This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Neuromuscular Blocker, Subject name: Anaesthesia
All true about CisATRACURIUM except- 
Select and explain. 
A. It is pure Cis isomer of atracurium, B. It is more potent than atracurium, C. It is also causes histamine release like atracurium, D. Metabolism similar to atracurium
C: It is also causes histamine release like atracurium
Answer: C: It is also causes histamine release like atracurium 
Explanation: Cisatracurium is pure sis isomer of atracurium. It is more potent and has longer onset time than atracurium. Metabolism is similar to atracurium. It releases less histamine than atracurium. Cisatracurium does not cause histamine release unlike atracurium. Cisatracurium produces laudanosine but is about five times lesser than that of atracurium. Cisatracurium is a stereoisomer of atracurium that is four times more potent. Cisatracurium undergoes Hofmann Elimination which is a spontaneous non-enzymatic organ-independent degradation. So its clearance is independent of renal function. Hence it is the agent of choice in renal failure patients.