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Serious adverse events have not been widely reported, but this may reflect the relatively small number of people who have used the compound and the limited reporting mechanisms available

doi:10.1016/j.ejmg.2019.103713

Well look at the differences between these methods

Although our experience suggests that hydroxocobalamin does not cause clinically significant interference with non-invasive pulse oximetry, there is evidence to suggest that co-oximetric blood gas analysis with several unique analyzers may be altered in the presence of hydroxocobalamin, specifically with false elevations of carboxyhemoglobin and methemoglobin concentrations and underestimation of true oxygen saturation values.5 There is no available evidence regarding the accuracy of other commonly utilized oximetric monitoring modalities (e.g., cerebral oximetry) following hydroxocobalamin administration