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# Liquid Paraffin (Mineral Oil)
## Overview
Liquid paraffin is a highly refined mineral oil acting as an emollient laxative. It functions by coating fecal matter and the bowel mucosa, increasing water retention in the stool and reducing water absorption from the colon, thereby lubricating the feces to facilitate passage.
## Primary Indications
* Short-term management of chronic or simple constipation.
* Fecal impaction (fecal softening).
## Adult Dosing
* **Oral:** 10–30 mL taken once daily, preferably at bedtime.
* **Maximum:** Follow local protocol; prolonged use is generally discouraged due to absorption risks.
## Pediatric Dosing
* **Children ≥ 3 years:** 5–10 mL once daily, preferably at bedtime.
* **Note:** Use is generally avoided in children under 3 years due to safety concerns. Dosing should be individualized based on institutional guidelines.
## Dose Adjustments
* **Renal/Hepatic Impairment:** No specific adjustments provided; however, use caution in patients with debility or swallowing disorders.
* **Elderly:** Use with extreme caution due to the high risk of aspiration pneumonitis.
## Contraindications
* Hypersensitivity to the drug.
* Nausea, vomiting, abdominal pain, or other symptoms of appendicitis/obstruction.
* Dysphagia or anatomical predispositions to gastroesophageal reflux (risk of lipoid pneumonia).
* Bedridden or patients who may remain supine shortly after administration.
## Adverse Effects
* **Aspiration:** Risk of exogenous lipoid pneumonia (potentially fatal if aspirated).
* **Gastrointestinal:** Anal leakage (seepage) causing pruritus ani or soiling.
* **Nutritional:** Malabsorption of fat-soluble vitamins (A, D, E, and K) with chronic, excessive use.
* **Granulomas:** Rare foreign-body granulomatous reactions in the intestinal mucosa or mesenteric lymph nodes (paraffinoma).
## Key Drug Interactions
* **Fat-soluble vitamins:** Chronic use may reduce the absorption of vitamins A, D, E, and K.
* **Oral Contraceptives:** Potential for reduced contraceptive efficacy.
* **Docusate:** Concurrent use is generally contraindicated as docusate may increase the systemic absorption of liquid paraffin.
## Monitoring
* Frequency and consistency of bowel movements.
* Signs of aspiration or respiratory distress.
* In cases of long-term use, monitor vitamin levels (A, D, E, K) and consider supplementation if clinically necessary.
## Clinical Pearls
* **Safety Warning:** Never administer immediately before lying down; the risk of aspiration into the lungs can cause severe lipoid pneumonia, which is often difficult to treat.
* **Therapeutic Positioning:** Ensure the patient is sitting upright when dosing and remains upright for at least 30–60 minutes post-administration.
* **First-line status:** Liquid paraffin is increasingly considered a secondary treatment; osmotic laxatives (e.g., macrogols) or stimulant laxatives are more commonly preferred for chronic constipation.
* **Hydration:** Always ensure the patient maintains adequate fluid intake to assist efficacy.
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*Disclaimer: This information is for educational purposes only. Drug protocols, indications, and safety profiles are subject to change. Always verify the most current prescribing information via institutional guidelines, official drug monographs, or a licensed pharmacist before administering.*
