Rectal Suppository 101: What It’s For and How to Use It

Rectal suppositories are medication forms placed into the rectum. People sometimes use them as an alternative to oral medicines, particularly when swallowing pills or liquids is not possible.

Suppositories used rectally come in various sizes and contours but typically taper at one end.

They can deliver a range of drugs. For example, some contain glycerin to relieve constipation, while others include acetaminophen to lower a fever.

Medications given via rectal suppository often act quickly because the suppository dissolves inside the body and the active ingredients are absorbed into the bloodstream.

Below we describe benefits and potential adverse effects of rectal suppositories and provide step-by-step guidance for administering them.

When are rectal suppositories used?

Rectal suppositories are used to give medicines when oral administration isn’t feasible. This approach can be particularly useful for young children and older adults who are unable to take medications by mouth, according to a 2021 review.

For instance, fever-reducing agents like acetaminophen may be given rectally if vomiting or other issues prevent swallowing of liquids or tablets. Administering antipyretics rectally can also lower the chance of certain stomach and small intestine side effects, as noted in the same review.

Historically, rectal suppositories have been used for treatments such as hemorrhoid therapy and laxatives. Other medications that can be given rectally include:

• hydrocortisone
• mesalazine for inflammatory bowel disease (IBD)
• bisacodyl or glycerol for constipation
• promethazine or ondansetron for nausea and vomiting
• certain analgesics, for example ibuprofen or oxycodone

In some situations, rectal delivery may be used for people who are unconscious, as described in the same 2021 review.

Potential side effects

Possible downsides of rectal suppositories include leakage of the medication, local pain, and discomfort. Correct insertion technique and following aftercare recommendations can help minimize these issues.

Per a 2019 source, certain gastrointestinal (GI) conditions can reduce the effectiveness of rectally administered drugs and may increase the risk of pain. Discuss any history of IBD, irritable bowel syndrome (IBS), or other GI disorders with a healthcare provider before using rectal suppositories.

Do not use acetaminophen both rectally and orally at the same time, as this could potentially result in an overdose and liver injury.

How to insert a rectal suppository

These directions explain how to administer a rectal suppository to yourself. Caregivers can also follow them to give a suppository to a child or another adult. If you have difficulty, ask someone you trust to help by using the same steps.

What you’ll need

Before you begin, gather soap and water or hand sanitizer to clean your hands. You may also need a clean single-edge razor and a water-based lubricant.

Before

1. If possible, empty your bowels.
2. Wash hands with soap and water, or use hand sanitizer if soap isn’t available. Dry with a clean towel or disposable paper towel.
3. Gently squeeze the suppository to confirm it’s firm enough to insert. If it’s too soft, keep it in its wrapper and hold under cold running water until it firms up, or chill it briefly in the refrigerator.

• Remove clothing to expose the buttocks.
• Unwrap the suppository. If you must divide it, slice it lengthwise with a clean single-edge razor.
• Moisten the tip with a water-based lubricant like K-Y Jelly. If no lubricant is available, wet the tip with a little water.

During

1. Choose a comfortable position. You can stand with one foot on a chair, or lie on your side with your top leg slightly bent toward your abdomen and the bottom leg straight. This side-lying posture is often easiest for self-administration and for giving a suppository to another person.

• Relax your buttocks to help insertion.
• Insert the suppository narrow end first. Push gently but firmly past the sphincter, the muscular opening of the rectum. For adults, insert about 3 inches or deep enough so it won’t slide out. For children, insert roughly 2 inches, and for infants insert about a half-inch, depending on size.

After

1. Remain sitting or lying with your legs together for a few minutes. If administering to a child, you might need to hold their buttocks gently closed during this time.
2. Dispose of any used materials in the trash.
3. Wash your hands promptly with soap and warm water.

Helpful tips

Best positions for rectal suppository insertion

Generally, lying on your side is the recommended position for inserting rectal suppositories. It provides easy access and usually makes self-administration or helping another person simpler. For optimal access, lie on your left side and draw your knees toward your chest.

If that posture is uncomfortable or insertion is difficult, try kneeling with your hips raised and head lowered toward the floor.

How deep should you insert a rectal suppository?

You’ve likely inserted the suppository far enough if it doesn’t immediately come back out. It’s also useful to observe the suggested insertion depths, which vary by age:

Age GroupSuppository InsertionAdultsAbout 3 inchesChildren2 inches or lessInfants½ inch

Troubleshooting

If the suppository slips out after insertion, it may not have been pushed in far enough. Be sure to insert it past the sphincter, the muscular opening of the rectum.

When to consult a doctor

These instructions should help with rectal suppository use. If you have difficulty or questions about insertion, consult a physician or pharmacist. Contact a clinician if you have GI conditions or if you experience persistent pain or other concerning side effects.

Bottom line

Rectal suppositories are an alternative to oral medication and can be useful when swallowing drugs isn’t possible for you or your child.

Follow the recommended insertion steps to ensure the medicine is delivered correctly and to lower the chance of discomfort and other adverse effects.

Speak with a healthcare provider if you encounter problems or have additional questions about rectal suppositories.