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# Liquid Paraffin
## Overview
Liquid paraffin, also known as mineral oil, is a laxative that works by softening the stool and lubricating the intestinal tract, making defecation easier. It is poorly absorbed from the gastrointestinal tract.
## Primary Indications
* Constipation
## Adult Dosing
* **Oral:** 10 mL to 30 mL once daily, usually at bedtime. Some sources suggest up to 45 mL daily may be used for short-term management. Dosing depends on patient response and local protocol.
## Pediatric Dosing
* **Oral:**
* **Ages 1-12 years:** 5 mL to 15 mL once daily at bedtime. Dosing depends on patient response and local protocol.
* **Under 1 year:** Generally not recommended due to risk of aspiration and potential systemic absorption. If used, very cautious dosing under strict medical supervision is required, typically 1-3 mL once daily.
## Dose Adjustments
No specific dose adjustments are typically required for hepatic or renal impairment.
## Contraindications
* Hypersensitivity to liquid paraffin.
* Patients with dysphagia or a history of aspiration, due to the risk of lipoid pneumonia.
* Inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis) or bowel obstruction.
## Adverse Effects
* Abdominal cramping, bloating, diarrhea.
* Anal leakage (particularly with higher doses or if taken in a recumbent position).
* Malabsorption of fat-soluble vitamins (A, D, E, K) with chronic, long-term use.
* Lipoid pneumonia (rare but serious complication, especially with aspiration).
## Key Drug Interactions
* **Fat-soluble vitamins (A, D, E, K):** Chronic use may decrease their absorption. Consider vitamin supplementation if long-term use is necessary.
* **Docusate:** Concomitant use may increase absorption of liquid paraffin.
* **Other laxatives:** Avoid concomitant use of other laxatives unless specifically directed by a healthcare provider, as this can lead to electrolyte imbalance and dehydration.
## Monitoring
* Monitor for bowel movements, stool consistency, and signs of abdominal discomfort or cramping.
* Assess for anal leakage.
* With chronic use, monitor for signs of fat-soluble vitamin deficiency.
## Clinical Pearls
* Administer at bedtime to minimize anal leakage and allow for overnight effect.
* Advise patients to remain upright for at least 2 hours after administration to reduce aspiration risk.
* Limit duration of use to avoid vitamin malabsorption and dependency.
* If anal leakage occurs, reduce the dose.
* Do not use in patients with difficulty swallowing.
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**Disclaimer:** This information is intended for healthcare professionals. Always consult the most current prescribing information and institutional protocols for definitive guidance.
