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# Liquid Paraffin
## Overview
Liquid paraffin is a mineral oil used as a laxative. It lubricates the intestinal tract, softening stool and facilitating bowel movements. It is not absorbed systemically.
## Primary Indications
Constipation.
## Adult Dosing
* **Oral:** 15 mL to 30 mL once daily, typically at bedtime. Dosing may be adjusted based on patient response. Maximum daily dose is generally not specified but should be guided by clinical effect and avoidance of adverse events.
## Pediatric Dosing
* **Oral:** Dosing is not well-established in children and should be used with caution. If used, a common approach is 5 mL to 10 mL once daily at bedtime for children over 6 years of age. Dosing for younger children is generally not recommended or requires specific consultation.
## Dose Adjustments
No dose adjustments are typically required for hepatic or renal impairment due to minimal systemic absorption.
## Contraindications
* Abdominal pain, nausea, vomiting, or other symptoms of appendicitis or undiagnosed abdominal conditions.
* Intestinal obstruction.
* Hypersensitivity to liquid paraffin.
## Adverse Effects
* Gastrointestinal: Anal leakage (especially with higher doses), abdominal cramping, diarrhea, nausea.
* Aspiration: If given to patients with impaired swallowing reflexes, it can lead to lipoid pneumonia. This is a significant concern, especially in the elderly or debilitated.
* Reduced absorption of fat-soluble vitamins (A, D, E, K) with chronic use.
## Key Drug Interactions
* **Fat-soluble vitamins (A, D, E, K):** Chronic use may decrease their absorption.
* **Docusate:** Coadministration is generally not recommended due to potential for increased absorption of mineral oil.
## Monitoring
* Bowel movement frequency and consistency.
* Signs of anal leakage or cramping.
* Assess for aspiration risk, especially in vulnerable populations.
## Clinical Pearls
* Administer at bedtime to minimize daytime anal leakage.
* Do not use in patients with difficulty swallowing.
* Long-term, frequent use is discouraged due to potential for dependence, vitamin malabsorption, and anal leakage.
* If symptoms persist after a week of use, reassess the patient for underlying causes of constipation.
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**Disclaimer:** This information is intended for healthcare professionals. Always consult the most current prescribing information and relevant guidelines for complete and up-to-date drug details before making clinical decisions.
