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# Liquid Paraffin
## Overview
Liquid paraffin is a mineral oil used as an emollient and laxative. It lubricates the intestinal tract, softening stool and easing passage.
## Primary Indications
* Constipation
## Adult Dosing
* **Laxative:** 10-30 mL once daily, typically at bedtime. Effects may take 24-48 hours. Not recommended for routine daily use.
## Pediatric Dosing
* **Constipation (under 12 years):** Dosing is highly variable and should be guided by a healthcare provider and local protocols. Generally, doses are lower than adults, but specific recommendations are not established.
* **Constipation (12 years and older):** 10-20 mL once daily at bedtime.
## Dose Adjustments
No specific dose adjustments are typically required for renal or hepatic impairment. However, use with caution in the elderly due to potential aspiration risk.
## Contraindications
* Intestinal obstruction
* Abdominal pain of unknown cause
* Nausea or vomiting
* Appendicitis
* Fecal impaction
* Concurrent use with docusate
* Patients who are bedridden or have difficulty swallowing (risk of aspiration and lipoid pneumonia)
## Adverse Effects
* Diarrhea, abdominal cramps, anal leakage
* Nausea, vomiting
* Vitamin malabsorption (especially fat-soluble vitamins A, D, E, K) with chronic, long-term use.
* Lipoid pneumonia from aspiration (rare but serious, especially in those with impaired gag reflexes or repeated vomiting).
## Key Drug Interactions
* **Fat-soluble vitamin absorption:** May decrease absorption of vitamins A, D, E, and K with chronic use. Consider vitamin supplementation if long-term therapy is necessary.
* **Other laxatives:** Concurrent use can lead to excessive fluid loss and electrolyte imbalance.
* **Docusate:** Concurrent administration is contraindicated; may increase absorption of mineral oil and risk of systemic toxicity.
## Monitoring
* Bowel movements (frequency, consistency)
* Signs of electrolyte imbalance (if diarrhea is significant)
* Signs of vitamin deficiency (if used chronically)
* Signs of aspiration (coughing, difficulty breathing)
## Clinical Pearls
* Administer undiluted and usually at bedtime to minimize leakage.
* Avoid administration in patients lying down or with gastrointestinal
motility disorders.
* Long-term, regular use is generally not recommended due to potential for
dependency and vitamin malabsorption.
* Consider alternative agents for chronic constipation.
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*This information is intended for healthcare professionals. Always consult the most current prescribing information and relevant guidelines before making any treatment decisions. Dosing may vary based on individual patient factors and local protocols.*
