Which urine color change is considered normal for a patient taking amitriptyline?

• A. Yellow
• B. Blue-green
• C. Red
• D. Black

Answer: (B)

Drug-induced urine color changes are a common teaching point. Amitriptyline, a tricyclic antidepressant, can cause urine to take on a blue-green tint because the drug and its metabolites are excreted in the urine and can impart this color. This is a benign, expected side effect and does not indicate a problem with the kidneys or a medical emergency. If the urine were red, black, or another alarming color, or if there were symptoms like pain, fever, or blood in the urine, that would warrant further evaluation. Yellow urine simply reflects normal hydration and urine concentration and isn’t the color change specifically associated with amitriptyline.