Suppositories are single solid dosage forms intended for insertion into body orifices/cavities (nasal, vagina, rectal, ear, nose) where they melt, soften, or dissolve and exert localized or systemic effects.
- The medicament is incorporated into a suppository base.
- Suppository must dissolve in the body cavity fluid to release drug/medicament (local & systemic)
- The suppository can be used for both Local & systemic action. even can be use in unconcious patient.
- The suppositories are available in different weight, size & shapes.
Types of Suppositories
Based on Weight, size & shape of Suppositories, five types of suppositories as follows.
| S. No | Suppositories | Weight | Size & Shape |
|---|---|---|---|
| 1 | Ear cones (also known as Aurinaria) | 1 g | Thin, long, cylindrical |
| 2 | Nasal suppositories (also known as nasal Bougies) | 1 g | Thin, long, cylindrical |
| 3 | Urethral (also known as urethral Bougies) Male urethral: 4g in wt. & 100-150 mm long Female urethral: 2 g in wt & 60-75 mm long | 2-4 g | Thin, long, cylindrical |
| 4 | Vaginal suppository (also know as Pessaries) | 4-8 g (largest suppository) 5g (as per USP) | Oviform, conical/rod/wedge shape |
| 5 | Rectal (150 mm long) | 1-2 g; (Children: 1g & Adult : 2 g) | Torpedo or cone |
Note: Nowadays, vaginal tablets & capsules. are present and most commonly is used.
1. Rectal Suppositories:
- Rectal suppositories for adults as tapered at one or both ends and usually weighing about 2 g each for adults (as per USP).
- Infant rectal suppositories usually weigh about one-half that of adult suppositories i.e 1 g.
- For systemic effects, such as sedatives, tranquilizers, and analgesics, suppositories are administered by rectal suppository. By the Rectal route, about 50 % of the drug is bypassed live (first-pass metabolism).
- Irritant & unpleasant drugs can be administered by this route.
2. Vaginal suppository/Pessaries
- Vaginal suppositories or Pessaries weigh about 3-5 gm and are molded in globular or oviform shape or compressed on a tablet press into conical shapes.
- Vaginal medications are available in a variety of physical forms, e.g., creams, gels, or liquids.
3. Pessaries/Vaginal suppository
- Pessaries are a type of suppository intended for vaginal use.
- The larger size moulds are usually used in the preparation of pessaries such as 4 g and 8 g moulds. Pessaries are used almost exclusively for local medication, the exception being prostaglandin pessaries that do exert a systemic effect.
- Common ingredients for inclusion in pessaries for local action include antiseptics, contraceptive agents, local anesthetics, various therapeutic agents to treat trichomonal, bacterial and monilial infections.
4. Urethral suppositories
- Urethral suppositories called bougies are thin, long, cylindrical, pencils in shape. Those intended for males weigh 4 gm each and are 100-150 mm long. Those for females are 2 gm each and 60-75 mm in length.
5. Nasal suppositories
- Nasal suppositories is also called nasal bougies or bugies meant for introduction into the nasal cavity. They are prepared with a glycerogelatin base. They weigh about 1 gm and length 9-10 cm.
6. Ear cones/Aurinaria
- Ear cones is also called Aurinaria and are meant for introduction into the ear. Rarely used.
- Theobroma oil is used as the base.
Advantage of Suppositories:
- Can exert local effect on rectal mucosa.
- Used to promote evacuation of bowel.
- Avoid any gastrointestinal irritation.
- Can be used in unconscious patients (patient with convulsion)& in cash of vomiting)
- Can be used for systemic absorption of drugs and avoid the first-pass metabolism (about 50 % bypassed liver)
- Babies or old people who cannot swallow oral medication.
- Postoperative people who cannot be administered oral medication.
- People suffering from severe nausea or vomiting.
Disadvantages of Suppositories
- The problem of patient acceptability.
- Suppositories are not suitable for patients suffering from diarrhea.
- In some cases the total amount of the drug must be given will be either too irritating or in greater amount than reasonably can be placed into a suppository.
- Incomplete absorption may be obtained because suppository usually promotes evacuation of the bowel.
New Trends of Suppositories
Pessaries: Pessaries are meant for introduction into the vagina.
- Compressed Tablet Suppository – recommended for vaginal use
- Rectal / Urethral Suppositories – melt/ soften
- Vaginal Suppositories are compressed tablets and designed to disintegrate in body fluids. So Rectal suppositories usually are not compressed as tablets because the amount of liquid in the rectal cavity is inadequate for tablet disintegration.
Suppositories MCQ Quiz
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