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# Liquid Paraffin
## Overview
Liquid paraffin is a mineral oil used as a laxative. It lubricates the intestinal tract, softening stool and easing passage. It is not absorbed systemically.
## Primary Indications
* Constipation
## Adult Dosing
* 10-30 mL orally once daily, typically at bedtime. Dosing may be adjusted based on patient response.
* Maximum dose: Not explicitly defined, but higher doses increase the risk of adverse effects.
## Pediatric Dosing
* **1-5 years:** 5 mL orally once daily.
* **6-12 years:** 10 mL orally once daily.
* **Over 12 years:** Dosing as per adults (10-30 mL orally once daily).
* *Note: Use in infants and children under 1 year should be under strict medical supervision due to increased risk of aspiration and adverse events.*
## Dose Adjustments
* No dose adjustments are typically required for hepatic or renal impairment as the drug is not absorbed.
## Contraindications
* Hypersensitivity to liquid paraffin.
* Acute abdominal pain, nausea, vomiting, or other symptoms of appendicitis or undiagnosed intestinal obstruction.
* Difficulty swallowing (risk of aspiration).
* Use with caution in patients with a history of aspiration.
## Adverse Effects
* Most common: Diarrhea, abdominal cramping, nausea.
* Less common: Anal leakage, perianal irritation, malabsorption of fat-soluble vitamins (A, D, E, K) with chronic, high-dose use.
* Rare but serious: Lipoid pneumonia secondary to aspiration.
## Key Drug Interactions
* **Fat-soluble vitamins (A, D, E, K):** Long-term use may decrease absorption. Consider separating administration or providing supplements.
* **Other laxatives:** Concurrent use may lead to excessive bowel stimulation and electrolyte imbalance.
## Monitoring
* Monitor for effectiveness (bowel movements, stool consistency).
* Monitor for adverse effects, particularly abdominal pain, cramping, and anal leakage.
* For long-term use, consider monitoring for signs of fat-soluble vitamin deficiency.
## Clinical Pearls
* Administer undiluted and instruct patients to avoid lying down for at least 1-2 hours after taking to minimize aspiration risk.
* May cause anal leakage, particularly with higher doses.
* Not intended for chronic use; lifestyle modifications and other therapeutic approaches should be considered for persistent constipation.
* The risk of aspiration is a significant concern, especially in the elderly, those with impaired gag reflexes, or when given in a recumbent position.
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*Disclaimer: This information is intended for healthcare professionals. Always consult the most current prescribing information and relevant guidelines for complete and up-to-date details.*
