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# Liquid Paraffin
## Overview
Liquid paraffin is a mineral oil used as a lubricant laxative. It coats the intestinal walls, softening stool and facilitating its passage.
## Primary Indications
* Constipation
## Adult Dosing
* **Oral:** 10 mL to 30 mL once daily, usually at bedtime.
* **Maximum:** Doses exceeding 30 mL daily are generally not recommended without medical supervision.
## Pediatric Dosing
* **Oral (Ages 6-12 years):** 5 mL to 15 mL once daily, usually at bedtime.
* **Oral (Under 6 years):** Use is generally not recommended and should only be under strict medical guidance. Safety and efficacy in younger children are not well established.
## Dose Adjustments
No specific dose adjustments are routinely required for hepatic or renal impairment.
## Contraindications
* Known hypersensitivity to liquid paraffin.
* Patients with intestinal obstruction, acute abdominal pain of unknown origin, nausea, vomiting, or fecal impaction.
* Avoid use in individuals with dysphagia or a history of aspiration, as there is a risk of lipoid pneumonia.
## Adverse Effects
* Abdominal cramping
* Diarrhea
* Nausea
* Anal leakage/soiling
* Fat-soluble vitamin malabsorption (with chronic, high-dose use)
* Lipoid pneumonia (rare, especially with chronic aspiration)
## Key Drug Interactions
* **Bowel-acting drugs:** Concurrent use with other laxatives may potentiate fluid and electrolyte loss.
* **Fat-soluble vitamins (A, D, E, K):** May reduce absorption, especially with chronic use. Separate administration by at least 2 hours.
* **Docusate Sodium:** Some sources suggest avoiding co-administration as it might enhance systemic absorption of mineral oil, although clinical significance is unclear.
## Monitoring
* Bowel movements (frequency, consistency)
* Signs of electrolyte imbalance (especially with chronic use or if diarrhea occurs)
* Signs of abdominal discomfort or obstruction
## Clinical Pearls
* Administer at bedtime to minimize disruption and reduce the risk of leakage.
* Do not administer immediately before lying down due to the risk of aspiration.
* Inform patients that anal leakage can occur, especially at higher doses or with poor sphincter control.
* Long-term, frequent use may lead to dependency and malabsorption of fat-soluble vitamins. It is generally intended for short-term or intermittent use.
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*Disclaimer: This information is intended for healthcare professionals. Always consult the most current prescribing information and local protocols before making clinical decisions.*
