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# Liquid Paraffin
## Overview
Liquid paraffin is a highly refined mineral oil used as a lubricant and emollient. It is poorly absorbed from the gastrointestinal tract.
## Primary Indications
* **Constipation:** Used as a laxative to relieve constipation.
* **Skin Conditions:** Used topically as an emollient for dry skin and eczema.
## Adult Dosing
### Oral (Constipation)
* **General:** 10-30 mL once daily, typically at bedtime.
* **Maximum:** Not well-defined, but prolonged use is generally discouraged.
### Topical (Emollient)
* Apply to affected skin areas as needed.
## Pediatric Dosing
### Oral (Constipation)
* **Children 6-12 years:** 5-10 mL once daily.
* **Children 1-5 years:** 5 mL once daily.
* **Under 1 year:** Dosing is not routinely recommended and should only be under strict medical supervision, with doses typically much lower (e.g., 1-2.5 mL once daily). **Caution:** Risk of aspiration is higher in infants.
### Topical (Emollient)
* Apply to affected skin areas as needed.
## Dose Adjustments
No specific dose adjustments are typically required for hepatic or renal impairment.
## Contraindications
* Appendicitis or undiagnosed abdominal pain.
* Intestinal obstruction.
* Hypersensitivity to liquid paraffin.
* **Caution:** In individuals with dysphagia or impaired gag reflex due to risk of aspiration.
## Adverse Effects
* **Gastrointestinal:** Anal leakage, abdominal cramping, diarrhea, nausea.
* **Aspiration:** If aspirated into the lungs, can cause lipoid pneumonia, which can be severe and chronic. This is a significant risk, especially in infants, the elderly, and those with swallowing difficulties.
* **Systemic Absorption:** While generally poorly absorbed, chronic ingestion may lead to decreased absorption of fat-soluble vitamins (A, D, E, K).
* **Topical:** Skin irritation or rash in rare cases.
## Key Drug Interactions
* **Fat-Soluble Vitamins:** May decrease absorption of concurrently administered fat-soluble vitamins. Separate administration by several hours.
* **Mineral Oil:** Generally considered to have minimal significant drug interactions when used as directed.
## Monitoring
* **Constipation:** Monitor for bowel movement frequency and consistency, and for signs of fecal impaction or overflow.
* **Aspiration Risk:** Assess swallowing ability, especially in at-risk populations.
* **Nutritional Status:** Consider monitoring vitamin levels with chronic, high-dose use, particularly in children.
## Clinical Pearls
* Administer at bedtime to minimize daytime anal leakage.
* Avoid administration shortly before lying down, especially in at-risk individuals, due to aspiration risk.
* Do not use for prolonged periods without medical advice.
* Topical application should be to clean, dry skin.
* Inform patients about the potential for anal leakage and to use protective pads if necessary.
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*This information is intended for clinical use and does not replace comprehensive prescribing information. Always consult the most current product monograph or local protocols for complete details.*
