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# Liquid Paraffin
## Overview
Liquid paraffin is a highly refined mineral oil used as an emollient and laxative. It works by lubricating the bowel contents, softening the stool, and easing its passage.
## Primary Indications
* Constipation (short-term relief)
* Softening of stool to prevent straining (e.g., after surgery, hemorrhoids)
## Adult Dosing
* **Laxative:** 10-30 mL once daily, typically at bedtime.
* **Emollient:** Apply topically as needed to affected skin areas.
## Pediatric Dosing
* **Constipation:** Dosing varies significantly by age and weight. Typically, 5 mL once daily for children 1-5 years old, and 10 mL once daily for children 6-12 years old. For infants under 1 year, consult a pediatrician. Doses greater than 10 mL daily are generally not recommended for children without medical supervision.
## Dose Adjustments
No specific dose adjustments are typically required for hepatic or renal impairment.
## Contraindications
* Patients with known hypersensitivity to liquid paraffin.
* Patients with acute abdominal pain, nausea, vomiting, or bowel obstruction.
* Do not administer to patients who are lying down due to the risk of aspiration and lipoid pneumonia.
## Adverse Effects
* **Gastrointestinal:** Anal leakage of oil, abdominal cramping, diarrhea.
* **Aspiration:** Risk of lipoid pneumonia if aspirated, particularly in the elderly, debilitated patients, or those with swallowing difficulties.
* **Malabsorption:** Long-term, frequent use may impair absorption of fat-soluble vitamins (A, D, E, K).
## Key Drug Interactions
* **Other Laxatives:** Concurrent use may lead to excessive diarrhea and electrolyte imbalance.
* **Mineral Oil:** Concurrent use of other mineral oil-containing products should be avoided to prevent cumulative effects and increased risk of adverse events.
* **Cholestyramine/Colestipol:** May potentially reduce the absorption of other medications.
## Monitoring
* Monitor for bowel movements and stool consistency.
* Assess for signs of anal leakage or cramping.
* Monitor for signs of vitamin deficiency with chronic use.
## Clinical Pearls
* Administer at bedtime to minimize daytime anal leakage.
* Advise patients to remain upright during and after administration.
* Avoid chronic daily use; it is intended for short-term relief.
* Topical use can help soften and moisturize dry, cracked skin.
* The risk of aspiration is significant; extreme caution is advised in patients with dysphagia or impaired gag reflexes.
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*Always verify current prescribing information with the most up-to-date official drug compendium or manufacturer's labeling.*
