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# Liquid Paraffin
## Overview
Liquid paraffin is a mineral oil used as an emollient and a laxative. It works by lubricating the intestinal tract, softening the stool, and easing its passage.
## Primary Indications
* Constipation
## Adult Dosing
* **Oral:** 10-45 mL once daily, usually at bedtime. Doses may be adjusted based on individual response. Some sources recommend up to 60 mL daily in divided doses for severe constipation.
## Pediatric Dosing
* **Oral:** Dosing varies significantly by age and formulation.
* **Under 1 year:** Generally not recommended due to risk of aspiration.
* **1-5 years:** 5-10 mL once daily.
* **6-12 years:** 10-20 mL once daily.
* **Over 12 years:** 10-45 mL once daily.
* **Note:** Pediatric dosing is often guided by local protocols and physician judgment.
## Dose Adjustments
* No specific dose adjustments are typically required for hepatic or renal impairment, as systemic absorption is minimal.
## Contraindications
* Hypersensitivity to liquid paraffin.
* Intestinal obstruction, appendicitis, inflammatory bowel disease, or other acute abdominal conditions.
* Difficulty swallowing (risk of aspiration).
* Prophylactic use in the elderly or debilitated individuals where aspiration is a significant risk.
## Adverse Effects
* Most common: Diarrhea, abdominal cramping, nausea.
* Long-term use or high doses can lead to leakage, anal irritation, and decreased absorption of fat-soluble vitamins (A, D, E, K).
* **Aspiration:** Can cause lipoid pneumonia, which can be severe and potentially fatal. This risk is increased with supine administration, large doses, or in individuals with impaired gag reflexes.
## Key Drug Interactions
* **Fat-soluble vitamins (A, D, E, K):** Absorption may be decreased with concurrent use. Administer liquid paraffin at least 2 hours apart from vitamin supplements.
* **Docusate:** Concurrent use may increase absorption of liquid paraffin.
## Monitoring
* Bowel movements and stool consistency.
* Signs of abdominal pain or distension.
* Signs of vitamin deficiency with long-term use.
* Monitor for aspiration, especially in at-risk populations.
## Clinical Pearls
* Administer oral liquid paraffin with caution and preferably in an upright position to minimize the risk of aspiration.
* Avoid use in patients with dysphagia or a history of aspiration.
* If used long-term, consider monitoring for fat-soluble vitamin deficiencies.
* For children, particularly infants, the risk of aspiration is higher, and alternative laxatives are often preferred.
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**Disclaimer:** This information is intended for clinical use and is not a substitute for professional medical advice. Always consult the most current prescribing information and product labeling, or your pharmacist or physician, for complete and up-to-date drug information. Dosing and recommendations may vary based on individual patient factors and local practice guidelines.
