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# Liquid Paraffin
## Overview
Liquid paraffin is a mineral oil that acts as an emollient and lubricant. It is poorly absorbed from the gastrointestinal tract.
## Primary Indications
* Constipation (laxative)
* Softering of stool in conditions like anal fissures or hemorrhoids.
## Adult Dosing
* **For constipation:** 10-30 mL once daily, typically at bedtime. Doses may be adjusted based on response. Maximum dose generally not established but should be guided by clinical response and tolerability.
* **For stool softening:** 5-15 mL once daily.
## Pediatric Dosing
Dosing in children should be guided by a pediatrician. Generally, lower doses are used, and treatment duration is shorter.
* **Ages 1-5 years:** 5 mL once daily.
* **Ages 6-12 years:** 10 mL once daily.
* **Over 12 years:** Can follow adult dosing.
## Dose Adjustments
No dose adjustments are typically required for renal or hepatic impairment due to minimal systemic absorption.
## Contraindications
* Ileus
* Bowel obstruction
* Acute inflammatory bowel disease
* Abdominal pain of unknown origin
* Nausea or vomiting
* Hypersensitivity to liquid paraffin
## Adverse Effects
* Anal leakage/soiling (most common)
* Abdominal cramping
* Diarrhea
* Nausea
* Vomiting
* Lipoid pneumonia (if aspirated, especially in infants or those with swallowing difficulties)
* Vitamin malabsorption (with chronic, high-dose use, particularly fat-soluble vitamins A, D, E, K)
## Key Drug Interactions
* **Fat-soluble vitamins (A, D, E, K):** Liquid paraffin can decrease their absorption, leading to potential deficiency with prolonged use.
* **Cholestyramine:** May enhance the effects of liquid paraffin by further reducing fat absorption.
## Monitoring
* Bowel movements for effectiveness and frequency.
* Signs of anal leakage or soiling.
* Signs of vitamin deficiency with prolonged use.
## Clinical Pearls
* Administer at bedtime to minimize daytime anal leakage.
* Advise patients to expect anal leakage and to use protective pads.
* Avoid use in patients at risk for aspiration.
* Limit duration of use to avoid potential vitamin malabsorption.
* Should not be taken immediately before lying down due to aspiration risk.
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*Disclaimer: This information is intended for clinical use and does not replace the need for consultation of the official prescribing information and institutional protocols. Always verify current drug information with a reliable source before prescribing.*
