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# Liquid Paraffin
## Overview
Liquid paraffin is a mineral oil used as a laxative. It lubricates the bowel, softening stool and facilitating its passage. It is not absorbed systemically.
## Primary Indications
Constipation.
## Adult Dosing
* **Oral:** 10 mL to 40 mL once daily, typically at bedtime. Higher doses may be used for short-term management of severe constipation.
## Pediatric Dosing
* **Oral:** Dosing varies significantly by age and indication.
* **1 to 5 years:** 5 mL once daily.
* **6 to 12 years:** 10 mL once daily.
* **Over 12 years:** Adult dosing may be used.
* **Note:** Dosing should be guided by local protocol and clinical judgment. Use in infants under 1 year should be avoided unless specifically recommended by a pediatrician due to risk of aspiration.
## Dose Adjustments
No dose adjustments are typically required for renal or hepatic impairment as the drug is not absorbed.
## Contraindications
* Hypersensitivity to liquid paraffin.
* Patients with difficulty swallowing or a history of aspiration due to risk of lipoid pneumonia.
* Concurrent use with docusate sodium.
## Adverse Effects
* Abdominal cramping, bloating, diarrhea.
* Anal leakage (especially with higher doses or if taken in an upright position).
* Fat-soluble vitamin malabsorption (with chronic, high-dose use).
* Lipoid pneumonia (rare, but serious, if aspirated).
## Key Drug Interactions
* **Fat-soluble vitamins (A, D, E, K):** Reduced absorption with chronic, high-dose use. Administer vitamins at least 2 hours apart from liquid paraffin.
* **Docusate sodium:** Concurrent administration is contraindicated due to potential for increased absorption of liquid paraffin.
## Monitoring
* Bowel movements, frequency, and consistency.
* Signs of anal leakage or soiling.
* Signs of malabsorption with chronic use (e.g., vitamin deficiencies).
* Monitor for signs of aspiration, especially in vulnerable populations.
## Clinical Pearls
* Administer at bedtime to minimize daytime anal leakage.
* Recommend taking in a reclining position or with a straw to reduce aspiration risk.
* Advise patients to avoid taking immediately before lying down.
* Long-term, daily use should be discouraged due to potential for dependency and malabsorption.
* Ensure adequate hydration when using laxatives.
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**Disclaimer:** This information is intended for healthcare professionals. Always consult the most current prescribing information and relevant clinical guidelines for definitive guidance.
