IPPP-II (Supp)

SUPPOSITORIES AND PESSARIES
Dereje K (PhD)
Pharmaceutics course team
School of Pharmacy, Jimma University,
Jimma, Ethiopia
Suppositories and Pessaries

Objectives
After the end of this topic, students should be able to:

Define suppositories and pessaries.
Classify suppositories.
List advantages & disadvantages of suppositories.
List factors affecting drug absorption from rectal suppository.
Discuss different suppository bases used.
Describe methods of suppository preparation
key counseling points a pharmacist should share with the patient

Introduction
 The derivation of the word suppository is from the Latin word

‘supponere’
‘sub’ meaning ‘under’
‘Ponere’ meaning ‘to place’
to be placed under the body, as into the rectum.
Suppositories are solid dosage forms intended for insertion into body
orifices other than mouth where they
melt, soften, or
dissolve and liberate the therapeutic agent to produce local or
systemic effects.

Introduction
 These body cavities includes;

commonly, rectum and vagina and
occasionally, urethra.
Suppositories generally have been employed for three reasons, to

1. promote defecation
2. introduce drugs into the body (systemic)
3. treat anorectal diseases
 Purpose of Pessaries??

Classification of suppository
 There are different types of suppository

Rectal suppository
Vaginal suppository (pessaries)
Urethral suppository (bougies)
Nasal suppository (nasal bougies or buginaria)
Ear cone (aurinaria)

Rectal suppository
 usually about 32 mm (1.5 inch) long
 Cylindrical, and have one or both ends

tapered
 Some rectal suppositories are shaped

like a bullet, a torpedo, or the little
finger.
 the weight may vary depends on the

density of the base and the
medicaments
 Suppositories and Pessaries

Rectal suppository
 Adult rectal suppositories weigh about 2 g

when cocoa butter (theobroma oil) is employed
as the base
 For infants and children

are about half the weight and size of the
adult suppositories
assume a more pencil-like shape.

Vaginal suppositories
 Currently. It is also k.as Vaginal inserts
 are usually globular, oviform,or cone shaped
 weigh about 5 g when cocoa butter is the

base.
 However, depending on the base and the

manufacturer’s product, the weights of
vaginal inserts may vary widely.

Urethral suppositories
Also k. as Urethral inserts, or bougies
are slender, pencil-shaped suppositories
intended for insertion into the male or female

urethra.
Male urethral suppositories

may be 3 to 6 mm in diameter
approximately 140 mm long, although this may
vary.
When cocoa butter is employed as the base,
these suppositories weigh about 4 g..
Urethral suppositories
Female urethral suppositories

are about half the length weight of the
male urethral suppository
being about 70 mm long
weighing about 2 g when made of cocoa
butter
Are generally packaged in an applicator tube

for vaginal administration

Advantages of suppository
Avoiding First-pass effect In children
Drug stability (for drugs that are In patients experiencing nausea

susceptible to gastric and vomiting or when the patient
degradation) is unconscious
Ability to administer somewhat The presence of disease of the

larger doses upper GIT that may interfere
with drug absorption
Irritating drugs
Achievement of a rapid drug
Unpleasant taste or smell effect systemically

The disadvantages of suppositories
 Mucosal irritation  Defecation may interrupt the

absorption process of the drug
 Patient compliance
 The absorbing surface area of
 exhibit variable effectiveness the rectum is much smaller than
depending upon many factors that of the SI.
 High cost of manufacture  The fluid content of the rectum
is much less than that of the SI.
 The “bullet-shaped” suppository
move to rectosigmoid and  degradation of some drugs by
descending colon. the microflora in the rectum.

FACTORS AFFECTING THE ABSORPTION DRUG
FROM RECTAL SUPPOSITORIES

Anatomy of rectum
 The rectum is the terminal portion of the large intestine
 beginning at the sigmoid colon and ending at the anal canal.
 is about 15 to 20 cm long.
 acts as a temporary storage site for solid waste
 contains about 2 to 3 ml of mucous, which has a pH of 7.4. little

buffering capacity.

Anatomy of rectum
 Following absorption from the rectum, the drug enters the

haemorrhoidal veins.
 Blood from the upper haemorrhoidal vein enters the portal vein,
which flows into the liver, where drug metabolism occurs.
 Conversely, blood in the middle and lower haemorrhoidal veins

enters the general circulation

Physiological Factors
1. The colonic contents

Diarrhea, fecal matter , and tissue dehydration can slowdown
rectal drug absorption
For systemic drug effect , the absorption is greater in rectum that
is void/ empty.

Physiological Factors…
2. site of absorption within the rectum

The fate of the absorbed drug is dependent on the area of the
rectum from which absorption has occurred.
In general, the chance of a drug being delivered to the portal

circulation and thus directly to the liver for first pass metabolism
increases as the absorption site distance from the anus
increases.


3. pH and lack of buffering capacity of the rectal fluids
The pH of the rectal fluid is generally in the range of 7.2 to 7.4
it has negligible buffer capacity.
The form in which the drug is administered will not generally be

chemically changed by the rectal environment
Therefore, the pH of the medium may be determined by the

characteristics of the drug.

Physicochemical factors
1. lipid-water solubility
 The more drug the base contains, the more drug will be available for
absorption.
 A lipophilic drug that is distributed in a fatty base(at low concentration)

has less tendency to be released into the body fluid, than a
hydrophilic drug in fatty base.

2. Particle size
Effect on dissolution of the particles
The rate of dissolution of the drug is inversely proportional to the
particle size of the dispersed active agent.
3. Nature of the base

ability to melt, soften, or dissolve at body temperature,
ability to release the drug substance
hydrophilic or hydrophobic character

 Notes
If the base interacts with the drug to inhibit its release, drug
absorption will be impaired or even prevented.
Also, if the base irritates the mucous membranes of the rectum, it

may initiate a colonic response and prompt a bowel movement,
eliminating the prospect of complete drug release and absorption

FORMULATION OF SUPPOSITORY

Suppository Bases
 The major inactive component of a suppository dosage form is the

suppository base.
 Analogous to the ointment bases
 Suppository bases play an important role in the release of the

medication they hold and, therefore, in the availability of the drug

Suppository Bases
 Ideal properties of suppository bases

melts at body temperature or dissolves in body fluids
non-toxic and non-irritant
compatible with any medicament
releases any medicament readily
easily moulded and removed from the mould
stable to heating above the melting point.
easy to handle and stable on storage

Classification of Bases
 Suppository bases classified according to their physical

characteristics into two main categories
1. fatty or oleaginous bases
2. water-soluble or water-miscible bases
 But there are miscellaneous bases, (combinations of lipophilic and

hydrophilic substances).

Fatty (oleaginous) bases
 the most frequently employed suppository bases.
 composed of naturally occurring or semi-synthetic/synthetic fatty

acid esters of glycerol.
 designed to melt within the rectum at 30OC to 36OC thereby

facilitating drug release and subsequent dissolution

Fatty (oleaginous) bases
 There are several types of fatty bases.
 the most frequently employed suppository bases

Principally because of cocoa butter
 Other fatty or oleaginous materials used in suppository bases are:

many hydrogenated fatty acids of vegetable oils, such as palm kernel oil
and cottonseed oil
fat-based compounds containing compounds of glycerin with the
higher–molecular-weight fatty acids, such as palmitic and stearic acids,
may be found in fatty bases.

Cocoa butter(theobroma oil)
 It is the fat obtained from the roasted seed of

Theobroma cacao.
 At room temperature, it is a
yellowish-white solid,
chocolate-like odour.
 Chemically, it is a triglyceride

Cocoa butter(theobroma oil)…
Characteristics of Cocoa butter

safe, non-toxic and non-irritating
melts at 30°C to 36°C; so, it is an ideal suppository base,

 melting just below body temperature
 Ideal supp base
cocoa butter exhibits marked polymorphism

 metastable crystalline form (alpha crystals) with a melting point much lower
than that of the original cocoa
 more stable beta form of crystals having the greater stability and a higher
melting point

Advantages of Cocoa butter

 Nonirritating to sensitive membrane tissues
 Excellent emollient
 Melt just below body temperature
Disadvantages of Cocoa butter

 May give poor and somewhat erratic release of some drugs
 Store products under refrigeration to avoid softening or melting prior to use.

