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# Liquid Paraffin (Mineral Oil)
## Overview
Liquid paraffin is a highly refined mineral oil used as a laxative. It works by lubricating the stool and the intestinal walls, softening the stool and making it easier to pass. It is not absorbed systemically.
## Primary Indications
* Short-term relief of occasional constipation.
## Adult Dosing
* **Laxative:** 15 mL to 45 mL once daily, usually at bedtime. Maximum dose typically not specified, but higher doses increase the risk of adverse effects.
## Pediatric Dosing
* **Laxative:**
* **Children 6 to 12 years:** 5 mL to 15 mL once daily.
* **Children under 6 years:** Dosing is not well-established and should be done under medical supervision. Generally, lower doses are used if deemed necessary, but caution is advised due to increased risk of aspiration.
## Dose Adjustments
No dose adjustments are typically needed for renal or hepatic impairment due to minimal systemic absorption.
## Contraindications
* Known hypersensitivity to liquid paraffin.
* Patients with dysphagia, gastrointestinal obstruction, or acute abdominal pain where the cause is unknown.
* Use with caution in patients at risk of aspiration, particularly in the elderly or those with neurological impairment, due to the risk of lipoid pneumonia.
## Adverse Effects
* Gastrointestinal: Abdominal cramping, nausea, vomiting, diarrhea, anal leakage/incontinence (especially with higher doses or prolonged use).
* Long-term use: Can lead to decreased absorption of fat-soluble vitamins (A, D, E, K) and potential dependence.
* Aspiration: Can cause lipoid pneumonia, which can be serious.
## Key Drug Interactions
* **Fat-soluble vitamins (A, D, E, K):** Liquid paraffin can decrease their absorption. Separation of administration is recommended if concurrent use is necessary.
* **Other laxatives:** Concurrent use may increase the risk of dehydration and electrolyte imbalance.
* **Docusate:** While sometimes co-administered, the benefit of this combination is debated, and it may increase the risk of anal leakage.
## Monitoring
* Monitor for bowel movement frequency and consistency.
* Assess for abdominal pain, cramping, or signs of obstruction.
* Evaluate for anal leakage or incontinence.
* In long-term use, consider monitoring for signs of fat-soluble vitamin deficiency.
## Clinical Pearls
* Administer at bedtime to minimize disruption and potential for anal leakage during the day.
* Advise patients to drink a full glass of water with each dose to help with stool softening.
* Avoid prolonged or frequent use. If constipation persists, patients should consult a healthcare provider to rule out underlying causes.
* Caution patients about the risk of aspiration, especially if swallowing difficulties are present.
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*This information is intended for healthcare professionals. Always consult the most current prescribing information and relevant clinical guidelines for definitive guidance.*
