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# Liquid Paraffin
## Overview
Liquid paraffin is a mineral oil used as an emollient and laxative. It lubricates the intestinal tract, softening stool and facilitating bowel movements.
## Primary Indications
* Constipation
## Adult Dosing
* **Oral:** 10 mL to 30 mL once daily at bedtime. Doses may be adjusted based on clinical response. Maximum dose is typically 45 mL daily, but consult local protocols.
* **Rectal (enema):** As directed by local protocol, typically 100-150 mL as an enema.
## Pediatric Dosing
Dosing in pediatric patients should be based on age and weight, and is often guided by local institutional protocols. Generally, lower doses are used for younger children and infants.
* **Oral (2-12 years):** 5 mL to 10 mL once daily at bedtime.
* **Oral (infants < 2 years):** Use with caution and typically under medical supervision. Doses are generally lower, around 2.5 mL to 5 mL once daily.
## Dose Adjustments
* **Renal Impairment:** No dose adjustment is typically required as absorption is minimal.
* **Hepatic Impairment:** No dose adjustment is typically required.
## Contraindications
* Known hypersensitivity to liquid paraffin.
* Ileus, intestinal obstruction, acute abdominal conditions (e.g., appendicitis, ulcerative colitis, diverticulitis), and fecal impaction.
* Risk of aspiration, especially in patients with impaired gag reflex or those who are debilitated.
## Adverse Effects
* Anal leakage, soiling, and irritation.
* Abdominal cramping, nausea, vomiting, diarrhea.
* Lipoid pneumonia (if aspirated).
* Decreased absorption of fat-soluble vitamins (A, D, E, K) with chronic, high-dose use.
## Key Drug Interactions
* **Fat-soluble vitamins (A, D, E, K):** Reduced absorption with chronic use. Consider separate administration or supplementation.
* **Docusate sodium:** Concurrent use may increase absorption of mineral oil. Avoid concurrent use.
## Monitoring
* Bowel movements, stool consistency, and presence of anal leakage.
* Signs of intestinal obstruction.
* Nutritional status with long-term use, particularly fat-soluble vitamin levels.
## Clinical Pearls
* Administer at bedtime to minimize anal leakage and soiling during the day.
* Aspiration is a significant risk, especially in the elderly, debilitated, or those with swallowing difficulties. Exercise extreme caution.
* Long-term, frequent use may lead to dependence for bowel evacuation.
* It is not systemically absorbed, making it generally safe in renal or hepatic impairment.
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*Please verify this information with the most current prescribing information and local institutional protocols before use.*
