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Most protocols cycle on and off rather than using continuously

Red or purple chromaturia is a side effect of hydroxocobalamin, typically resolving over several weeks.2 Additional causes of red urine include blood (e.g., traumatic catheterization, malignancy, infection), dietary ingestion (e.g., beets), and medications (e.g., rifampin, phenothiazines).3 Although benign and not warranting further evaluation by itself, hydroxocobalamin-induced discolouration of body fluids may interfere with colorimetric sensors

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Since it influences cellular metabolism, women should consult a healthcare professional before starting supplementation, especially if they are pregnant, nursing, or managing medical conditions