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# Liquid Paraffin
## Overview
Liquid paraffin is a mineral oil used as an emollient and laxative. It lubricates the intestinal tract, softening stool and facilitating bowel movements.
## Primary Indications
* Constipation
## Adult Dosing
* **Laxative:** 10 mL to 30 mL orally once daily, typically at bedtime. Maximum daily dose is generally considered 45 mL.
## Pediatric Dosing
* Dosing for children is not well-established and requires careful consideration due to the risk of aspiration and potential for systemic absorption. Consult specific pediatric guidelines or specialist advice. Generally, for children over 1 year: 5 mL once daily. For children under 1 year: use is generally not recommended unless under strict medical supervision.
## Dose Adjustments
* No specific dose adjustments are typically required for renal or hepatic impairment. However, the risk of complications may be increased in patients with swallowing difficulties or underlying conditions affecting gastrointestinal motility.
## Contraindications
* Hypersensitivity to liquid paraffin.
* Patients with dysphagia or a history of aspiration, as aspiration can lead to lipoid pneumonia.
* Acute abdominal pain, nausea, vomiting, or intestinal obstruction.
* Prolonged use, especially in the elderly or debilitated, due to potential for reduced absorption of fat-soluble vitamins (A, D, E, K).
## Adverse Effects
* **Common:** Abdominal cramping, diarrhea, nausea, vomiting, anal leakage.
* **Serious:** Lipoid pneumonia (if aspirated), malabsorption of fat-soluble vitamins with chronic use.
## Key Drug Interactions
* Can decrease the absorption of orally administered drugs, particularly fat-soluble vitamins and mineral oil-soluble medications (e.g., digoxin, anticoagulants, some steroids). Separate administration by at least 2 hours.
## Monitoring
* Bowel movement frequency and consistency.
* Signs of abdominal discomfort or distension.
* For chronic use, monitor for signs of vitamin deficiencies.
## Clinical Pearls
* Administer at bedtime to reduce the likelihood of anal leakage during the day.
* Due to the risk of aspiration and lipoid pneumonia, caution is advised, particularly in infants, the elderly, and those with impaired gag reflexes or swallowing difficulties.
* Avoid concurrent use with other mineral oil preparations.
* Liquid paraffin is not absorbed systemically and is considered relatively safe for occasional use. However, chronic use should be discouraged.
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*Please verify the current prescribing information for the most up-to-date recommendations and any specific product labeling.*
