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# Liquid Paraffin
## Overview
Liquid paraffin, also known as mineral oil, is a highly refined petroleum distillate used as a laxative. It lubricates the intestinal tract, softening stool and preventing water absorption, thus facilitating bowel movements.
## Primary Indications
Constipation.
## Adult Dosing
* **Oral:** 15-45 mL once daily, typically at bedtime. The dose may be adjusted based on response. A common starting dose is 15 mL. Maximum daily dose is generally not specified but should be used judiciously.
## Pediatric Dosing
* **Oral:**
* **1-5 years:** 5-15 mL once daily.
* **6-12 years:** 10-20 mL once daily.
* **Over 12 years:** As per adult dosing.
Dosing should be individualized and used with caution.
## Dose Adjustments
No specific dose adjustments are required for renal or hepatic impairment, but use should be cautious in these populations due to potential for complications.
## Contraindications
* Hypersensitivity to liquid paraffin.
* Patients with acute abdominal pain, nausea, vomiting, intestinal obstruction, or appendicitis.
* Prolonged use is generally discouraged.
* Avoid use in patients at risk of aspiration, especially those with impaired gag reflexes or in a recumbent position.
## Adverse Effects
* **Common:** Abdominal cramping, diarrhea, nausea, anal leakage (particularly with higher doses or with the liquid form), and perianal irritation.
* **Less Common/Serious:** Vitamin malabsorption (fat-soluble vitamins A, D, E, K) with chronic use. Lipid pneumonia can occur if aspirated. Granulomatous colitis has been reported with chronic use.
## Key Drug Interactions
* **Fat-soluble vitamins (A, D, E, K):** Liquid paraffin can decrease their absorption. Separate administration by at least 2 hours.
* **Other laxatives:** Concurrent use may increase the risk of dehydration and electrolyte imbalance.
* **Cholestyramine:** May reduce absorption of liquid paraffin.
## Monitoring
* Monitor for effectiveness (frequency and consistency of bowel movements).
* Assess for adverse effects, particularly anal leakage, abdominal cramping, and signs of vitamin deficiency with prolonged use.
* Monitor fluid and electrolyte balance if diarrhea occurs.
## Clinical Pearls
* Administer undiluted.
* Taking with a full glass of water may improve palatability and reduce anal leakage.
* Avoid administration in a recumbent position or in patients with swallowing difficulties to minimize the risk of aspiration.
* Limit the duration of use to avoid potential vitamin malabsorption and dependency.
* Oil retention enemas are a separate formulation and administration route.
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**Disclaimer:** This information is intended for healthcare professionals. It is essential to consult the most current prescribing information and relevant clinical guidelines for definitive patient care decisions, as drug information can change.
