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99% purity by HPLC, third-party Certificate of Analysis available

When hydroxocobalamin is given in high doses (such as during cyanide poisoning treatment), unique effects can be observed: patients often experience a transient reddening of the skin or mucous membranes and a reddish discoloration of the urine due to drug excretion

Goyette, P

In addition to the systemic side effect of the weakened immune system, there can also be some more localised side effects from steroid injections, such as atrophy or shrinkage or thinning of surrounding tissues

Do not inject into areas that are bruised, red, irritated, scarred, or have hard lumps beneath them