What are suppositories? Understand the purpose and use of this method of medical treatment for various conditions.

A suppository is a type of drug delivery system that is inserted into a body cavity, usually the rectum or vagina. It is a solid medication that melts inside the body and releases the active ingredients for absorption. Suppositories are often used to administer medications locally to treat various conditions, such as constipation, hemorrhoids, and vaginal infections.

Suppositories have different shapes and sizes, depending on their intended use. They are usually bullet-shaped for rectal administration and conical-shaped for vaginal administration. The active ingredients in suppositories can vary greatly, from moisturizers and lubricants to anti-inflammatories and antibiotics. Some suppositories also contain substances that help the medication adhere to the walls of the body cavity, ensuring optimal absorption.

Important: Suppositories are a convenient and effective way to administer medications locally, avoiding the digestive system and hepatic metabolism. This allows for a faster onset of action and reduces the risk of systemic side effects. However, it is important to follow proper insertion techniques and dosing instructions provided by healthcare professionals to ensure safe and effective use.

Understanding the Basics

In the case of rectal suppositories, they are primarily used to administer medications to treat conditions such as constipation, hemorrhoids, or inflammation of the rectal area. Rectal suppositories are especially useful when oral medication is not effective or when patients are unable to swallow. This route of administration allows direct absorption of the medication into the bloodstream, without passing through the digestive system. The active ingredients in the suppository are released gradually, providing sustained symptom relief.

Suppositories are solid medications designed to be introduced into the body through the rectum, vagina, or urethra. They dissolve and release active ingredients directly into the bloodstream, without passing through the digestive system.

Suppositories have different shapes and sizes, depending on the area of administration. For rectal use, they are usually bullet-shaped and made from a mixture of cocoa butter and the active medication. Instead, vaginal suppositories are usually oval in shape and may contain hormones, antifungals, or other medications. Each suppository is carefully measured to provide the proper dosage needed for treatment. The use of suppositories can greatly improve the effectiveness of medication as they offer more direct and concentrated administration compared to oral ingestion.

• Rectal suppositories are often used to treat conditions such as constipation, hemorrhoids, or inflammation of the rectal area.
• Vaginal suppositories may contain hormones, antifungal agents, or other medications tailored to gynecological conditions.
• Urethral suppositories are less common, but can be used for localized treatment of urinary tract infections.

The Different Types of Suppositories

There are several types of suppositories available, each designed for specific purposes and shaped accordingly. A common type is the rectal suppository, which is most often used to relieve constipation or administer medications such as anti-inflammatories, antipyretics, or laxatives. Another type is the vaginal suppository, a solid dosage form designed specifically for the administration of medications into the vagina. These suppositories are often used to treat infections, hormonal imbalances, or provide localized symptom relief.

Rectal suppositories:

• Glycerin suppositories are often used for their laxative effect, which relieves constipation. They work by introducing water into the stool, softening it and facilitating evacuation.
• Antipyretic suppositories, such as paracetamol, are used to reduce fever in people who cannot take oral medications.
• Anti-inflammatory suppositories, such as those containing ibuprofen, provide localized relief from pain and inflammation in the rectal area.

Vaginal suppositories:

1. Antifungal suppositories are commonly used to treat vaginal yeast infections. They contain antifungal agents such as clotrimazole or miconazole, which help eliminate excessive fungal growth.
2. Hormonal suppositories, such as progesterone suppositories, are used to improve reproductive health and may be prescribed during fertility treatments.
3. Local anesthetic suppositories provide temporary relief from discomfort or pain in the vaginal area and are often used during medical procedures or childbirth.

In addition to rectal and vaginal suppositories, there are also urethral suppositories that are used for specific medical purposes. They are usually inserted into the urethra to treat conditions such as urinary tract infections or urinary incontinence.

How Suppositories Work: Administration and Absorption

Suppository administration:

The administration of suppositories consists of introducing the solid medication into the body through the rectum or vagina. A suppository is usually cone-shaped or bullet-shaped, and its size can vary depending on the medication used. Before administration, it is essential to wash hands thoroughly to maintain hygiene. In the case of rectal suppositories, the patient is usually placed lying on their side with one leg bent towards the chest. The suppository is then carefully inserted into the rectum using light pressure. For vaginal suppositories, the patient can choose a comfortable position, such as lying or squatting, before inserting the medication into the vagina.

Important information: It is essential to carefully read the instructions that accompany the suppository, as they may vary depending on the medication. Some suppositories may need to be refrigerated before use, while others may need to be inserted deeper into the rectum or vagina. It is important to follow the instructions provided to ensure proper administration and effectiveness of the medication.

Absorption of suppositories:

Once the suppository is put into the body, it begins to dissolve or melt due to body heat. This allows the medication to be absorbed by surrounding tissues and enter the bloodstream. Absorption time may vary depending on factors such as the composition of the medication, the individual’s metabolism and the insertion area. In some cases, the drug may act locally without significant systemic absorption. It is essential to keep in mind that each medication has a different absorption rate and can have different effects on the body.

