Liquid%252520paraffin

# Liquid Paraffin (Mineral Oil) ## Overview Liquid paraffin is a high-viscosity, non-absorbable mineral oil that acts as a lubricant laxative. It works by coating the fecal mass and preventing water absorption from the colon, thereby softening the stool and facilitating passage. ## Primary Indications * Short-term management of constipation. * Fecal impaction (clearing). ## Adult Dosing * **Oral:** 15–45 mL daily, taken as a single dose or in divided doses. * **Rectal (Enema):** Typically 100–120 mL of a paraffin-based retention enema. * **Maximum:** Do not exceed 45 mL/day orally due to the risk of aspiration or chronic malabsorption. ## Pediatric Dosing * **Children 3–6 years:** 5–10 mL daily. * **Children 6–12 years:** 10–20 mL daily. * **Note:** Use is generally discouraged in children under 3 years due to aspiration risk. Dosing is highly protocol-dependent; consult local pediatric guidelines. ## Dose Adjustments * **Geriatric/Debilitated:** Use with extreme caution. Reduce doses to the minimum effective amount to avoid aspiration pneumonia. * **Renal/Hepatic Impairment:** No specific adjustments, but use caution in patients with poor swallow reflexes. ## Contraindications * Hypersensitivity to the drug. * Presence of nausea, vomiting, or abdominal pain (suggesting obstruction or appendicitis). * Difficulty swallowing (dysphagia) or risk of aspiration. * Bedridden patients or those at risk of lipid pneumonia. * Presence of fecal impaction caused by other underlying pathology (without clinical supervision). ## Adverse Effects * **Common:** Anal leakage (seepage) and pruritus ani. * **Serious:** Lipoid pneumonia (if aspirated), malabsorption of fat-soluble vitamins (A, D, E, K) with chronic use, and foreign body granuloma (paraffinoma) in rare instances of mucosal absorption. ## Key Drug Interactions * **Fat-soluble vitamins:** May decrease absorption of vitamins A, D, E, and K with long-term use. * **Oral contraceptives/Warfarin:** May decrease the absorption of other lipid-soluble drugs taken concurrently. * **Stool softeners (e.g., Docusate):** Avoid concurrent use to prevent excessive systemic absorption of liquid paraffin. ## Monitoring * Monitor for frequency and consistency of bowel movements. * Monitor for signs of anal leakage or skin irritation. * Monitor serum levels of fat-soluble vitamins if used long-term (though long-term use is not recommended). ## Clinical Pearls * **Aspiration Risk:** Never administer before sleep in elderly or debilitated patients due to the high risk of lipoid pneumonia if aspirated. * **Administration:** Ideally taken on an empty stomach, though patient tolerance may improve if taken with a light meal. * **Not a first-line agent:** Due to the risk of aspiration and vitamin malabsorption, osmotic laxatives (e.g., Macrogol) or stimulant laxatives are generally preferred. * **Duration:** Limit use to the shortest duration possible to resolve constipation. *** *Disclaimer: This information is for educational purposes only. Dosage protocols may vary by institution and patient status. Always verify current prescribing information, institutional guidelines, and the Summary of Product Characteristics (SmPC) before administration.*