Much work has been conducted in recent years as evidenced by the literature citations; in the past 50 years, there have been over 4,000 citations in Medline
Urethral administration of suppositories has become more acceptable with urethral suppositories in the treatment of male erectile dysfunction (Muse-Vivus)
Suppositories are used more routinely in southern European countries and in Latin American countries, as compared to northern European and Anglo-Saxon countries
Hormone replacement therapy in postmenopausal women using bioidentical hormones, or those that are identical to those hormones produced by the body as compared to synthetic or semisynthetic hormones, is more popular in the treatment of postmenopausal symptoms (flushing, night sweats, mood swings, etc.)
They are also a dosage form that can be administered to avoid nausea and vomiting caused by certain medications upon oral administration, and it is a dosage form that can often result in a fast onset of action
Solid dosage form in which one or more active pharmaceutical ingredients (APIs) are dispersed in a suitable base and molded or otherwise formed into a suitable shape for insertion into the rectum to provide local or systemic effect
Solid dosage form that is inserted into a naturally occurring (nonsurgical) body cavity other than the mouth or rectum, including the vagina and urethra
Slender, pencil-shaped suppositories intended for insertion into the male or female urethra
Male urethral suppositories may be 3 to 6mm in diameter and approximately 140 mm long, weighing about 4 g when cocoa butter is the base
Female urethral suppositories are about half the length and weight of the male urethral suppository, being about 70 mm long and weighing about 2 g when made of cocoa butter
Cylindrical in shape and generally range from 5 to 25 g
Packaged in an applicator tube for topical administration, and the applicator can be adjusted to continually expose new, fresh stick from inside the tube
Rectal administration provides for a rapid and, in many cases, extensive absorption of the active ingredient. The rapidity, intensity, and duration of action are three parameters that must be considered during formulation for rectal administration and, in many cases, can be altered to meet the needs of the individual patient
The factors that affect the rectal absorption of a drug administered in the form of a suppository may be divided into two main groups: (a) anatomic and physiologic factors and (b) physicochemical factors of the drug and the base
Most frequently used to relieve constipation or the pain, irritation, itching, and inflammation associated with hemorrhoids or other anorectal conditions
Nonoxynol 9 for contraception, trichomonacides to combat vaginitis caused by Trichomonas vaginalis, antifungals to treat Candida (Monilia) albicans, and anti-infectives/ antibiotics directed at other microorganisms
The dose of a drug administered rectally may be greater than or less than the dose of the same drug given orally, depending on such factors as the constitution of the patient, the physicochemical nature of the drug and its ability to traverse the physiologic barriers to absorption, and the nature of the suppository vehicle and its capacity to release the drug and make it available for absorption
Drugs absorbed rectally can bypass the portal circulation during their first pass into the general circulation, enabling drugs that are otherwise destroyed in the liver to exert systemic effects
The lower hemorrhoidal veins surrounding the colon receive the absorbed drug and initiate its circulation throughout the body, bypassing the liver
Lymphatic circulation also assists in the absorption of rectally administered drugs
When systemic effects are desired from the administration of a medicated suppository, greater absorption may be expected from a rectum that is void than from one that is distended with fecal matter