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# Liquid Paraffin
## Overview
Liquid paraffin is a mineral oil used as a lubricant and emollient. It is poorly absorbed from the gastrointestinal tract and works by softening fecal matter and coating the intestinal mucosa, easing defecation.
## Primary Indications
* Constipation
## Adult Dosing
* **Oral:** 10-30 mL once daily or in divided doses. Maximum dose not clearly established but generally limited by potential for leakage and malabsorption of fat-soluble vitamins.
* **Rectal (enema):** 100-200 mL as an enema as needed.
## Pediatric Dosing
Dosing in children should be guided by prescriber judgment and local protocol, as specific guidelines vary and are less well-established. Generally, lower doses are used compared to adults.
* **Oral:** For children over 1 year: 5-10 mL once daily. For younger children, consult with a pediatrician or local protocol.
* **Rectal (enema):** Typically 50-100 mL for children, depending on age and size.
## Dose Adjustments
No specific dose adjustments are typically required for hepatic or renal impairment due to minimal systemic absorption. However, caution is advised in elderly or debilitated patients, or those with dysphagia, due to the risk of aspiration and lipoid pneumonia.
## Contraindications
* Hypersensitivity to liquid paraffin.
* Appendicitis or undiagnosed abdominal pain.
* Intestinal obstruction.
* Inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis).
* Risk of aspiration (e.g., in patients with dysphagia).
## Adverse Effects
* **Common:** Abdominal cramping, diarrhea, anal leakage, perianal irritation.
* **Less Common:** Nausea, vomiting.
* **Rare/Serious:** Lipoid pneumonia (if aspirated), malabsorption of fat-soluble vitamins (A, D, E, K) with prolonged use.
## Key Drug Interactions
* **Fat-soluble vitamins (A, D, E, K):** Liquid paraffin can decrease their absorption. Separate administration by at least 2 hours.
* **Other medications:** May decrease the absorption of other orally administered drugs by forming a coating in the GI tract. Separate administration by at least 2 hours.
## Monitoring
* Bowel movements for effectiveness and frequency.
* Signs of anal leakage or perianal irritation.
* Signs of vitamin deficiency (if used long-term).
* Respiratory status if aspiration is a concern.
## Clinical Pearls
* Administer oral doses at bedtime to minimize leakage.
* Aspiration is a significant risk, especially in elderly, debilitated, or very young patients. Use with extreme caution or avoid in these populations.
* Prolonged or frequent use can lead to dependence and malabsorption of fat-soluble vitamins. Limit duration of use.
* Rectal administration (enema) provides more rapid relief for fecal impaction.
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**Disclaimer:** This information is intended for healthcare professionals. Always verify current prescribing information and consult relevant guidelines before administering any medication.
