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# Liquid Paraffin
## Overview
Liquid paraffin, also known as mineral oil, is a laxative that lubricates the intestinal tract, softening stool and facilitating its passage. It is poorly absorbed from the gastrointestinal tract.
## Primary Indications
Constipation.
## Adult Dosing
* **Oral:** 10-30 mL once daily or as needed. Doses may be adjusted based on response. Maximum daily dose is typically considered 45 mL, but can vary based on formulation and local protocol.
## Pediatric Dosing
* **Oral:**
* **1-5 years:** 5 mL once daily.
* **5-10 years:** 5-10 mL once daily.
* **10-15 years:** 10-15 mL once daily.
* **Over 15 years:** Same as adult dosing.
Dosing is highly dependent on age and the specific product used. Always consult product labeling or local pediatric guidelines. Prolonged use in children is generally discouraged due to potential for vitamin malabsorption.
## Dose Adjustments
No specific adjustments are typically required for hepatic or renal impairment, as absorption is minimal.
## Contraindications
* Ileus.
* Bowel obstruction.
* Acute abdominal pain of unknown origin.
* Nausea and vomiting.
* Hypersensitivity to liquid paraffin.
* Use with caution in patients with dysphagia due to the risk of aspiration and lipoid pneumonia, particularly if taken in the supine position or with hot liquids.
## Adverse Effects
* Abdominal cramping and discomfort.
* Diarrhea.
* Nausea.
* Impaction (rare).
* Fecal incontinence.
* Anal irritation.
* **Long-term or high-dose use:** Malabsorption of fat-soluble vitamins (A, D, E, K), leading to deficiencies. Lipoid pneumonia if aspirated.
## Key Drug Interactions
* **Fat-soluble vitamins (A, D, E, K):** Decreased absorption. Consider separate administration if deficiencies are a concern.
* **Docusate:** Concurrent use is generally not recommended as it may enhance paraffin absorption.
* **Anticoagulants (e.g., warfarin):** Potential for decreased absorption and reduced efficacy due to vitamin K malabsorption with chronic use.
## Monitoring
* Bowel movements (frequency, consistency).
* Signs of abdominal discomfort or pain.
* In patients with a history of dysphagia, monitor for signs of aspiration or lipoid pneumonia.
* In cases of prolonged use in children, monitor for signs of vitamin deficiencies.
## Clinical Pearls
* Administer as a single dose, preferably at bedtime, to minimize disruption.
* May be mixed with a small amount of water or juice, but avoid taking with hot liquids or in the supine position to reduce aspiration risk.
* Not intended for chronic use; other laxative classes should be considered for long-term management of constipation.
* Ensure adequate hydration when using laxatives.
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***Disclaimer:** This information is intended as a clinical reference and does not replace a thorough review of the most current prescribing information (e.g., package insert) and clinical judgment. Dosing and recommendations may vary. Always verify current drug information before prescribing or dispensing.*
