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## Liquid Paraffin
### Overview
Liquid paraffin is a mineral oil that acts as an emollient and lubricant. It is poorly absorbed from the gastrointestinal tract.
### Primary Indications
Constipation.
### Adult Dosing
* **Oral:** 10-30 mL once daily, typically at bedtime. Higher doses may be used under medical supervision. Do not exceed 45 mL per day.
### Pediatric Dosing
* **Oral:** Dosing varies by age and is typically guided by local protocols. A general guideline for children over 1 year of age is 5-10 mL once daily. **Not recommended for infants under 1 year of age due to risk of aspiration and lipoid pneumonia.**
### Dose Adjustments
No specific dose adjustments are typically required for renal or hepatic impairment due to minimal systemic absorption.
### Contraindications
* Hypersensitivity to liquid paraffin.
* Concurrent use of certain medications that may increase the risk of aspiration (e.g., in patients with difficulty swallowing).
* Patients with a history of aspiration or risk factors for aspiration.
* Inflammatory bowel disease.
* Intestinal obstruction.
### Adverse Effects
* Gastrointestinal: Abdominal cramping, diarrhea, nausea, vomiting, anal leakage.
* Long-term use: Risk of vitamin malabsorption (especially fat-soluble vitamins A, D, E, K), and granulomatous colitis if aspirated.
* Aspiration: Can lead to lipoid pneumonia, which can be severe and fatal.
### Key Drug Interactions
* **Fat-soluble vitamins (A, D, E, K):** Liquid paraffin can decrease their absorption. Consider separate administration times or vitamin supplementation.
* **Cholestyramine/Colestipol:** May enhance the effect of liquid paraffin by increasing intestinal transit time.
* **Docusate sodium:** Concurrent use may increase the risk of anal leakage.
### Monitoring
* Bowel movements and consistency.
* Signs of electrolyte imbalance or dehydration with prolonged or excessive use.
* Nutritional status, especially with long-term use or in vulnerable populations.
### Clinical Pearls
* Administer at bedtime to minimize disruption and potential anal leakage during the day.
* Advise patients to take upright and avoid lying down immediately after administration to reduce aspiration risk.
* Do not use in patients with acute abdominal pain, nausea, vomiting, or signs of intestinal obstruction.
* Long-term daily use is generally discouraged due to potential for vitamin malabsorption and dependence.
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*This information is intended for clinical use and does not replace comprehensive drug monographs or local protocols. Always consult current prescribing information and patient-specific factors before making therapeutic decisions.*
