots In Urine After Taking Lovenox?

Posted on Thu, 25 Jun 2015

Question: +Hi, I was diagnosed with blood clots three weeks ago. Finished the loading dose (15g 2x day) of Xarelto tuesday morning. I began having blood in my urine Monday. I called my GP's triage nurse, who talked to my Dr. Told me to watch for other symptoms, light headed coughing blood.... Did't have any. In the morning (Tuesday) no blood in urine! Saw GP @ 8:30 Am Tuesday to discuss. He is @ Mayo XXXXXXX He called a cardiologist, hematologist, and urologist,a nd pulmonologist, and made appointments for me over the last few days, and scheduled for this test tomorrow morning @ 7:30 I am pasting this from my Mayo account page) - "AZ RAD CT Abd WO+W+Pelvis W/CST with Rad CT OP MCB (AZ)" - tomorrow morning @ 7:30. Back to Tuesday. After the GP appointment w/no blood in urine, I took my morning Xarelto. 3-4 hours later blood in urine! Lasted all day and night. Next morning Weds - saw Pulmonologist, who prescribed Lovenox, no more Xarelto. Didn't have any blood in urine since, until an hour and 1/2 ago, when I not only had blood, my stream completely stopped, and as I pushed to urinate, black globs of blood, or ???, came out along with more bloody urine. Same thing, but less black muck @ next urine. Just urinated again, blood, but no black mucky mass. I may have taken too much Lovenox, as I am supposed to get rid of 20mg, of 200, take 80 2 x a day, , start warfarin tomorrow night,a nd wean off of Lovenox. Should I go to the hospital? I don't feel very light headed, though have anxiety, so maybe a little?? Also, remember I have the test in the Am @ Mayo. There is a Mayo hospital 15/20 mins from my house. Wife gone, but I can drive myself if I should go. Should I wait to see if it continues? The blobs, not so much the blood, as I know have used too much Lovenox. Scheduled for the test tomorrow Am\,and a bladder probe, but not until XXXXXXX 22nd! Also met today with the head nurse @ Mayo coagulation dept. Wasn't urinating blood then, and definitely not the masses/muck! Please advise. Was going to call the hospital, bit prefer a Dr's opinion verses likely talking to a nurse @ hospital. My lower back might hurt slightly, maybe in my head. I do have chronic neck and back issues. Also, this is my 2nd DVT, actually 4 blood lots this time, I think, but did have one back in 2010. was on warfarin for over a year, partly my choice, due to anxiety. Please advise. Thanks you!!!! XXXXXXX

Answered by Dr. Ilir Sharka (3 hours later)

Brief Answer:
I recommend you to go to the hospital and have some tests

Detailed Answer:
Hello!

Thank you for your question on HCM! I understand your concern.

I recommend you to go to the hospital and have some tests like : a routine blood analysis for Hb and platelets account, coagulation tests.

I agree with your doctor that you should undergo radiologic tests for the urinary tract hemorrhage like an urinary tract ultrasound and an pelvico-abdominal CT scan with and without contrast (AZ RAD CT Abd WO+W+Pelvis W/CST with Rad CT OP MCB (AZ)) like he has recommended.
This is very important to locate the site and the amount of hemorrhage, a possible internal hemorrhage not visible, its amount and any other cause of hemorrhage like a urinary tract abnormality not related to Xarelto.

He has asked you for dizziness, back pain or hemorrhage during cough, to have information about possible intracranial, internal abdominal or lung hemorrhage which can be severe complications of anticoagulation therapy besides the urinary tract hemorrhage that you refer to have had.

If you will start on warfarin I would also recommend you to perform INR test which is necessary before starting it and monitor it.

Hope to have been helpful!

I am sorry for the unjustified delay in answering to you but it was an unexpected network blackout. Wish not to have such inconvenience in the future!

Greetings ! Dr. Iliri

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar