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# Liquid Paraffin
## Overview
Liquid paraffin is a mineral oil used as a laxative. It lubricates the intestinal tract, softening the stool and easing passage. It is poorly absorbed from the gastrointestinal tract.
## Primary Indications
* Constipation
## Adult Dosing
* **Oral:** 10-30 mL once daily, typically at bedtime.
* **Maximum dose:** Not explicitly defined but generally kept to the lowest effective dose.
## Pediatric Dosing
* Dosing varies significantly by age and weight. Local protocols should be consulted.
* **General guidance:**
* 1-5 years: 5 mL once daily.
* 6-12 years: 10 mL once daily.
* Over 12 years: Adult dosing.
* **Caution:** Use in infants and young children should be under medical supervision due to the risk of aspiration and lipid pneumonia.
## Dose Adjustments
* No specific dose adjustments are typically required for hepatic or renal impairment due to minimal systemic absorption.
## Contraindications
* Gastrointestinal obstruction
* Nausea, vomiting, abdominal pain of unknown origin
* Aspiration (risk increased in patients with impaired gag reflex, elderly, or those with neurological conditions)
* Appendicitis
* Concurrent use of docusate sodium
## Adverse Effects
* **Common:** Abdominal cramps, bloating, diarrhea, anal leakage (especially with higher doses).
* **Serious/Rare:** Lipid pneumonia (if aspirated), vitamin malabsorption (with chronic use, particularly fat-soluble vitamins A, D, E, K).
## Key Drug Interactions
* **Mineral Oil:** Can decrease the absorption of fat-soluble vitamins (A, D, E, K) and other lipid-soluble drugs.
* **Docusate Sodium:** Concomitant use may increase absorption of mineral oil, increasing the risk of adverse effects.
## Monitoring
* Monitor for bowel movements and stool consistency.
* Assess for signs of abdominal discomfort or cramping.
* Monitor for anal leakage, which may indicate a dose that is too high.
* Consider monitoring fat-soluble vitamin levels in patients on chronic therapy.
## Clinical Pearls
* Administer undiluted and do not administer immediately before lying down due to the risk of aspiration.
* Taking at bedtime minimizes discomfort from anal leakage.
* Long-term, daily use should be avoided due to potential vitamin malabsorption and dependency.
* Not recommended for children under 1 year of age without medical advice.
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*Disclaimer: This information is intended for healthcare professionals. Always consult the most current prescribing information and local institutional protocols before making clinical decisions. Dosing and recommendations may vary.*
