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# Liquid Paraffin
## Overview
Liquid paraffin, also known as mineral oil, is a laxative that works by lubricating the stool and intestinal wall, making defecation easier. It is not absorbed systemically.
## Primary Indications
* Constipation
## Adult Dosing
* **Oral:** 15 mL to 45 mL once daily, typically at bedtime. Dosing may be adjusted based on response. Maximum daily dose is generally considered 45 mL, but higher doses may be used under medical supervision.
* **Rectal (as an enema):** 100 mL to 200 mL per rectum as needed.
## Pediatric Dosing
* **Oral:**
* **1-5 years:** 5 mL to 10 mL once daily.
* **6-12 years:** 10 mL to 15 mL once daily.
* **Over 12 years:** Adult dosing.
* **Rectal (as an enema):** Generally not recommended for children without specific medical guidance.
## Dose Adjustments
No dose adjustments are typically needed for renal or hepatic impairment due to minimal systemic absorption.
## Contraindications
* Hypersensitivity to liquid paraffin.
* Ileus, intestinal obstruction, appendicitis, or undiagnosed abdominal pain.
* Aspiration risk (e.g., in individuals with impaired swallowing reflexes).
## Adverse Effects
* Diarrhea, abdominal cramping, nausea, vomiting.
* Anal leakage or irritation.
* **Long-term or high-dose use (oral):**
* Vitamin malabsorption (fat-soluble vitamins A, D, E, K).
* Lipoid pneumonia (if aspirated).
* Perianal irritation.
## Key Drug Interactions
* **Fat-soluble vitamins (A, D, E, K):** May decrease absorption. Separate administration by at least 2 hours.
* **Anticoagulants (e.g., warfarin):** Potential for reduced absorption and efficacy, though clinical significance is debated. Monitor INR closely if used concurrently.
* **Docusate:** May increase absorption of liquid paraffin, increasing the risk of adverse effects. Avoid concurrent use.
## Monitoring
* Bowel movements (frequency, consistency).
* Signs of electrolyte imbalance if diarrhea occurs.
* Nutritional status, particularly vitamin levels, with long-term use.
* Signs of aspiration (coughing, wheezing) if there is a history of impaired swallowing.
## Clinical Pearls
* Administer oral liquid paraffin at bedtime to minimize daytime anal leakage.
* Patients should be advised to remain upright during and after administration to reduce aspiration risk.
* Discontinue use if significant adverse effects occur or if constipation is not resolved within 7 days.
* Oral liquid paraffin is for short-term use only (usually less than 1 week) unless specifically directed by a healthcare provider.
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*This information is intended for healthcare professionals. Always consult the most current prescribing information or a drug reference for complete details and to verify accuracy before making clinical decisions.*
