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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

Deviations from optimal pH accelerate degradation, and this effect intensifies at room temperature