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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
Sohn SI, Priya A, Balasubramaniam B, Muthuramalingam P, Sivasankar C, Selvaraj A, et al
However, because it is a potent co-enzyme, some individuals may experience temporary sensations: Nausea: Often triggered by a drip rate that is too fast
Oral administration, when using acetate or amidate-stabilized KLOW formulations, delays onset by 4070 minutes due to gastric transit time and first-pass hepatic metabolism, which reduces bioavailability to approximately 3045%
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