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# Liquid Paraffin
## Overview
Liquid paraffin is a mineral oil used as a laxative. It lubricates the intestinal walls, softening the stool and easing passage. It is poorly absorbed from the gastrointestinal tract.
## Primary Indications
Constipation.
## Adult Dosing
* **Oral:** 10-45 mL once daily, typically at bedtime. Some sources suggest up to 60 mL daily in divided doses for more severe constipation. The exact dose depends on patient response and local protocol.
## Pediatric Dosing
* **Oral:**
* **1-5 years:** 5-10 mL once daily.
* **6-12 years:** 10-20 mL once daily.
* **Over 12 years:** As per adult dosing.
* *Note: Use in infants and children under 1 year should be under strict medical supervision due to risk of aspiration.*
## Dose Adjustments
No dose adjustments are typically required for hepatic or renal impairment, as systemic absorption is minimal.
## Contraindications
* Known hypersensitivity to liquid paraffin.
* Appendicitis or symptoms of acute abdominal conditions.
* Intestinal obstruction or fecal impaction.
* Galactosemia (due to potential excipients in some formulations).
* Use with caution in patients with dysphagia or impaired gag reflex, due to risk of aspiration and lipoid pneumonia.
## Adverse Effects
* Diarrhea, abdominal cramping, nausea, vomiting.
* Anal leakage, particularly with higher doses.
* Long-term, high-dose use may lead to decreased absorption of fat-soluble vitamins (A, D, E, K).
* Lipoid pneumonia if aspirated.
## Key Drug Interactions
* **Mineral Oil:** May reduce the absorption of orally administered medications, especially fat-soluble vitamins and certain drugs like digoxin. Separate administration by at least 2 hours.
* **Docusate Sodium:** Concurrent use may increase absorption of mineral oil, potentially increasing the risk of adverse effects.
## Monitoring
* Bowel movements (frequency and consistency).
* Signs of dehydration or electrolyte imbalance, especially with prolonged or excessive use.
* Nutritional status and fat-soluble vitamin levels with long-term therapy.
## Clinical Pearls
* Administer at bedtime to minimize discomfort from anal leakage.
* Avoid use in patients at high risk for aspiration.
* Long-term daily use is generally not recommended; intermittent use is preferred for managing constipation.
* Some products may contain flavoring agents or other excipients that could be relevant for specific patient populations (e.g., allergies, diabetes).
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*This information is intended for clinical use and does not replace the need to consult the most current prescribing information and relevant guidelines.*
