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It is not for self-injection or over-the-counter sale without appropriate training and authorisation

[13] Chloramphenicol has been shown to blunt reticulocyte response to cyanocobalamin, while ethanol, colchicine, and nitrous oxide interfere with cobalamin metabolism or utilization, each warranting clinician awareness when evaluating suboptimal treatment outcomes

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Signs of bacterial contamination: Cloudiness (should be clear) Particles or floating material Unusual odor Color change Physical degradation signs Visual changes indicating degradation: Clear solution becomes cloudy Color change (especially copper peptides) Precipitation or crystals forming Separation of layers When in doubt: Discard

Maintaining sterile technique is essential when working with bacteriostatic water