Liquid%25252525252520paraffin

# Liquid Paraffin (Mineral Oil) ## Overview Liquid paraffin is a highly refined mineral oil used as a lubricant laxative. It is indigestible and works by coating the stool with a water-immiscible film, which prevents excessive water absorption in the colon and eases passage. ## Primary Indications * Short-term management of occasional constipation. * Fecal impaction (often as an adjunct to rectal enemas). ## Adult Dosing * **Oral:** 15 mL to 45 mL (1 to 3 tablespoons) once daily or in divided doses, preferably at bedtime. * **Maximum:** Do not exceed 45 mL per 24 hours. Limit use to no more than 7 days to avoid adverse effects. ## Pediatric Dosing * **Children 6–12 years:** 5 mL to 15 mL once daily. * **Children <6 years:** Not recommended without direct specialist supervision due to the high risk of aspiration and systemic absorption. ## Dose Adjustments * **Renal/Hepatic Impairment:** No specific adjustments provided; not systemically absorbed. * **Geriatric:** Avoid use if possible. Increased risk of aspiration pneumonia and fecal incontinence (anal leakage). ## Contraindications * Known hypersensitivity. * Presence of symptoms of appendicitis or undiagnosed abdominal pain. * Nausea, vomiting, or surgical abdomen. * Patients with dysphagia (risk of lipid pneumonia). * Bedridden or immobile patients (high risk of aspiration). * Pregnancy (may reduce absorption of fat-soluble vitamins [A, D, E, K] essential for fetal development). ## Adverse Effects * **Aspiration:** Lipid pneumonia (serious, potentially fatal). * **Anal:** Anal leakage leading to pruritus ani, soiling, or irritation. * **Nutritional:** Malabsorption of fat-soluble vitamins (A, D, E, K) with chronic use. * **GI:** Rectal granulomas (rare; with long-term use). ## Key Drug Interactions * **Fat-soluble vitamins (A, D, E, K):** Reduced oral absorption if taken concurrently. Administer at least 2 hours apart. * **Stool Softeners (e.g., Docusate):** May increase systemic absorption of liquid paraffin. Concurrent use is generally discouraged. * **Oral Contraceptives:** Potential for reduced absorption and efficacy (clinical significance is debated). ## Monitoring * Monitor for signs of respiratory distress (cough, dyspnea) if aspiration is suspected. * Monitor bowel movement frequency and consistency. * Assess for perianal skin breakdown. ## Clinical Pearls * **Aspiration Risk:** Never administer to patients in a supine position or those with impaired swallow reflex. * **Stool Consistency:** Should only be used for softening stools; it is not a stimulant and will not accelerate transit time significantly. * **Patient Education:** Advise patients to drink plenty of fluids. Do not take immediately before bed to minimize aspiration risk while reclining. * **Evidence Note:** Due to the risk of lipid pneumonia and potential for bowel obstruction (paraffinoma) with chronic use, newer osmotic laxatives (e.g., PEG 3350) are generally preferred as first-line therapy. *** **Educational Disclaimer:** This information is for educational purposes only. Clinical practice guidelines vary by institution and region. Always verify specific dosing, safety profiles, and current protocols with your local pharmacy formulary and the official manufacturer’s prescribing information before administration.