Liquid%25252525252525252520paraffin

# Liquid Paraffin (Mineral Oil) ## Overview Liquid paraffin is a refined mineral oil acting as a lubricant laxative. It works by coating the stool with a water-immiscible film, which prevents water resorption in the colon and eases passage through the intestinal tract. It is pharmacologically inert and non-absorbed. ## Primary Indications * Short-term management of occasional constipation. * Fecal impaction (often as an adjunct to rectal administration). ## Adult Dosing * **Oral:** 15–45 mL once daily, preferably at bedtime. * **Maximum:** Should not exceed 45 mL/day or be used for longer than 7 days without medical supervision. ## Pediatric Dosing * **Children (1–6 years):** 5–10 mL daily. * **Children (6–12 years):** 10–20 mL daily. * **Note:** Not recommended for children under 1 year of age due to high risk of aspiration and subsequent lipid pneumonia. ## Dose Adjustments * **Elderly/Debilitated patients:** Use the lowest effective dose; high risk of aspiration and incontinence. * No specific renal or hepatic adjustments required due to lack of systemic absorption. ## Contraindications * Hypersensitivity to the product. * Existing or risk of intestinal obstruction or bowel perforation. * Severe abdominal pain, nausea, vomiting, or undiagnosed rectal bleeding. * Patients with impaired swallowing reflex (e.g., dysphagia, neurological impairment) due to aspiration risk. ## Adverse Effects * **Lipid (Aspiration) Pneumonia:** Occurs if the oil is aspirated; can be fatal. * **Anal Leakage:** Seepage of oil causing pruritus ani and soiling. * **Malabsorption:** Prolonged use may interfere with the absorption of fat-soluble vitamins (A, D, E, K). * **Foreign-body Granulomas:** Rare, can occur in the intestinal mucosa or mesenteric lymph nodes with chronic use. ## Key Drug Interactions * **Fat-soluble vitamins:** Long-term use reduces the absorption of vitamins A, D, E, and K. * **Oral Contraceptives/Other oral medications:** May decrease the absorption of concurrently administered drugs by accelerating transit time. * **Docusate:** Concurrent use with docusate sodium is strictly **contraindicated**, as liquid paraffin facilitates the absorption of docusate, potentially leading to hepatotoxicity or oil deposition in tissues. ## Monitoring * Monitor bowel regularity and stool consistency. * Assess for signs of aspiration (coughing, wheezing). * Monitor for signs of perianal irritation. ## Clinical Pearls * **Administration:** Should be taken on an empty stomach. Avoid taking at bedtime if the patient has gastroesophageal reflux (GERD) to minimize aspiration risk. * **Texture/Palatability:** Often formulated as an emulsion to improve taste and texture. * **Safety:** Never use while the patient is recumbent. It is widely considered an "old-school" therapy; modern osmotic agents (e.g., PEG 3350) are generally preferred for safety and efficacy. *** **Disclaimer:** This information is for educational purposes only. Drug dosing, indications, and safety information can change based on local protocols and new clinical guidelines. Always consult current institutional drug formularies, prescribing information, and patient-specific medical history before administering any medication.