Water pressure is my concern my pressure is 45lb it has a 1 1/2" inlet spud

Do you already have the toilet, or are you still in the shopping around phase of this venture?

At 45psi I would recommend going with a wall mount toilet with a pressure assist tank instead of using a toilet with a flushometer valve.

The in wall carrier will work with both styles of toilets, so that isn't much of a concern -- The sticking point is that a toilet with a flushometer valve will require a minimum water inlet size of 1" with an 1-1/4" feed (meaning your incoming waterline must be a minimum of 1-1/4") and at 45psi, that's kind of pushing it, whereas a tank style wall hung toilet will require only a 1/2" feed.

Hi Widdershins...

Always a pleasure to see you... or at least... most of the time... ;)

Hey, seriously, great answer as usual!

Glad to see you prowling the AMHD again!

MARK