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# Liquid Paraffin
## Overview
Liquid paraffin is a mineral oil used as a laxative and emollient. It works by lubricating the stool and intestinal wall, softening the stool and easing its passage.
## Primary Indications
* Constipation
## Adult Dosing
* **Oral:** 10 mL to 30 mL once daily, usually at bedtime. Higher doses may be used for more severe constipation, but prolonged use is not recommended.
## Pediatric Dosing
* **Oral:**
* Under 1 year: Not generally recommended due to risk of aspiration and lipid pneumonia.
* 1-5 years: 5 mL once daily.
* 6-12 years: 10 mL once daily.
* Over 12 years: As per adult dosing.
* Dosing should be individualized and used cautiously in children.
## Dose Adjustments
No dose adjustments are typically required based on renal or hepatic impairment.
## Contraindications
* Hypersensitivity to liquid paraffin.
* Patients with appendicitis, intestinal obstruction, or fecal impaction.
* Children under 1 year of age (due to aspiration risk).
* Patients with difficulty swallowing (due to aspiration risk).
## Adverse Effects
* **Common:** Abdominal cramping, nausea, vomiting, diarrhea.
* **Serious:**
* Lipid pneumonia (if aspirated).
* Anal leakage, particularly with higher doses or prolonged use.
* Reduced absorption of fat-soluble vitamins (A, D, E, K) with chronic use.
* Pruritus ani (anal itching).
## Key Drug Interactions
* **Fat-soluble vitamins:** Chronic use can decrease absorption of vitamins A, D, E, and K. Separate administration by several hours.
* **Other laxatives:** Increased risk of diarrhea and electrolyte imbalance.
* **Anticoagulants (e.g., warfarin):** Theoretical concern for reduced absorption of warfarin, leading to decreased anticoagulant effect. Monitor INR closely if used concomitantly.
## Monitoring
* Bowel movement frequency and consistency.
* Signs of aspiration (coughing, choking) during or after administration.
* For chronic use, monitor for signs of vitamin deficiencies and consider supplementation.
## Clinical Pearls
* Administer undiluted.
* Avoid administration immediately before lying down due to risk of aspiration.
* It is a non-systemically absorbed laxative, making it generally safe for short-term use.
* Long-term daily use is discouraged due to potential for dependency, decreased nutrient absorption, and anal leakage.
* Can be used topically as an emollient for dry skin.
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**Disclaimer:** This information is intended for healthcare professionals and is not a substitute for professional medical advice. Always verify current prescribing information with the product's official labeling and consult with a healthcare provider for any medical decisions.
