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# Liquid Paraffin
## Overview
Liquid paraffin is a highly refined mineral oil used as an emollient and lubricant. It is poorly absorbed from the gastrointestinal tract.
## Primary Indications
* Constipation (laxative)
* Skin irritation and dryness (emollient)
## Adult Dosing
**Constipation:**
* Oral: 10-30 mL once daily or as needed. Higher doses may be used for severe constipation, but long-term use of high doses is discouraged.
**Skin Emollient:**
* Topical: Apply to affected skin as needed.
## Pediatric Dosing
**Constipation:**
* **Infants < 1 year:** 2.5-5 mL once daily. **Use with caution and only under medical supervision.**
* **Children 1-5 years:** 5-10 mL once daily.
* **Children > 5 years:** 10-20 mL once daily.
**Skin Emollient:**
* Topical: Apply to affected skin as needed.
## Dose Adjustments
No specific dose adjustments are typically required based on renal or hepatic impairment due to minimal systemic absorption.
## Contraindications
* Hypersensitivity to liquid paraffin.
* Suspected intestinal obstruction or perforation.
* Appendicitis.
* Patients with difficulty swallowing, due to the risk of aspiration and lipoid pneumonia, especially when administered orally.
## Adverse Effects
* **Gastrointestinal:** Anal leakage, abdominal cramping, nausea, diarrhea.
* **Systemic (rare, with chronic high-dose use or aspiration):** Vitamin malabsorption (fat-soluble vitamins A, D, E, K), lipoid pneumonia.
* **Topical:** Skin irritation, rash (rare).
## Key Drug Interactions
* **Mineral oil may decrease the absorption of fat-soluble vitamins (A, D, E, K) and other orally administered lipophilic drugs.** Separate administration by at least 2 hours.
* Concomitant use with stool softeners may increase the risk of anal leakage.
## Monitoring
* For constipation: Monitor for bowel movement frequency and consistency, abdominal pain, and signs of anal leakage.
* For long-term, high-dose oral use: Monitor for signs of vitamin deficiency.
* For patients with swallowing difficulties: Monitor for signs of aspiration or respiratory distress.
## Clinical Pearls
* Oral liquid paraffin should be taken on an empty stomach to maximize its laxative effect and minimize interference with nutrient absorption.
* Patients should be advised that anal leakage can occur, especially with higher doses, and to use protective pads if necessary.
* Caution is advised in the elderly and those with significant co-morbidities, particularly if they have swallowing difficulties, due to the risk of aspiration.
* Topical use can help maintain skin hydration and barrier function.
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*Disclaimer: This information is intended for clinical use and does not replace professional medical judgment. Always consult the most current prescribing information and relevant guidelines for definitive guidance. Dosing may vary based on specific product formulation and local protocols.*
