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Sometimes this is because doctors dont know from the manufacturer to tell their patients to drink more in the first place, which is part of the drug manufacturers failure to warn

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In the UK, hydroxocobalamin is the standard licensed preparation for injection, as recommended by NICE and the BNF, due to its superior retention in the body

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Like with methacholine, the extra methyl side group in bethanechol results in selectivity for muscarinic vs nicotinic receptors, and contributes to resistance to metabolism by cholinesterases