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# Liquid Paraffin
## Overview
Liquid paraffin is a highly refined mineral oil used as a lubricant laxative. It works by coating the stool, softening it, and stimulating bowel movements. It is not absorbed by the body.
## Primary Indications
* Constipation
## Adult Dosing
* **Oral:** 10 mL to 30 mL once daily, typically at bedtime. Higher doses may be used for more severe constipation, but should not exceed 45 mL daily.
## Pediatric Dosing
* **Oral:** Dosing varies by age and weight.
* **1-6 years:** 5 mL once daily.
* **6-12 years:** 10 mL once daily.
* **Over 12 years:** As per adult dosing.
* *Note: Use in infants and very young children should be under strict medical supervision due to the risk of aspiration and lipid pneumonia.*
## Dose Adjustments
* No specific dose adjustments are typically required for renal or hepatic impairment due to minimal systemic absorption.
## Contraindications
* Allergic reactions to liquid paraffin.
* Patients with difficulty swallowing due to the risk of aspiration and lipid pneumonia.
* Inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis).
* Intestinal obstruction.
* Appendicitis or undiagnosed abdominal pain.
## Adverse Effects
* Most common: Diarrhea, abdominal cramping, anal leakage.
* Long-term use or high doses: Impaction, anal irritation, malabsorption of fat-soluble vitamins (A, D, E, K).
* **Serious:** Lipid pneumonia (especially if aspirated).
## Key Drug Interactions
* **Fat-soluble vitamins (A, D, E, K):** Liquid paraffin can decrease their absorption; administer vitamins at least 2 hours apart from liquid paraffin.
* **Warfarin:** May decrease warfarin absorption, potentially leading to reduced anticoagulant effect. Monitor INR closely.
## Monitoring
* Bowel movements frequency and consistency.
* Signs of anal irritation or leakage.
* For long-term users, monitor for signs of fat-soluble vitamin deficiencies.
## Clinical Pearls
* Administer at bedtime to minimize anal leakage during the day.
* Advise patients to sip slowly to reduce the risk of aspiration.
* Avoid use in patients with a risk of aspiration (e.g., elderly, those with swallowing difficulties, or impaired gag reflex).
* Not intended for chronic use; management of constipation should include dietary and lifestyle modifications.
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*This information is intended for healthcare professionals. Always consult the current prescribing information or a reliable drug reference for the most up-to-date and complete details.*
