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# Liquid Paraffin
## Overview
Liquid paraffin is a mineral oil used as a laxative. It lubricates the fecal mass and intestinal walls, softening stool and facilitating its passage.
## Primary Indications
* Constipation
## Adult Dosing
* **Oral:** 15-45 mL once daily, usually at bedtime. The dose can be adjusted based on response.
* **Rectal (Retention Enema):** 120-150 mL as a retention enema to relieve fecal impaction.
## Pediatric Dosing
Dosing in children should be individualized and under medical supervision. Generally:
* **Ages 1-12 years:** 5-15 mL once daily at bedtime.
* **Infants:** Use with caution and only under medical advice. Lower doses are typically used, e.g., 2.5-5 mL once daily.
## Dose Adjustments
No specific dose adjustments are typically required for renal or hepatic impairment, as systemic absorption is minimal. However, caution is advised in elderly or debilitated patients due to increased risk of aspiration.
## Contraindications
* Acute abdominal conditions (e.g., appendicitis, intestinal obstruction, undiagnosed abdominal pain).
* Hypersensitivity to liquid paraffin.
* Patients at risk of aspiration (e.g., those with impaired gag reflex, gastroesophageal reflux, or who are unconscious or semi-conscious).
## Adverse Effects
* **Common:** Anal leakage (especially with higher doses), abdominal cramping, bloating, nausea.
* **Rare/Serious:** Lipoid pneumonia (if aspirated), vitamin malabsorption (with chronic use, particularly fat-soluble vitamins A, D, E, K), rectal irritation.
## Key Drug Interactions
* **Concurrent use with other medications:** Liquid paraffin can reduce the absorption of fat-soluble vitamins and other orally administered medications. It is advisable to separate administration by at least 2 hours.
## Monitoring
* Bowel movements (frequency, consistency).
* Signs of anal leakage or perianal irritation.
* For chronic use, monitor for signs of vitamin deficiency, although this is rare.
## Clinical Pearls
* Administer liquid paraffin with caution, especially to the elderly and those at risk of aspiration. It should be taken upright and not immediately before lying down.
* Avoid prolonged use (typically no more than 1 week) without medical advice to prevent dependence and potential complications.
* Refrigeration may make the medication more palatable for some patients.
* The oil can stain clothing.
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*This information is intended for healthcare professionals. Always consult the current prescribing information or a drug reference for complete details, including specific formulations and potential off-label uses. Dosing may vary based on local protocols and individual patient factors.*
