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# Liquid Paraffin
## Overview
Liquid paraffin, also known as mineral oil, is a highly refined mineral oil used as a laxative. It works by lubricating the stool and the intestinal walls, easing its passage.
## Primary Indications
* Constipation
## Adult Dosing
* **Oral:** 15-45 mL once daily, usually at bedtime. Maximum dose is generally considered to be 45 mL daily.
## Pediatric Dosing
* **Oral:**
* 6-12 years: 5-15 mL once daily.
* 1-6 years: 5 mL once daily.
* Under 1 year: Use is generally not recommended without physician advice due to increased risk of aspiration and adverse effects.
## Dose Adjustments
* No specific dose adjustments are typically required for hepatic or renal impairment.
## Contraindications
* Hypersensitivity to liquid paraffin.
* Patients with impaired swallowing, particularly the elderly, due to risk of lipid pneumonia from aspiration.
* Intestinal obstruction or perforation.
* Appendicitis or undiagnosed abdominal pain.
* Inflammatory bowel disease.
## Adverse Effects
* **Most Common:** Diarrhea, abdominal cramping, nausea.
* **Serious:**
* Lipid pneumonia (if aspirated, especially in the elderly or those with impaired swallowing).
* Anal leakage, pruritus ani, and staining.
* Malabsorption of fat-soluble vitamins (A, D, E, K) with chronic, high-dose use.
## Key Drug Interactions
* **Concurrent use with stool softeners (e.g., docusate):** May increase absorption of liquid paraffin and the risk of lipid pneumonia.
* **Concurrent use with anticoagulants (e.g., warfarin):** Long-term use of mineral oil can decrease absorption of vitamin K, potentially reducing the effectiveness of warfarin. Monitor INR closely.
## Monitoring
* Monitor for bowel movements and consistency.
* Assess for signs of abdominal pain, cramping, or diarrhea.
* In patients with risk factors for aspiration, monitor for signs of respiratory distress.
* For patients on long-term therapy, consider monitoring for vitamin deficiencies.
## Clinical Pearls
* Administer at bedtime to minimize interference with meals and reduce the risk of aspiration.
* Avoid administration immediately before lying down.
* Advise patients to report any unintended weight loss, abdominal pain, or changes in bowel habits.
* Due to the risk of aspiration and lipid pneumonia, caution is advised, particularly in the elderly and infants.
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*This information is intended for healthcare professionals. Please consult the most current prescribing information and local protocols for complete details before making clinical decisions.*