 Cocoa butter can very easily be overheated causing it to form a

lower‐melting polymorph
 Adherence to the mould:

Sticking may be overcome by adequate lubrication.
 Melting point reduced by soluble ingredients (Phenol and chloral hydrate)
solidifying agents like beeswax (4%) may be incorporated
 Rancidity on storage
Due to the oxidation of unsaturated glycerides

Synthetic/semisynthetic hard fat
 Composed of mixtures of triglycerides of higher saturated fatty acids

and di/monoglycerides
 triglycerides from palm, palm kernel, and coconut oils with self-
emulsifying glyceryl monostearate and polyoxyl stearate)
 ranging from C8H17COOH to C18H37COOH) and di/monoglycerides.
 For example: Suppocire, witepsol

Synthetic/semisynthetic hard fat…
Advantages
Their solidifying points are unaffected by overheating.
Good resistance to oxidation
They are marketed in a series of grades with different melting point

ranges
Contain a proportion of w/o emulsifying agents

 their water-absorbing capacities are good
No mould lubricant is necessary

Disadvantages
Brittle if cooled rapidly

 avoid refrigeration during preparation
The melted fats are less viscous than theobroma oil.

 risk of drug particles to sediment during preparation, lack of
uniform

Choice of synthetic/semisynthetic base
 hydroxyl number
refers directly to the amount of mono- and di-glycerides present in the

fatty base
A high number
the base is less hydrophobic
its power to absorb water is high, leads to hydrolysis
affect drug release and subsequent absorption

 Melting point
the selected base should melt to facilitate drug release and hence
absorption
considered in conjunction with the solubility of the chosen

therapeutic agent
 If the active agent is soluble in the base, this will lead to a reduction
in the melting point of the base

 Viscosity of the melted base
The dispersion of solid drug particles into the molten base will
dramatically affect the viscosity of the product
affects the spreading of the formulation on the rectal mucosa and

the subsequent drug release

Water-soluble and water-miscible bases
 The main members of this group are

1. Glycerinated gelatin
2. Polyethylene glycols.

Glycerol–gelatin
 is a mixture of glycerol, gelatin and water.
 The mixture forms a translucent, gelatinous mixture
 dispersible in the rectum
 The ratio of glycerol, gelatin and water can affect the dispersion
time and thus the duration of action.
 A higher proportion of gelatin in the mixture makes it more rigid and longer
acting.

Glycerol–gelatin…
 The following is an example composition of the base

Gelatin …………………..20 g
Glycerol …………………70 g
Purified water …………..10 g
 Preservatives such as methyl and/ or propyl parabens may be

added

Limitation of Glycerol–gelatin
 Physiological effect (a laxative effect).
 Can cause rectal irritation
 Hygroscopic, should be packaged in tight containers
 Microbial contamination likely
 Long preparation time.
 Lubrication of the mould is essential.

Notes
 Frequently used in preparation of vaginal suppositories, with which

prolonged local action of the medicinal agent is usually desired.
 It is slower to soften, and mix with the physiologic fluids therefore

provides a slower release.
 It’s suppositories should be moistened first with water to avoid

irritation to the tissue upon insertion.

Polyethylene glycols (PEGs)
 Consist of mixtures of polyethylene glycols of different MW

Lower MW PEGs (PEG 400 and 600) are liquid,
Those around 1000 are semi-solid
Those above 4000 are waxy solids
Different MW of PEG can be combined to produce the desired

properties

Polyethylene glycols (PEGs)..
Compositions of PEG bases with different physical characteristics

Advantage of PEG
 No laxative effect
 Less microbial contamination
 The base contract on cooling and easily removed
 Melting point above body temperature (Cool storage is not so critical,
Suitable for hot climates)
 The base dissolve in the body and disperse the medication slowly
 Produce high-viscosity solutions, so leakage is less likely.
 Good solvent properties
Limitations
Hygroscopic
 Thus may cause irritation to the mucosa
.The good solvent properties may result in retention of the drug
Incompatibilities:
 with several drugs and packaging materials, e.g. benzocaine,
penicillin and plastic
Brittleness: if cooled too quickly and also on storage

Choice of a suppository base

Other formulation excipients
Surface-active agents (surfactants)

to enhance the wetting properties of the suppository base with the
rectal fluid.
This in turn will enhance drug release/dissolution.
Examples:
sorbitan esters and
polyoxyethylene sorbitan fatty acid esters

Other formulation excipients …
Agents to reduce hygroscopicity

to reduce the uptake of water from the atmosphere during storage
e.g. colloidal silicon dioxide

Agents to control the melting point of the base
enhance physical stability of the suppository in response to:
 the deleterious effects of storage at higher temperature
 the presence of a therapeutic agent that is soluble in base.
E.g. beeswax (white or yellow wax), cetyl esters wax, stearic acid

 Antioxidants
 These are commonly used in all types of suppository
 Emulsifying agents
 Increase the water absorbing capacity of fatty bases.
 Preservatives
 used in suppository contains water soluble bases.
 Thickening agents
 prevent sedimentation of suspended in solid bases
 Plasticizers
 Improve flexibility of suppository and decrease brittle (macrogol)
 E.g castor oil, Glycerine, glycol

Preparation of Suppositories
 Suppositories are prepared by two methods:

molding from a melt
hand rolling and shaping.
 The molding is the method most frequently employed both on a

small scale and on an industrial scale.
 Cocoa butter, glycerinated gelatin, polyethylene glycol, and most

other bases are suitable for preparation by molding.

