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# Liquid Paraffin
## Overview
Liquid paraffin, also known as mineral oil, is a highly refined liquid hydrocarbon. It acts as an emollient and lubricant.
## Primary Indications
* Constipation
## Adult Dosing
* **Oral:** 10-30 mL once daily, typically at bedtime. Doses can be adjusted based on response. Maximum daily dose is generally not specified but should be used cautiously to avoid adverse effects.
* **Rectal (as an enema):** For fecal impaction, a dose may be administered rectally as per local protocol or physician order.
## Pediatric Dosing
* **Oral:**
* **1-5 years:** 5-10 mL once daily.
* **6-12 years:** 10-15 mL once daily.
* **Over 12 years:** 15-30 mL once daily.
* **Under 1 year:** Use with caution and only under medical supervision. Dosing is highly individualized and not well-established.
## Dose Adjustments
No specific dose adjustments are typically required for hepatic or renal impairment, as systemic absorption is minimal.
## Contraindications
* Hypersensitivity to liquid paraffin.
* Concurrent use with docusate sodium (potential for increased absorption of mineral oil).
* Patients with difficulty swallowing, due to the risk of aspiration and lipoid pneumonia.
* Inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis).
* Appendicitis or intestinal obstruction.
## Adverse Effects
* **Common:** Abdominal cramps, diarrhea, nausea, vomiting.
* **Serious:**
* **Lipoid Pneumonia:** Particularly with aspiration due to impaired swallowing or if given orally to patients with a gastroesophageal reflux or dysphagia.
* **Anal leakage:** May occur with higher doses, leading to perianal irritation and staining of clothing.
* **Malabsorption:** Chronic use can potentially lead to malabsorption of fat-soluble vitamins (A, D, E, K).
## Key Drug Interactions
* **Docusate Sodium:** Concurrent use may increase the absorption of mineral oil, increasing the risk of adverse effects.
* **Fat-soluble Vitamins (A, D, E, K):** Liquid paraffin can decrease their absorption with chronic use. Separate administration by at least 2 hours.
* **Other Laxatives:** Concomitant use should be approached cautiously to avoid electrolyte imbalances or excessive laxation.
## Monitoring
* Bowel movements and frequency.
* Signs of abdominal pain or distension.
* Signs of aspiration or respiratory distress if risk factors are present.
* Nutritional status with prolonged therapy.
## Clinical Pearls
* Administer between meals or at bedtime to minimize interference with nutrient absorption.
* Warn patients about potential anal leakage and staining of clothing.
* Caution is advised in elderly patients or those with impaired swallowing due to the risk of aspiration.
* Avoid prolonged or excessive use due to potential for vitamin malabsorption and dependency.
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*This information is intended for healthcare professionals. It is essential to consult the most current prescribing information and relevant clinical guidelines before making any treatment decisions.*
