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# Liquid Paraffin
## Overview
Liquid paraffin is a mineral oil used as a laxative. It lubricates the intestinal walls, softening stool and easing passage.
## Primary Indications
Constipation.
## Adult Dosing
10-30 mL orally once daily, typically at bedtime. Maximum dose not explicitly defined, but larger doses increase risk of adverse effects.
## Pediatric Dosing
* **Under 1 year:** Generally not recommended due to aspiration risk. If necessary, consult a pediatrician. Dosing is highly individualized.
* **1-5 years:** 5 mL orally once daily.
* **6-12 years:** 10 mL orally once daily.
* **Over 12 years:** 10-30 mL orally once daily.
**Note:** Pediatric dosing is based on general recommendations and should be confirmed with local protocol or a pediatrician.
## Dose Adjustments
No specific dose adjustments are typically required for renal or hepatic impairment.
## Contraindications
* Appendicitis or acute abdominal pain.
* Intestinal obstruction.
* Nausea, vomiting, or other symptoms of undiagnosed acute abdominal conditions.
* Hypersensitivity to liquid paraffin.
* Patients at risk of aspiration (e.g., elderly, those with swallowing difficulties, or lying down after administration).
## Adverse Effects
The most significant adverse effect is aspiration, which can lead to lipoid pneumonia, especially in children and the elderly. Other adverse effects include:
* Anal leakage (especially with larger doses)
* Abdominal cramping
* Diarrhea
* Nausea
* Pruritus ani
## Key Drug Interactions
* **Fat-soluble vitamins (A, D, E, K):** May decrease absorption due to the oil's effect on lipid absorption. Consider timing administration at least 2 hours apart from vitamin supplements.
* **Mineral oil:** Concomitant use with other mineral oil products may increase the risk of adverse effects.
## Monitoring
* Monitor for bowel movements and relief of constipation.
* Assess for signs of anal leakage or leakage of oil.
* Monitor for signs of aspiration (coughing, choking, shortness of breath).
## Clinical Pearls
* Advise patients to take liquid paraffin at bedtime to minimize anal leakage during the day.
* Avoid administration in patients who are lying down or have difficulty swallowing due to the risk of aspiration.
* Long-term, regular use is generally discouraged due to potential for decreased absorption of fat-soluble vitamins and dependency.
* It is a non-systemic agent, meaning it is not absorbed into the bloodstream.
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**Disclaimer:** This information is intended for healthcare professionals and does not replace a thorough review of the current prescribing information and applicable guidelines. Always verify the latest drug information before making clinical decisions.
