Calcium channel blocker overdose can be difficult to manage and sometimes requires the use of off-label medications, such as hydroxocobalamin, that may potentially interfere with hemodialysis therapy due to dialysate discoloration. We report a case of an adult patient who presented following an overdose of a dihydropyridine calcium channel blocker, and developed refractory vasoplegic shock. Management included the use of hydroxocobalamin, methylene blue, and hemodialysis. Hemodialysis treatment was interrupted due to recurrent false blood leak alarms triggered by dialysate discoloration due to hydroxocobalamin administration.