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# Liquid Paraffin
## Overview
Liquid paraffin is a mineral oil used as an emollient and laxative. It lubricates the intestinal tract, softening stool and easing defecation. It is poorly absorbed from the gastrointestinal tract.
## Primary Indications
* Constipation
## Adult Dosing
* **Oral:** 10-30 mL once daily or as needed. Some sources suggest up to 60 mL daily for short-term use. Specific dosing may vary by formulation and local protocol.
## Pediatric Dosing
* **Oral:** Dosing varies significantly by age and formulation.
* **1-12 years:** Generally 5-10 mL once daily.
* **Under 1 year:** Dosing is highly individualized and should be determined by a healthcare provider, often starting at 2.5-5 mL once daily.
* **Note:** Use in infants and young children requires careful consideration due to the risk of aspiration and potential for systemic absorption.
## Dose Adjustments
* No specific dose adjustments are typically required for renal or hepatic impairment, as the drug is poorly absorbed.
## Contraindications
* Hypersensitivity to liquid paraffin.
* Appendicitis or symptoms of acute abdominal pain.
* Intestinal obstruction.
* Concurrent use of other stool softeners or laxatives that may increase absorption.
* Risk of aspiration (e.g., in patients with swallowing difficulties, elderly, or debilitated patients).
## Adverse Effects
* Most common: Abdominal cramping, nausea, vomiting, diarrhea, anal leakage/staining.
* Long-term use: May lead to vitamin malabsorption (fat-soluble vitamins A, D, E, K), fecal impaction, and granulomatous colitis.
* Aspiration: Can lead to lipoid pneumonia, especially with improper administration or in patients with impaired gag reflexes.
## Key Drug Interactions
* **Fat-soluble vitamins:** Decreased absorption of vitamins A, D, E, and K with chronic use.
* **Other laxatives:** Increased risk of diarrhea and electrolyte imbalance.
* **Mineral oil-based suppositories:** Concurrent use can increase the risk of anal irritation and leakage.
## Monitoring
* Bowel movement frequency and consistency.
* Signs of abdominal discomfort or obstruction.
* For chronic use, monitor for signs of vitamin deficiency.
## Clinical Pearls
* Administer at bedtime to minimize anal leakage during the day.
* Avoid taking immediately before lying down due to aspiration risk.
* Should not be used for more than 7 days without medical advice.
* Educate patients about the potential for anal leakage and staining of underwear.
* Consider alternative laxatives for long-term management of constipation.
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**Disclaimer:** This information is intended for clinical decision support and does not replace professional medical advice. Always consult the most current prescribing information and relevant guidelines before making any treatment decisions.
