{{Short description|Dosage form used to deliver medications}} {{Context|date=November 2021}} A '''suppository''' is a dosage form used to deliver medications by insertion into a body orifice (any opening in the body), where it dissolves or melts to exert local or systemic effects. There are three types of suppositories, each to insert into a different sections: rectal suppositories into the rectum, vaginal suppositories into the vagina, and urethral suppositories into the urethra of a male.
Suppositories are ideal for infants, elderly individuals and post-operative patients, who are unable to swallow oral medications, and for individuals experiencing severe nausea and/or vomiting.<ref>{{Cite journal|last1=Jannin|first1=Vincent|last2=Lemagnen|first2=Gilles|last3=Gueroult|first3=Pascale|last4=Larrouture|first4=Denis|last5=Tuleu|first5=Catherine|date=2014-06-30|title=Rectal route in the 21st Century to treat children|journal=Advanced Drug Delivery Reviews|series=Drug delivery and the paediatric population: where are we at?|language=en|volume=73|pages=34–49|doi=10.1016/j.addr.2014.05.012|pmid=24871671|issn=0169-409X|doi-access=free}}</ref><ref>{{Cite web|title=Dulcolax 5 mg Suppositories - Summary of Product Characteristics (SmPC) - (emc)|url=https://www.medicines.org.uk/emc/product/5505/smpc|access-date=2021-12-11|website=www.medicines.org.uk}}</ref><ref>{{Cite magazine|last=Lowry|first=Michael|date=2016-02-22|title=Rectal drug administration in adults: how, when, why|url=https://www.nursingtimes.net/clinical-archive/neurology/rectal-drug-administration-in-adults-how-when-why-22-02-2016/|magazine=Nursing Times|language=en|access-date=2022-04-10|volume=112|number=8, 12–14}}</ref> Suppositories are administered through rectal route to reduce onset time of reaction.
==Composition== Several different ingredients can be used to form the base of a suppository: cocoa butter or a similar substitute, polyethylene glycol, hydrogels, and glycerinated gelatin. The type of material used depends on the type of suppository, the type of drug, and the conditions in which the suppository will be stored.<ref>{{cite book|last1=Troy|first1=David B.|last2=Beringer|first2=Paul|title=Remington: The Science and Practice of Pharmacy|date=2006|publisher=Lippincott Williams & Wilkins|pages=884–885|url=https://books.google.com/books?id=NFGSSSbaWjwC&q=Glycerinated+gelatin&pg=PA885|isbn=9780781746731}}</ref>
==Rectal suppositories== [[File:Glycerin suppositories.jpg|right|thumb|Glycerin suppositories (laxative)]] In 1991, a study on suppository insertion in ''The Lancet'' found that the "torpedo" shape helps the device to travel internally, increasing its efficacy.<ref>{{cite journal | last = Abd-El-Maeboud | first = K. H. |author2=T. El-Naggar |author3=E. M. M. El-Hawi |author4=S. A. R. Mahmoud |author5=S. Abd-El-Hay | title = Rectal suppository: commonsense and mode of insertion | journal = The Lancet | volume = 338 | issue = 8770 | pages = 798–800 | date = 28 September 1991| doi = 10.1016/0140-6736(91)90676-G | pmid=1681170| s2cid = 23190075 }}</ref> The findings of this single study have been challenged as there is insufficient evidence on which to base clinical practice.