Molding
The steps in molding
1. melting the base
2. incorporating any required medicaments
3. pouring the melt into molds
4. allowing the melt to cool and congeal into

suppositories
5. removing the formed suppositories from the

mold.
Suppository Molds
 Commercially available in various shapes and sizes
 Pharmacy mold are capable of producing 6, 12, or more

suppositories in a single operation
 Industrial molds produce hundreds of suppositories from a single

batch
 Molds in common use today are made from stainless steel, aluminum,
brass, or plastic.
 Reusable and disposable molds are commercially available

Suppository Molds…

Lubrication of the Mold
 Molds may require lubrication before the melt is poured to:

facilitate cleaning
easy removal of the molded suppositories
 Seldom necessary when the base is cocoa butter or polyethylene

glycol,
these materials contract sufficiently on cooling to separate from the
inner surfaces and allow easy removal
 Lubrication is usually necessary with glycerinated gelatin.

A thin coating of mineral oil applied with the finger to the molding
surfaces usually suffices.

Lubrication of the Mold…
 In case of greasy or oily base, water-soluble lubricants are required.
 For example, the following is the composition of lubricant solution for

cocoa butter
 For water-soluble or water-miscible bases, oily lubricant may be used
 For example, for glycerogelatin base, liquid paraffin or arachis oil may
be used as the lubricant.

Calibration of the Mold
 Each individual mold is capable of holding a specific volume of

material in each of its openings.
 Because of the difference in the densities of the materials, if the base

is cocoa butter, the weight of the suppositories will differ from the
weight of suppositories prepared in the same mold with a base of
polyethylene glycols.
 Similarly, any added medicinal agent alters the density of the base,
and the weight of the resulting suppository differs from that of those
prepared with base material alone.

Steps in calibration of a mold
1. Prepare molded suppositories from base material alone.
2. After removal from the mold, the suppositories are weighed and the
total weight and average weight of each suppository are recorded
3. To determine the volume of the mold, the suppositories are carefully

melted in a calibrated beaker
4. The volume of the melt is determined for the total number as well as
for the average of one suppository

DENSITY (DOSE DISPLACEMENT) CALCULATIONS
 To determine the weight of the individual suppositories, it is important

to know the density of the incorporated materials
 it is generally assumed that if the quantity of active drug is less than

100 mg, then the volume occupied by the powder is insignificant and
need not be considered
 Three methods are used to calculate the quantities of base that the
active medication will occupy and the quantities of ingredients
required.

DOSAGE REPLACEMENT FACTOR METHOD
100(𝑊−𝐴)
𝑓= +1
(𝐴)(𝑌)
Where
 f is the dosage replacement factor
 W is the weight of the pure base suppositories
 A is the weight of suppositories with Y% of the active ingredient

DOSAGE REPLACEMENT FACTOR METHOD…
Example 1
 Prepare a suppository containing 100 mg of phenobarbital (f = 0.81) using

cocoa butter as the base. The weight of the pure cocoa butter suppository is
2.0 g. Because 100 mg of phenobarbital is to be contained in an
approximately 2.0-g suppository, it will be about 5% phenobarbital. What will
be the total weight of each suppository?
100(𝑊−𝐴) 0.81=(100(2—A)/A(5)) +1)

𝑓= +1
(𝐴)(𝑌)
A=2.019g

DENSITY FACTOR METHOD
1. Determine the average blank weight, A, per mold, using the suppository
base of interest.
2. Weigh the quantity of suppository base necessary for 10 suppositories.
3. Weigh 1.0 g of medication. The weight of medication per suppository, B, is

then equal to 1 g/10 suppositories = 0.1 g/suppository.
4. Melt the suppository base, incorporate the medication, mix, pour into mold,
cool, trim, and remove from the mold.
5. Weigh the 10 suppositories and determine the average weight (C).
6. Determine the density factor as follows:

𝐵
𝐷𝑒𝑛𝑠𝑖𝑡𝑦 𝑓𝑎𝑐𝑡𝑜𝑟 =
𝐴−𝐶+𝐵
where A is the average weight of the blank suppository,

B is the weight of medication per suppository
C is the average weight of the medicated sup
7. Take the weight of the medication required for each supppository and divide
it by the density factor of the medication to find the replacement value of the
suppository base.
8. Subtract this quantity from the blank suppository weight.

