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# Liquid Paraffin
## Overview
Liquid paraffin, also known as mineral oil, is a highly refined liquid hydrocarbon. It acts as an emollient and a laxative by coating the intestinal wall, preventing water reabsorption and softening stool.
## Primary Indications
* Constipation (oral use)
* Skin moisturizer/emollient (topical use)
## Adult Dosing
* **Constipation:** 10-30 mL orally once daily or divided into 2-3 doses. Maximum dose typically not specified but generally kept to the lowest effective dose.
* **Topical:** Apply liberally to affected skin areas as needed.
## Pediatric Dosing
* **Constipation (oral):**
* 1-5 years: 5-10 mL once daily.
* 6-12 years: 10-15 mL once daily.
* Over 12 years: As per adult dosing.
* **Note:** Use in children under 1 year requires medical supervision due to risk of aspiration.
## Dose Adjustments
No dose adjustments are typically required for hepatic or renal impairment.
## Contraindications
* Hypersensitivity to liquid paraffin.
* Concurrent use with oral anticoagulants (warfarin) due to potential for reduced absorption of anticoagulants.
* Patients with difficulty swallowing or a history of aspiration due to risk of lipoid pneumonia.
* Acute abdominal pain, nausea, vomiting, or intestinal obstruction.
## Adverse Effects
* **Oral:** Diarrhea, abdominal cramping, anal leakage (especially with higher doses).
* **Topical:** Greasiness, potential for pore occlusion.
* **Rare but serious (oral):** Lipoid pneumonia if aspirated.
## Key Drug Interactions
* **Oral anticoagulants (e.g., warfarin):** May decrease absorption and efficacy. Separate administration by at least 2 hours.
* **Fat-soluble vitamins (A, D, E, K):** May decrease absorption with chronic oral use.
* **Other medications:** May decrease absorption of concurrently administered oral medications. Separate administration by at least 2 hours.
## Monitoring
* Monitor for bowel movements and stool consistency when used for constipation.
* Assess for signs of anal leakage or perianal irritation.
* Inquire about changes in effectiveness of oral anticoagulants if used concurrently.
## Clinical Pearls
* Oral liquid paraffin is a non-systemic laxative; onset of action is typically 6-8 hours.
* Advise patients to take oral liquid paraffin at bedtime or at least 2 hours apart from other medications and meals to minimize absorption interference.
* Emphasize the importance of avoiding aspiration, especially in the elderly and very young.
* Topical use provides a barrier to prevent moisture loss and is useful for dry, scaly skin conditions.
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*Disclaimer: This information is intended for healthcare professionals. Always verify current prescribing information and consult with a qualified healthcare provider before making any treatment decisions.*
