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## Liquid Paraffin
### Overview
Liquid paraffin is a mineral oil used as a laxative and emollient. It works by coating the fecal mass, preventing reabsorption of water and thus softening stools.
### Primary Indications
* Constipation
### Adult Dosing
* **Laxative:** 10 mL to 30 mL taken orally once daily or in divided doses. The dose should be titrated to effect. Some sources suggest a maximum of 45 mL daily.
### Pediatric Dosing
* **Constipation:** Dosing varies significantly by age and specific product.
* **Children 6-12 years:** 5 mL to 10 mL once daily.
* **Children 1-5 years:** 5 mL once daily.
* **Infants under 1 year:** Generally not recommended without physician guidance due to aspiration risk. If used, very low doses (e.g., 2.5 mL once daily) may be considered under strict medical supervision.
### Dose Adjustments
No dose adjustments are typically required for hepatic or renal impairment. However, use with caution in the elderly and those with dysphagia.
### Contraindications
* Hypersensitivity to liquid paraffin.
* Appendicitis or symptoms of appendicitis.
* Intestinal obstruction or fecal impaction.
* Nausea, vomiting, or abdominal pain of unknown origin.
* Use with caution in patients with dysphagia due to the risk of lipid pneumonitis from aspiration.
### Adverse Effects
* Anal leakage (especially with higher doses).
* Abdominal cramping or discomfort.
* Nausea or vomiting.
* Lipid pneumonitis (rare, but serious, especially with aspiration).
* Interference with absorption of fat-soluble vitamins (A, D, E, K) with chronic, high-dose use.
### Key Drug Interactions
* **Fat-soluble vitamins (A, D, E, K):** Long-term use may decrease absorption. Consider separate administration.
* **Cholestyramine/Colestipol:** May decrease absorption of other medications due to increased GI transit time.
* **Mineral oil may reduce the absorption of mineral oil-based laxatives.**
### Monitoring
* Bowel movements frequency and consistency.
* Signs of abdominal discomfort or obstruction.
* Monitor for signs of aspiration, especially in vulnerable populations.
### Clinical Pearls
* Administer 1-2 hours apart from other medications.
* Advise patients to remain upright for at least 30 minutes after administration to reduce aspiration risk.
* Chronic use can lead to vitamin malabsorption and dependence.
* Not intended for routine or long-term use; short-term symptomatic relief is preferred.
* May cause anal leakage, particularly with higher doses or if taken at bedtime.
**Disclaimer:** This information is intended for clinical professionals. Always verify current prescribing information with the official product monograph and consult relevant institutional protocols.
