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# Liquid Paraffin
## Overview
Liquid paraffin is a mineral oil used as a lubricant laxative. It coats the fecal mass, softening it and facilitating its passage.
## Primary Indications
* Constipation
## Adult Dosing
* **Oral:** 10-30 mL once daily, typically at bedtime. Higher doses may be used for short-term management of severe constipation.
* **Rectal (enema):** 100-200 mL as a retention enema.
## Pediatric Dosing
Dosing in children is less well-established and should be guided by clinical judgment and local protocols.
* **Oral:** Generally, 5-10 mL once daily for children aged 1-12 years, not to exceed adult doses. Use in infants under 1 year is generally not recommended due to risk of aspiration.
## Dose Adjustments
No specific dose adjustments are typically required for hepatic or renal impairment. However, caution is advised in elderly patients or those with swallowing difficulties due to the risk of aspiration.
## Contraindications
* Gastrointestinal obstruction
* Nausea, vomiting, abdominal pain of unknown etiology
* Intrauterine pregnancy (concern for aspiration)
* Patients with impaired swallowing or risk of aspiration (e.g., elderly, those with neurological impairment)
## Adverse Effects
* Diarrhea
* Abdominal cramping
* Nausea
* Anal leakage (particularly with higher doses or insufficient fluid intake)
* **Lipoid pneumonia** (rare but serious, associated with chronic aspiration of mineral oil, especially when taken orally for prolonged periods or in recumbent positions).
* Malabsorption of fat-soluble vitamins (A, D, E, K) with chronic, high-dose use.
## Key Drug Interactions
* **Mineral oil can decrease the absorption of:**
* Fat-soluble vitamins (A, D, E, K)
* Certain medications administered concurrently, including anticoagulants (e.g., warfarin) and some corticosteroids.
* Separate administration by at least 2 hours.
## Monitoring
* Bowel movements (frequency, consistency)
* Signs of abdominal pain or distension
* Evidence of fecal impaction or obstruction
* For chronic use, monitor for signs of vitamin deficiency.
## Clinical Pearls
* Administer undiluted.
* Advise patients to drink a full glass of water with each dose to help prevent aspiration and improve efficacy.
* Avoid use in patients at risk for aspiration. If used, consider alternative laxative agents.
* Prolonged or excessive use may lead to dependence, vitamin malabsorption, and lipoid pneumonia. Limit duration of use.
* Use of liquid paraffin as an enema should be administered slowly and with caution.
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*This information is intended for healthcare professionals. Please verify the current prescribing information and consult with a pharmacist or physician for patient-specific guidance.*
