Liquid%252525252525252525252525252520paraffin

# Liquid Paraffin (Mineral Oil) ## Overview Liquid paraffin is a highly refined petroleum-derived lubricant laxative. It works by coating the stool and intestinal mucosa, reducing water absorption from the colon, and softening fecal mass to facilitate passage. It is non-absorbable and chemically inert. ## Primary Indications * Short-term relief of occasional constipation. * Management of fecal impaction or chronic constipation (often used as an adjunct). ## Adult Dosing * **Oral:** 15–45 mL once daily, preferably at bedtime. * **Maximum:** 45 mL per 24 hours. Limit use to less than 7 consecutive days. ## Pediatric Dosing * **Children 6–12 years:** 5–20 mL once daily, preferably at bedtime. * **Children <6 years:** Not recommended without direct specialist supervision. * *Note:* Oral administration in children poses a significant aspiration risk. ## Dose Adjustments * **Geriatric:** Use with extreme caution due to high risk of aspiration pneumonia and potential for fecal incontinence/leakage. * **Renal/Hepatic:** No specific dose adjustments required due to lack of systemic absorption. ## Contraindications * Nausea, vomiting, or undiagnosed abdominal pain (suggestive of appendicitis or bowel obstruction). * Presence of bowel obstruction or fecal impaction (unless under clinical supervision). * Dysphagia or clinical conditions predisposing to aspiration (e.g., neurological impairment, GERD). * Pregnancy (systemic absorption of fat-soluble vitamins may occur). * Do not administer to bedridden or lethargic patients. ## Adverse Effects * **Aspiration:** Risk of lipoid pneumonia if aspirated into lungs (often silent/asymptomatic initially). * **GI:** Anal leakage (seepage of oil), pruritus ani, and flatulence. * **Nutritional:** Malabsorption of fat-soluble vitamins (A, D, E, K) with chronic, high-dose use. * **Systemic:** Foreign body reactions (lipid granulomas) in lymph nodes or spleen (rare, associated with long-term use). ## Key Drug Interactions * **Fat-soluble vitamins:** Decreased absorption; stagger doses by at least 2 hours. * **Oral Contraceptives:** Potential for reduced efficacy due to malabsorption. * **Stool Softeners (Docusate):** Avoid concurrent use; docusate may increase absorption of liquid paraffin, increasing the risk of systemic toxicity. * **Warfarin:** Theoretical risk of altered INR due to potential interference with Vitamin K absorption. ## Monitoring * Monitor for signs of aspiration (cough, dyspnea, crackles). * Monitor frequency/consistency of bowel movements. * Assess for perianal skin integrity. ## Clinical Pearls * **Aspiration Risk:** Never give immediately before sleep or to patients with a compromised gag reflex. * **Administration:** Can be taken with fruit juice to mask the texture/taste. * **Chronic Use:** Discourage long-term use. It does not address the underlying etiology of constipation and can lead to dependency or bowel habit modification. * **Alternative:** Generally considered a second-line agent compared to osmotic (PEG) or stimulant laxatives due to the safety profile. *** *Disclaimer: This information is for educational purposes only. Clinical protocols vary by institution. Always verify dosages, contraindications, and drug interactions against current institutional guidelines and official product labeling before prescribing or administering.*