Liquid%2525252525252520paraffin

# Liquid Paraffin (Mineral Oil) ## Overview Liquid paraffin is a highly refined, non-absorbable mixture of liquid hydrocarbons. It acts as a lubricant laxative by coating stool, reducing water absorption from the colon, and softening the fecal mass to facilitate easier evacuation. ## Primary Indications * Short-term management of occasional constipation. * Fecal impaction (often as an adjunct to stimulant laxatives). ## Adult Dosing * **Oral:** 15 mL to 45 mL daily, taken as a single dose or in divided doses. * **Maximum:** Generally recommended not to exceed 45 mL per 24 hours. ## Pediatric Dosing * **Children (6–12 years):** 5 mL to 20 mL daily, taken as a single dose or in divided doses. * **Children (<6 years):** Use is generally discouraged; consult a pediatrician. Clinical guidelines often prefer polyethylene glycol (PEG) 3350 for pediatric constipation due to safety concerns. ## Dose Adjustments * **Renal/Hepatic:** No specific dose adjustments established, but use caution in patients with impaired swallow reflexes or those prone to aspiration. ## Contraindications * Hypersensitivity to the drug. * Presence of abdominal pain, nausea, vomiting, or symptoms of appendicitis/intestinal obstruction. * Patients with impaired swallowing (e.g., dysphagia, neurological impairment) or those in a recumbent position due to the high risk of **lipoid pneumonia** via aspiration. * Prolonged use (avoid continuous use >7 days). ## Adverse Effects * **Respiratory:** Lipoid pneumonia (if aspirated). * **Gastrointestinal:** Anal leakage (seepage), pruritus ani, and chronic use may cause fecal incontinence. * **Nutritional:** Decreased absorption of fat-soluble vitamins (A, D, E, and K) with chronic use. * **Systemic:** Foreign body granulomas (rare, resulting from systemic absorption). ## Key Drug Interactions * **Vitamins:** May reduce absorption of fat-soluble vitamins. Administer at least 2 hours apart. * **Oral Contraceptives/Warfarin:** May theoretically reduce the absorption of co-administered drugs; clinical significance is variable. * **Docusate:** Concurrent use with docusate sodium is strictly contraindicated, as liquid paraffin enhances the systemic absorption of docusate, which can lead to liver toxicity. ## Monitoring * Monitor for signs of bowel obstruction or severe abdominal pain. * Monitor stool frequency and consistency. * Observe for respiratory symptoms (cough, dyspnea) suggesting accidental aspiration. ## Clinical Pearls * **Aspiration Risk:** Liquid paraffin should never be administered immediately before bedtime or to patients with a high risk of aspiration, including the elderly or those with gastroesophageal reflux disease (GERD). * **Palatability:** It is often chilled or mixed with fruit juice to improve taste. * **Alternatives:** Modern clinical practice strongly favors osmotic laxatives (e.g., PEG 3350) or stimulant laxatives over mineral oil due to the risk of lipoid pneumonia and nutrient malabsorption. * **Standardization:** Dosing protocols vary by institution and country; always defer to institutional pharmacy guidelines if available. *** **Educational Disclaimer:** This information is for educational purposes only. Always verify dosages, contraindications, and drug interactions with the most current version of the product label, clinical pharmacy database (e.g., Lexicomp, Micromedex), or your facility’s prescribing protocols before administration.