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Hyperosmolality consequences Administration of hyperosmolar oral medications alone or in combination with food or enteral nutrition may increase the risk for gastrointestinal adverse events such as - delayed gastric emptying, osmotic diarrhea, intestinal ischemia (restriction in oxygen availability), feeding intolerance, increased risk of necrotizing enterocolitis albeit this claim is disputed, increasing gastric residual volume, limited feeding capacity due to increased gastric residual volume, osmolality-dependent changes in water absorption likely cause changes in drug concentration in the gastrointestinal fluid, potentially altering drug absorption characteristics

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