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# Liquid Paraffin
## Overview
Liquid paraffin is a mineral oil used as a laxative. It lubricates the intestinal tract, softening the stool and easing passage.
## Primary Indications
Constipation.
## Adult Dosing
* **Oral:** 15-45 mL once daily, typically at bedtime. Doses can be adjusted based on response.
* **Rectal (as enema):** Varies by product; follow specific product instructions.
## Pediatric Dosing
* **Oral:**
* **1-5 years:** 5-10 mL once daily.
* **6-12 years:** 10-20 mL once daily.
* **Over 12 years:** 15-45 mL once daily.
* **Under 1 year:** Use is generally not recommended without physician guidance due to increased risk of aspiration.
## Dose Adjustments
No specific dose adjustments are typically required for hepatic or renal impairment.
## Contraindications
* Hypersensitivity to liquid paraffin.
* Patients with intestinal obstruction, appendicitis, inflammatory bowel disease, or rectal bleeding of unknown origin.
* Prolonged use is generally not recommended.
* Do not administer to patients who are lying down or who have difficulty swallowing due to the risk of aspiration and lipoid pneumonia.
## Adverse Effects
* Gastrointestinal: Anal leakage of oil, abdominal cramps, nausea, vomiting, diarrhea.
* Chronic use: Vitamin malabsorption (fat-soluble vitamins A, D, E, K), granulomatous colitis, fecal impaction.
* Aspiration: Lipoid pneumonia (especially in the elderly or those with impaired swallowing).
## Key Drug Interactions
* **Mineral Oil:** Can decrease the absorption of fat-soluble vitamins (A, D, E, K) and other lipid-soluble drugs (e.g., digoxin, some anticoagulants). Separate administration by at least 2 hours.
* **Docusate:** Concurrent use may increase absorption of mineral oil, increasing the risk of adverse effects.
## Monitoring
Monitor for bowel movements, stool consistency, and signs of abdominal discomfort or anal leakage. Assess for potential vitamin deficiency with chronic use.
## Clinical Pearls
* Administer with caution in the elderly or debilitated patients due to the risk of aspiration.
* Advise patients to take the medication in an upright position and to avoid lying down immediately after administration.
* Due to its lubricating action, it is often preferred for fecal impaction and in conditions where straining should be avoided (e.g., post-MI, anal fissures).
* Not for long-term daily use; consider alternative agents for chronic constipation.
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*Disclaimer: This information is intended for clinical use and does not replace a thorough review of the most current prescribing information and relevant medical literature. Always verify the latest drug details with official product monographs and consult with healthcare professionals.*