<ref>{{cite journal | last = Bradshaw | first = Ann | author2 = Lynda Price | title = Rectal suppository insertion: the reliability of the evidence as a basis for nursing practice | url = https://s3.amazonaws.com/academia.edu.documents/48198397/Rectal_suppository_insertion_the_reliabi20160820-21954-12vnm39.pdf?response-content-disposition=inline%3B%20filename%3DRectal_suppository_insertion_the_reliabi.pdf&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAIWOWYYGZ2Y53UL3A%2F20200229%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20200229T174503Z&X-Amz-Expires=3600&X-Amz-SignedHeaders=host&X-Amz-Signature=bba7b820f124c0dd1a70b15dd093db59f4037667e652a3d2bf0500900d2cbb6f | journal = Journal of Clinical Nursing | volume = 16 | issue = 1 | pages = 98–103 | date = 20 December 2006 | doi=10.1111/j.1365-2702.2005.01519.x | pmid=17181671| archive-url = https://web.archive.org/web/20200229174541/https://s3.amazonaws.com/academia.edu.documents/48198397/Rectal_suppository_insertion_the_reliabi20160820-21954-12vnm39.pdf?response-content-disposition=inline%3B%20filename%3DRectal_suppository_insertion_the_reliabi.pdf&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAIWOWYYGZ2Y53UL3A%2F20200229%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20200229T174503Z&X-Amz-Expires=3600&X-Amz-SignedHeaders=host&X-Amz-Signature=bba7b820f124c0dd1a70b15dd093db59f4037667e652a3d2bf0500900d2cbb6f | archive-date = 2020-02-29 }} </ref> Rectal suppositories are intended for localized or systemic action to relieve pain, constipation, irritation, inflammation, nausea and vomiting, fever, migraines, allergies, and sedation.<ref>{{Cite journal|last=Hua|first=Susan|date=2019-10-16|title=Physiological and Pharmaceutical Considerations for Rectal Drug Formulations|journal=Frontiers in Pharmacology|volume=10|pages=1196|doi=10.3389/fphar.2019.01196|issn=1663-9812|pmc=6805701|pmid=31680970|doi-access=free}}</ref><ref>{{Cite web|title=ANTIBIOTIC/ANESTHETIC/STEROID - RECTAL SUPPOSITORIES side effects, medical uses, and drug interactions.|url=https://www.medicinenet.com/antibioticanestheticsteroid-rectal/article.htm|access-date=2021-12-11|website=MedicineNet|language=en}}</ref> If they cause inflammation, chronic use of suppositories may cause rectal stricture,<ref name="Ahmad 2021" >Ahmad, A; Krishnamurthy, P (June 2021). "[https://practicalgastro.com/2021/08/17/benign-rectal-strictures-a-review-article/ Benign Rectal Strictures: A Review Article]". ''Practical Gastroenterology.'' '''45''' (6): 16-33.</ref> but overall this is a safe method of drug delivery.<ref name="Gupta2007">{{cite journal |last1=Gupta |first1=PJ |title=Suppositories in anal disorders: a review. |journal=European Review for Medical and Pharmacological Sciences |date=May 2007 |volume=11 |issue=3 |pages=165–70 |pmid=17970232}}</ref> [[File:Panadol suppositories.jpg|right|thumb|Four 500 mg paracetamol suppositories]]
==Urethral suppositories== Alprostadil pellets are urethral suppositories used for the treatment of severe erectile dysfunction (impotence). They are marketed under the name ''Muse'' in the United States.<ref>{{cite web|title=Muse Suppository - Facts and Comparisons|url=https://www.drugs.com/cdi/muse-suppository.html|publisher=Drugs.com|access-date=4 January 2013}}</ref> Its use has diminished since the development of oral impotence medications.
== See also == {{Commons and category|Suppository|Suppositories}} * Artesunate suppositories * Enema * Pessary
==Notes== {{reflist}}
==References==
* Doyle, D., [https://www.rcpe.ac.uk/sites/default/files/doyle_4.pdf "Per Rectum: A History of Enemata"], ''Journal of the Royal College of Physicians of Edinburgh'', Vol.35, No.4, (December 2005), pp. 367–370. * Payer, L., [https://nyaspubs.onlinelibrary.wiley.com/doi/10.1002/j.2326-1951.1990.tb02238.x "Borderline Cases: How Medical Practice Reflects National Culture"], ''The Sciences'', Vol.30, No.4, (July–August 1990), pp. 38–42.
{{Dosage forms|state=expanded}}{{Authority control}}
Category:Anus Category:Constipation Category:Dosage forms Category:Drug delivery devices Category:Drugs acting on the gastrointestinal system and metabolism Category:Laxatives Category:Rectum Category:Routes of administration