Liquid%25252520paraffin

# Liquid Paraffin (Mineral Oil) ## Overview Liquid paraffin is a refined mineral oil that acts as a lubricant laxative. It works by coating the stool and intestinal mucosa, preventing water absorption from the colon, and facilitating easy passage of fecal matter. ## Primary Indications * Short-term management of occasional constipation. * Fecal impaction (often as an adjunct to bowel disimpaction protocols). ## Adult Dosing * **Oral:** 15–45 mL once daily, or in divided doses, preferably at bedtime. * **Maximum:** Should not exceed 45 mL/day or be used for more than 7 consecutive days without medical supervision. ## Pediatric Dosing Dosing is highly variable and usually based on institutional protocol. Pediatric use should be strictly supervised by a clinician due to aspiration risks. * **Children (1–6 years):** 2–10 mL daily. * **Children (7–12 years):** 10–20 mL daily. * **Administration:** Ensure the patient is sitting upright during administration to prevent aspiration. ## Dose Adjustments * **Geriatric:** Use with extreme caution due to high risk of lipid pneumonia if aspirated. Avoid routine use. * **Renal/Hepatic Impairment:** No specific adjustments provided by manufacturers; generally avoided in patients with swallow dysfunction. ## Contraindications * Patients with dysphagia, hiatal hernia, or impaired gag reflex (high risk of lipid pneumonia). * Presence of nausea, vomiting, or undiagnosed abdominal pain (suggesting appendicitis or bowel obstruction). * Bedridden patients (increased aspiration risk). * Acute surgical abdomen or intestinal obstruction. ## Adverse Effects * **Common:** Anal leakage (seepage/pruritus ani), abdominal cramps, nausea. * **Serious:** Lipid pneumonia (due to aspiration), malabsorption of fat-soluble vitamins (A, D, E, K) with chronic use, granulomatous reaction in intestinal mucosa or lymph nodes. ## Key Drug Interactions * **Fat-soluble vitamins:** Chronic use may impair absorption of vitamins A, D, E, and K. * **Stool softeners (e.g., docusate):** Avoid concomitant use; liquid paraffin may increase the absorption of docusate, potentially leading to systemic toxicity. * **Oral Contraceptives:** May decrease absorption of oral contraceptives, potentially reducing efficacy. * **Warfarin:** May impact vitamin K absorption, potentially enhancing the anticoagulant effect. Monitor INR. ## Monitoring * Frequency and consistency of bowel movements. * Signs of respiratory distress (if aspiration is suspected). * Long-term use: Monitor for vitamin deficiency (A, D, E, K). * Discontinue if rectal bleeding occurs or if failure to defecate follows administration. ## Clinical Pearls * **Aspiration Risk:** Liquid paraffin should **never** be administered to patients at risk of aspiration. If aspirated, it can cause severe, irreversible lipoid pneumonia that may not be immediately apparent on initial chest imaging. * **Timing:** Do not administer immediately before bedtime in patients with reflux or swallowing difficulties, as the risk of aspiration is highest when recumbent. * **Anal Leakage:** A common side effect is oil leakage from the rectum; patients should be advised that this may soil undergarments. * **Long-term use:** Generally discouraged due to potential for dependency and chronic malabsorption. *** *Disclaimer: This information is for educational purposes only. Clinical practice guidelines and local protocols may vary. Always verify current prescribing information, contraindications, and dosing with institutional resources and the official manufacturers' product literature before clinical use.*