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# Liquid Paraffin
## Overview
Liquid paraffin, also known as mineral oil, is a highly refined, inert hydrocarbon. It acts as a lubricant and a barrier.
## Primary Indications
* Constipation (laxative)
* Protection of skin from irritation (e.g., in diaper rash, perineal excoriation)
## Adult Dosing
* **Constipation:** 10-30 mL once daily or every other day, typically at bedtime. Doses can vary based on formulation and product concentration.
* **Skin Protection:** Apply a thin layer to affected skin as needed.
## Pediatric Dosing
* **Constipation:**
* 1-12 years: 5-10 mL once daily or every other day.
* Under 1 year: Dosing is less well-established and should be determined by a healthcare provider. Typically lower doses (e.g., 2.5-5 mL) may be considered.
* **Skin Protection:** Apply a thin layer to affected skin as needed.
## Dose Adjustments
No specific dose adjustments are typically required for hepatic or renal impairment due to minimal systemic absorption.
## Contraindications
* Known hypersensitivity to liquid paraffin.
* Patients with difficulty swallowing, as aspiration can lead to lipoid pneumonia.
* Use with caution in infants and the elderly, especially if there is a risk of aspiration.
* Avoid prolonged use in patients with inflammatory bowel disease.
## Adverse Effects
* **Gastrointestinal:** Anal leakage (especially with higher doses), abdominal cramping, bloating, nausea.
* **Aspiration:** Can cause lipoid pneumonia, which can be severe and chronic. This is the most significant risk, particularly with oral administration.
* **Skin:** Allergic reactions are rare. With topical use, potential for skin irritation or occlusion.
* **Nutrient Malabsorption:** Long-term, high-dose oral use can impair absorption of fat-soluble vitamins (A, D, E, K).
## Key Drug Interactions
* **Fat-soluble Vitamins (A, D, E, K):** Oral liquid paraffin can decrease their absorption. Separate administration by at least 2 hours.
* **Other Medications:** Can potentially affect the absorption of other orally administered drugs by coating the gastrointestinal tract.
## Monitoring
* **Efficacy:** Assess for relief of constipation or improvement in skin condition.
* **Adverse Effects:** Monitor for anal leakage, abdominal discomfort, and signs of aspiration.
* **Nutrient Status:** Consider monitoring fat-soluble vitamin levels with chronic, high-dose oral use.
## Clinical Pearls
* Administer oral liquid paraffin at bedtime to minimize anal leakage during the day.
* Advise patients to use a straw for oral administration to reduce the risk of aspiration.
* For topical use, apply a thin, even layer to cleansed, dry skin.
* Limit oral use to short-term management of constipation unless otherwise directed by a healthcare provider. The risk of lipoid pneumonia and nutrient malabsorption increases with duration and dose.
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*This information is intended for healthcare professionals. Please consult the current prescribing information and relevant literature for complete details and to ensure patient safety.*