9. Multiply by the number of suppositories required to obtain the quantity of
suppository base required for the prescription.
10. Multiply the weight of drug per suppository by the number of suppositories
required to obtain the quantity of active drug required for the prescription.
DENSITY FACTOR METHOD
Example
Prepare 12 acetaminophen 300 mg suppositories using cocoa butter.

The average weight of the cocoa butter blank is 2 g, and the average
weight of the medicated suppository is 1.8 g.
𝐵
𝐷𝑒𝑛𝑠𝑖𝑡𝑦 𝑓𝑎𝑐𝑡𝑜𝑟 = DF= 0.3/(2-1.8)+0.3= 0.6
𝐴−𝐶+𝐵
step 7: (0.3 g)/0.6 = 0.5 (the replacement value of the base)

step 8: 2.0 − 0.5 g = 1.5 g
step 9: 12 × 1.5 g = 18 g cocoa butter required
step 10: 12 × 0.3 g = 3.6 g acetaminophen

OCCUPIED VOLUME METHOD
1. Determine the average weight per mold (blank) using the suppository
base of interest.
2. Weigh the quantity of suppository base necessary for 10

suppositories.
3. Divide the density of the active drug by the density of the suppository
base to obtain a ratio.
4. Divide the total weight of active drug required for the total number of
suppositories by the ratio obtained in step 3 (this will give the amount
of suppository base displaced by the active drug).
 5.
5. Subtract the amount obtained in step 4 from the total weight of the
prescription (number of suppositories multiplied by the weight of the
blanks) to obtain the weight of suppository base required.
6. Multiply the weight of active drug per suppository by the number of

suppositories to be prepared to obtain the quantity of active drug
required

Example
 Prepare 10 suppositories, each containing 200 mg of a drug with a

density of 3.0. The base has a density of 0.9, and a prepared blank
weighs 2.0 g. Using the determination of occupied volume method,
prepare the requested suppositories.

OCCUPIED VOLUME METHOD…
step 1: The average weight per mold is 2.0 g.
step 2: The quantity required for 10 suppositories is 2 × 10 g = 20 g.
step 3: The density ratio is 3.0/0.9 = 3.3.

step 4: The amount of suppository base displaced by the active drug is 2.0
g/3.3 = 0.6 g.
step 5: The weight of the base required is 20 − 0.6 g = 19.4 g.
step 6: The quantity of active drug required is 0.2 × 10 g = 2.0 g.
The required weight of the base is 19.4 g, and the weight of the active drug is 2 g.

Class work
 A prescription for 10 acetaminophen 300 mg suppositories, using

cocoa butter as the base, needs to be filled. The average weight of
the cocoa butter blank is 2.0 g, and the average weight of the
medicated suppository is 1.8 g.
 calculate the amount of cocoa butter and acetaminophen needed for

the prescription.
 (Answer: acetaminophen: 3.0 g; cocoa butter: 15.0 g)

Class work
 prescription for 300-mg zinc oxide suppositories needs cocoa butter

as the vehicle. The density zinc oxide and cocoa butter are 4.0 and
0.9, respectively. If the suppository mold holds 2.0 g of cocoa butter
 what quantities of cocoa butter and zinc oxide would be required to

prepare 6 suppositories?
 (Answer: zinc oxide: 1.8 g; cocoa butter: 11.59 g)

Hand Rolling and Shaping
 is a historic part of the art of the pharmacist
 there is little requirement for today’s pharmacist to shape

suppositories by hand.

