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# Liquid Paraffin
## Overview
Liquid paraffin is a mineral oil used as an emollient and laxative. It acts as a lubricant in the intestines, softening stool and easing passage.
## Primary Indications
* Constipation
## Adult Dosing
* **Laxative:** 10-30 mL once daily, typically at bedtime. The dose may be adjusted based on patient response.
## Pediatric Dosing
* **Constipation:**
* **1-5 years:** 5 mL once daily.
* **6-12 years:** 10 mL once daily.
* **Over 12 years:** 10-20 mL once daily.
* Dosing may be adjusted based on patient response. Higher doses are generally not recommended.
## Dose Adjustments
* No specific dose adjustments are typically required for renal or hepatic impairment. However, caution is advised in patients with swallowing difficulties or those at risk for aspiration.
## Contraindications
* Intestinal obstruction
* Appendicitis or undiagnosed abdominal pain
* Patients with swallowing difficulties (risk of aspiration leading to lipoid pneumonia)
* Hypersensitivity to liquid paraffin
## Adverse Effects
* Gastrointestinal: Diarrhea, abdominal cramps, nausea, vomiting.
* Anal leakage (especially with higher doses or prolonged use).
* Malabsorption of fat-soluble vitamins (A, D, E, K) with chronic, high-dose use.
* Lipoid pneumonia if aspirated.
## Key Drug Interactions
* **Fat-soluble vitamins:** Long-term use can impair absorption of vitamins A, D, E, and K. Consider vitamin supplementation if chronic use is necessary.
* **Other oral medications:** Liquid paraffin can potentially decrease the absorption of other orally administered drugs by coating the intestinal lining or altering gastrointestinal transit time. Administer other medications at least 2 hours before or after liquid paraffin.
## Monitoring
* Bowel movements (frequency, consistency).
* Signs of anal leakage or perianal irritation.
* For chronic use: Monitor for signs of fat-soluble vitamin deficiency.
## Clinical Pearls
* Administer at bedtime to minimize daytime inconvenience from anal leakage.
* If anal leakage occurs, reduce the dose or discontinue use.
* Long-term daily use is generally not recommended and should be re-evaluated.
* Patients with gastroesophageal reflux disease or dysphagia should use with caution due to the risk of aspiration.
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**Disclaimer:** This information is intended for healthcare professionals. Always consult the most current prescribing information and local protocols for definitive guidance.
