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# Liquid Paraffin (Mineral Oil)
## Overview
Liquid paraffin is a non-digestible lubricant laxative. It works by coating the fecal mass and retaining moisture, resulting in stool softening and easier passage through the colon.
## Primary Indications
* Short-term management of occasional constipation.
* Prevention of straining in patients with hemorrhoids or post-rectal surgery.
## Adult Dosing
* **Oral:** 15–45 mL once daily, preferably at bedtime.
* **Maximum:** Do not exceed 45 mL per 24 hours. Limit use to no more than 7 consecutive days.
## Pediatric Dosing
* **Children 6–12 years:** 5–15 mL once daily.
* **Children <6 years:** Not recommended without specialist pediatrician oversight.
* *Note:* Use in children is generally discouraged due to the risk of aspiration pneumonia and malabsorption of fat-soluble vitamins.
## Dose Adjustments
* **Renal/Hepatic Impairment:** No specific adjustments provided; clinical judgment required regarding electrolyte balance and aspiration risk.
* **Geriatrics:** Generally avoided due to significantly increased risk of lipoid pneumonia from aspiration.
## Contraindications
* Hypersensitivity to the drug.
* Patients with dysphagia, esophageal dysfunction, or gastroesophageal reflux (high risk of aspiration).
* Abdominal pain, nausea, vomiting, or other symptoms of appendicitis or bowel obstruction.
* Pregnancy (systemic absorption may occur, and it interferes with vitamin K absorption).
* Bedridden or debilitated patients.
## Adverse Effects
* **Common:** Anal leakage (seepage), pruritus ani, abdominal cramping (rare).
* **Serious:** Lipoid pneumonia (from accidental aspiration), malabsorption of fat-soluble vitamins (A, D, E, K) with chronic use, granulomatous reactions in the gut wall or liver.
## Key Drug Interactions
* **Vitamin Supplements:** Decreased absorption of fat-soluble vitamins (A, D, E, K) when taken concurrently. Separate doses by at least 2–4 hours.
* **Oral Contraceptives/Warfarin:** May decrease the absorption of various oral medications.
* **Docusate:** Concurrent use is contraindicated as it may increase the systemic absorption of mineral oil, leading to inflammatory tissue reactions.
## Monitoring
* Monitor bowel patterns and stool consistency.
* Observe for signs of respiratory distress (coughing, wheezing) indicating potential aspiration.
* Assess for perianal irritation.
## Clinical Pearls
* **Aspiration Risk:** The most significant safety concern is lipid aspiration pneumonia; the formulation should never be administered to patients who are prone to regurgitation or have impaired swallowing.
* **Administration:** Typically consumed empty-stomach at bedtime to minimize impact on nutrient absorption. Must not be taken immediately before reclining.
* **Alternative:** First-line stool softeners (e.g., docusate) or osmotic laxatives (e.g., PEG 3350/lactulose) are generally preferred and safer for chronic management.
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**Disclaimer:** This information is for educational purposes for healthcare professionals. Clinical practice protocols vary by region. Always verify dosages, contraindications, and drug interactions against the most current local formulary or prescribing information (e.g., BNF, manufacturers' SPC, or equivalent) before prescribing or administering.