Manufacturing Suppositories
 prepared by the melt fusion method using Commercially automated

equipment for melt fusion
 continually produce large quantities of finished suppositories per

hour (30,000 suppositories per hour)

Quality Control
 For compounded suppositories  for manufactured suppositories

calculations of theoretical and Identification & assay,
actual weight loss on drying,
weight variation
Disintegration
Color & Hardness
Dissolution
surface texture
Stability
overall appearance

Packaging and storage
 Suppositories are usually packed in tin or aluminium, or plastic.
 Poorly packed suppositories may give rise to staining, breakage or

deformation by melting
 In the method using the latest technology, the suppositories are

individually molded in their wrapping materials

Patient counselling

Patient counselling…

Case study
A 32-year-old woman is complaining of mood

swings, irritability, and loss of libido. She is having an
irregular menstrual cycle, bloating, and breast
swelling and tenderness. She has noticed impaired
work ability and strained interpersonal relationships.
The physician, after a thorough examination,
diagnosed the condition as PMS (premenopausal
syndrome) and, prescribed 125-mg progesterone
suppositories.

Case study….
1. A ____________ base would be an appropriate suppository base

for the drug, progesterone.
(a) Hydophilic (b) Lipophilic
2. The pharmacist understands that progesterone is a lipophilic drug

and its slow release from the suppository is desirable. Which of
the following bases the pharmacist should choose?
( a) Cocoa butter (b) Polyethylene glycol (c) Glycero-gelatin

Case study….
3. The amount of progesterone per suppository required is 125 mg. In

this case, the pharmacist does not need to do density displacement
factor calculations. (a) True (b) False
 The pharmacist selects the PEG base for the suppositories to be

dispensed. The average weight per suppository with the polyethylene
glycol base was only 2.371 g. The weight of medicated supp is found
to be 2,35g
 The density displacement factor of a drug is the number of grams of

drug that will displace 1 g of the base.

Case study….
5. Polyethylene glycol–based progesterone suppositories should be

stored at:
(a) Below 0°C (b) Between 5 and 10°C (c) Room temperature
6. Prescribed progesterone suppositories will not melt at:
(a) Between 5 and 10°C (b) Room temperature
(c) Body temperature (d) All of the above

Case study….
4. The pharmacist needs to calculate the density displacement factor

of progesterone in the chosen polyethylene glycol base. It turns
out to be:
(a) 0.67 (b) 0.87 (c) 0.78 (d) 1.08

Summary
 What is a suppository? Name the types of different suppositories
 Advantages & disadvantages of suppositories
 Describe the characteristics of an ideal suppository base.
 Mention different types of bases used.
 What are the different methods for the preparation of suppositories

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SUPPOSITORIES AND PESSARIES

Suppositories and Pessaries

After the end of this topic, students should be able to:

Suppositories and Pessaries

 The derivation of the word suppository is from the Latin word

Suppositories and Pessaries

 These body cavities includes;

Suppositories generally have been employed for three reasons, to

Suppositories and Pessaries

 There are different types of suppository

Vaginal suppository (pessaries)

Urethral suppository (bougies)

Nasal suppository (nasal bougies or buginaria)

Ear cone (aurinaria)

Suppositories and Pessaries

 usually about 32 mm (1.5 inch) long

 Cylindrical, and have one or both ends

 Some rectal suppositories are shaped

 the weight may vary depends on the

 Suppositories and Pessaries

 Adult rectal suppositories weigh about 2 g

 For infants and children

Suppositories and Pessaries

 Currently. It is also k.as Vaginal inserts

 are usually globular, oviform,or cone shaped

 weigh about 5 g when cocoa butter is the

 However, depending on the base and the

Suppositories and Pessaries

Also k. as Urethral inserts, or bougies

are slender, pencil-shaped suppositories

intended for insertion into the male or female

Male urethral suppositories

Female urethral suppositories

Are generally packaged in an applicator tube

Suppositories and Pessaries

Avoiding First-pass effect In children

Drug stability (for drugs that are In patients experiencing nausea

Ability to administer somewhat The presence of disease of the

Suppositories and Pessaries

 Mucosal irritation  Defecation may interrupt the

Suppositories and Pessaries

Suppositories and Pessaries

 The rectum is the terminal portion of the large intestine

 beginning at the sigmoid colon and ending at the anal canal.

 acts as a temporary storage site for solid waste

 contains about 2 to 3 ml of mucous, which has a pH of 7.4. little

Suppositories and Pessaries

 Following absorption from the rectum, the drug enters the

 Conversely, blood in the middle and lower haemorrhoidal veins

Suppositories and Pessaries

1. The colonic contents

Suppositories and Pessaries

2. site of absorption within the rectum

In general, the chance of a drug being delivered to the portal

Suppositories and Pessaries

Suppositories and Pessaries

3. pH and lack of buffering capacity of the rectal fluids

The pH of the rectal fluid is generally in the range of 7.2 to 7.4

it has negligible buffer capacity.