Important information: Absorption of suppositories may be influenced by several factors, including the patient’s general health, the presence of any medical condition, and the concurrent use of other medications. It is important to consult any questions or possible interactions with a healthcare professional before using the suppositories.

The Advantages and Disadvantages of Suppositories

Advantages:

• Selective effect: One of the biggest advantages of suppositories is their ability to deliver medication directly to the affected area. For example, rectal suppositories can provide spot treatment for conditions such as hemorrhoids or inflammatory bowel disease.
• Rapid absorption: Suppositories do not pass through the digestive system, allowing for faster absorption of the medication into the bloodstream. This can be especially beneficial in situations where quick relief is needed, such as in cases of severe pain or nausea.
• Patient comfort: Suppositories are often preferred by patients who have difficulty swallowing tablets or who cannot take oral medication due to vomiting or digestive problems. They provide an alternative route for medication administration.

Disadvantages:

1. Insertion difficulties: The process of inserting a suppository may be uncomfortable or embarrassing for some people. It requires proper positioning and relaxation of the muscles in the area. There may also be difficulty inserting larger suppositories.
2. Possible leaks: Sometimes, suppositories can leak or be expelled after insertion, which reduces the effectiveness of the medication. This can be worrying, especially when using vaginal suppositories.
3. Irregular absorption: The absorption of medication from suppositories may vary from person to person. Factors such as intestinal pH, stool consistency, and rectal sensitivity can affect the rate and extent of absorption, making dosing unpredictable in some cases.

Note: It is important to follow proper instructions for using suppositories, including hygiene practices, correct positioning, and recommended dosages. If you experience discomfort or adverse effects, consult your doctor.

Common Uses of Suppositories in Medicine

Rectal Suppositories

Rectal suppositories are usually used in medical practice for both systemic and local effects. They are especially useful when oral administration is not feasible, as in cases of nausea or vomiting. In addition, rectal administration avoids firs t-step metabolism in the liver, allowing the medication between directly in systemic circulation. This route of administration is often chosen for medications that are badly absorbed orally or that have a hig h-firs t-step metabolism.

Systemic effects:

Rectal suppositories can be used to administer medications with systemic effects, such as pain relievers for pain or antiemetics for nausea and vomiting. They are also frequently used for the administration of antifebrile medicines in children.

Local effects:

Rectal suppositories can provide localized treatment for conditions that affect the lower gastrointestinal tract. For example, they are often used for the treatment of hemorrhoids or to relieve constipation. They can also be used to administer ant i-inflammatory medications for conditions such as ulcerative colitis or proctitis.

Vaginal Suppositories

Vaginal suppositories are specifically designed to be introduced into the vagina for the localized treatment of various conditions. They are usually used for gynecological problems and can relieve symptoms or treat infections directly in the place of action.

• Hormonal balance: vaginal suppositories can contain hormones, such as progesterone, to regulate hormonal imbalances and treat conditions such as menopause or infertility.
• Infections: antifungal or antimicrobial medications can be administered through vaginal suppositories for the treatment of mushroom infections or bacterial vaginosis.
• Contraception: Certain types of vaginal suppositories can serve as an effective form of contraception, providing a convenient alternative to other methods.

Safety Considerations and Potential Side Effects

1. Security considerations:

• Always consult with a healthcare professional before using suppositories, especially if you suffer from a pr e-existing disease or are taking other medications.
• Make sure the suppository is used according to the indications and carefully follow the recommended dosing instructions.
• Keep the suppositories out of reach of children to avoid their accidental ingestion.
• Save the suppositories in a cool and dry place and check your expiration date before using them.
• If you experience any adverse reaction or discomfort after using a suppository, interrupt its use immediately and look for medical attention.

2. Possible side effects:

1. Rectal discomfort: Some people may experience minor discomfort, such as itching, burning or irritation in the rectal zone after using the suppositories. These discomforts usually refer after a short time.
2. Rectal bleeding: rarely, suppositories can cause rectal bleeding. If you observe blood in the stool or experience persistent bleeding, it is important that you contact a healthcare professional.
3. Allergic reactions: Although it is rare, some people can develop allergic reactions to the ingredients of a suppository. Symptoms may include cutaneous, urticaria eruption, difficulty breathing or swelling of the face, lips, tongue or throat. Look for immediate medical attention if you experience any of these symptoms.
4. Drug interactions: suppositories can interact with other medications or substances, potentially affecting their efficacy or causing adverse reactions. Always report your doctor about any medication, supplement or substance you are taking.

Note: It is essential to read and understand the product information and the warnings provided with each specific suppository. If you have any questions or questions about the safety or side effects of the suppositories, consult your healthcare professional.

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Author of the article

Dr.Greenblatt M.

Medical oncologist at the Robert Larner College of Medicine, MD, at the University of Vermont