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# Liquid Paraffin + Milk of Magnesia + Sodium Picosulphate
## Overview
This combination product typically contains liquid paraffin (a lubricant laxative), milk of magnesia (an osmotic laxative), and sodium picosulphate (a stimulant laxative). It is formulated as an oral suspension.
## Primary Indications
Treatment of occasional constipation.
## Adult Dosing
Dosing varies significantly by product formulation and concentration. A common starting dose for an adult may be 10-15 mL taken once daily, usually at bedtime. Always refer to the specific product's labeling for precise dosing instructions. Maximum daily doses should not be exceeded.
## Pediatric Dosing
Use in children is generally not recommended without specific physician guidance and a product specifically formulated and labeled for pediatric use. Dosing for children, if prescribed, will depend on age and weight and must be determined by a healthcare professional.
## Dose Adjustments
No specific dose adjustments are typically required for hepatic or renal impairment. However, caution is advised in elderly patients due to potential for dehydration and electrolyte imbalance.
## Contraindications
* Ileus or intestinal obstruction
* Abdominal pain of unknown origin
* Nausea or vomiting
* Severe dehydration
* Hypersensitivity to any component of the preparation
## Adverse Effects
Common adverse effects include abdominal cramping, diarrhea, nausea, and electrolyte disturbances (especially with prolonged use or overdose). Aspiration of liquid paraffin can lead to lipoid pneumonia, a serious and potentially fatal condition.
## Key Drug Interactions
* **Antibiotics:** Liquid paraffin may reduce the absorption of fat-soluble vitamins and some antibiotics (e.g., tetracyclines, fluoroquinolones). Separate administration by at least 2 hours.
* **Cardiac Glycosides (e.g., Digoxin):** Electrolyte disturbances (hypokalemia) from laxative use can increase sensitivity to cardiac glycosides.
* **Diuretics/Corticosteroids:** Increased risk of electrolyte imbalance.
## Monitoring
Monitor for signs of dehydration (thirst, dry mouth, reduced urine output) and electrolyte imbalance (muscle cramps, weakness, irregular heartbeat). Monitor bowel movements to assess efficacy and prevent overuse.
## Clinical Pearls
* Liquid paraffin should be taken with caution and not in a recumbent position due to the risk of aspiration.
* This combination is for short-term use only. Chronic use can lead to laxative dependence and impaired bowel function.
* Encourage increased fluid intake and dietary fiber alongside laxative use.
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*Disclaimer: This information is intended for healthcare professionals. Always consult the latest prescribing information and local protocols for definitive guidance. Verify the specific product formulation and concentration before administering.*
