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# Liquid Paraffin
## Overview
Liquid paraffin, also known as mineral oil, is a highly refined, inert mineral oil. It acts as a lubricant and is poorly absorbed from the gastrointestinal tract.
## Primary Indications
* Constipation (laxative)
* Prophylaxis against fecal impaction
## Adult Dosing
* **Laxative:** 15 mL to 45 mL once daily, usually at bedtime.
* **Prophylaxis:** 15 mL once daily.
## Pediatric Dosing
* **Under 1 year:** Not generally recommended; use with extreme caution and only under medical supervision. Dosing is highly variable and should be determined by a healthcare professional.
* **1 to 12 years:** 5 mL to 15 mL once daily, usually at bedtime.
## Dose Adjustments
No specific 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.
* Ileus.
* Patients who are bedridden or have difficulty swallowing, due to risk of aspiration and lipid pneumonia.
## Adverse Effects
* **Gastrointestinal:** Abdominal cramping, diarrhea, nausea, vomiting, anal leakage.
* **Aspiration:** Lipid pneumonia (especially with chronic use or in patients at risk of aspiration).
* **Malabsorption:** Reduced absorption of fat-soluble vitamins (A, D, E, K) with chronic, long-term use.
* **Other:** Rash, itching.
## Key Drug Interactions
* **Fat-soluble vitamins (A, D, E, K):** Decreased absorption. Separate administration by at least 2 hours.
* **Docusate:** Increased absorption of mineral oil, increasing the risk of systemic adverse effects. Avoid concomitant use.
* **Anticoagulants (e.g., warfarin):** May potentially decrease the absorption of vitamin K, theoretically increasing anticoagulant effect. Monitor INR closely.
## Monitoring
* Bowel movements for effectiveness and to assess for diarrhea or impaction.
* Signs and symptoms of aspiration or lipid pneumonia, especially in at-risk patients.
* Nutritional status and signs of vitamin deficiency with chronic use.
## Clinical Pearls
* Administer at bedtime to minimize daytime inconvenience from anal leakage.
* Avoid use in patients with dysphagia or a history of aspiration.
* Long-term, daily use should be discouraged due to potential for vitamin malabsorption and dependence.
* May be used to soften stool in conditions like hemorrhoids or anal fissures.
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*Disclaimer: This information is intended for healthcare professionals. Always consult the most current prescribing information and relevant clinical guidelines before making therapeutic decisions.*
