What Are CBD Suppositories Used For?

Suppositories are not exactly the most popular form of ingesting drugs and those who have tried them would likely agree that they can be invasive, uncomfortable, and somewhat embarrassing.  These are designed to be inserted for absorption in a body orifice and the most common types are rectal, urethral, or vaginal suppositories. Nasal and ear cones do exist but are quite rare. Suppositories often use a base that melts at body temperature, like cocoa butter, polyethylene glycol, hydrogels, or glycerinated gelatin¹ and are formed into a small capsule or torpedo shape for easier insertion. CBD suppositories are pretty much the same.

Types of suppositories

• Rectal suppositories are effective for administering laxatives, as well as a wide range of drugs used for treating conditions like fever, pain, allergies, and even mental illnesses. 
• Vaginal suppositories are often used for delivering locally-acting drugs like antibacterial and antifungal medication. Some vaginal moisturizers or contraceptives also come in suppository form.
• Urethral suppositories are quite rare, but one such example is Alprostadil which comes in rice grain-sized pellets and is used to address erectile dysfunction.  

Why use a suppository?

Suppositories are obviously still on the market today since they offer a number of unique advantages over more traditional methods of administration like oral ingestion or injection. Here are some of the more popular reasons that make suppositories more preferable over other delivery formats:

• It has a higher bioavailability compared to oral ingestion.²
• Since the walls of the rectum and vagina are relatively dense with nerve endings, suppositories allow for better and faster absorption of drugs which means a lower dose can be used, thereby reducing systemic toxicity. 
• It is a way to get drugs into the bloodstream without having them reduced by the intestinal and hepatic first-pass effect³
• Compared to injection, it is less traumatic.
• It can be a way to administer medicine to unconscious patients or those who are unable to take it orally.
• It is also a way to take medication that may otherwise irritate the stomach and intestines.

Disadvantages of suppositories

There are also occasions when it is not appropriate to use suppositories. Some of its common disadvantages⁴ are as follows:

• Suppositories are not popular since these are administered via body parts that are considered sensitive or intimate. The experience of being given a suppository can be more traumatic for a young child.
• It is definitely not as convenient as popping a pill. Suppositories melt at body temperature and should be kept in a cool place before use.
• In most cases, even a medical professional will need the consent of the patient before they can administer a suppository.
• Suppositories can often trigger defecation and in some cases, mucosal irritation. 
• The state of the GI tract can affect absorption.
• Absorption can be incomplete and erratic.⁵

Comparing the advantages and disadvantages of suppositories, it becomes fairly evident that it is a practical yet underutilized method of drug administration for both local and systemic actions.⁶ 

Is there such a thing as a “CBD suppository”?

It may be surprising to know that taking cannabis suppositories are not actually new and that they actually go further back than one might expect. Documented history suggests that around 1550 BC, the ancient Egyptians already knew of the medicinal properties of cannabis and used hemp suppositories to treat hemorrhoid pain.⁷

Looking at the advantages that suppositories offer, it actually makes perfect sense to deliver CBD in such a form. 

Advantages of CBD suppositories

• Pure CBD oil does not taste particularly pleasant since it is extracted from hemp seeds, stalks, and flowers. Users say that it bears the aroma and flavor of cannabinoids, terpenes, and chlorophyll. Most users say that it has an earthy, grassy taste with a bitter aftertaste that lingers on the palate. However, the sublingual method is one of the best ways to take CBD. This requires the user to place a few drops under the tongue and hold it there for around a minute and a half before swallowing. Most users find this difficult to do because CBD oil has a tendency to linger in the mouth. Likewise, those who use tinctures complain of a “burning” sensation since it usually has an alcohol base. Taking CBD as a suppository effectively eliminates this problem.
• Vaping is a popular way of taking CBD, particularly since it has the highest bioavailability next to direct injection into the bloodstream, but it carries its own significant health risks. This is partly why sublingual CBD, which has the next highest bioavailability, is more mainstream. However, rectal suppositories have roughly the same or sometimes higher bioavailability⁸ compared to sublingual drops. This makes them a better option for people who want better bioavailability than edibles but cannot bear the taste of CBD oils or tinctures.
• CBD is well-known for its pain-relieving properties so it makes a lot of sense to deliver it as a suppository so it can provide fast relief particularly for pain in the lower back, pelvic area, thighs before spreading throughout the body. This includes conditions like hemorrhoids, sciatica, lumbar backache and irritable bowel syndrome (IBS). Similarly, vaginal CBD suppositories are also effective in treating local pain such as menstrual cramps or pain during sexual intercourse.

Are rectal and vaginal CBD suppositories the same?

Most CBD suppositories, like CBD Living’s suppositories, are meant for vaginal and rectal use and are typically made of CBD mixed with cocoa butter or coconut oil.⁹ However, some products, like Foria’s Basic CBD Suppositories, are marketed as “formulated especially for women”. 

How to use CBD suppositories

Most CBD suppositories do not require an applicator and can be administered normally. For rectal administration, follow these steps:

1. Clean your hands by washing with soap and water. 
2. Make sure the suppository is firm enough to handle. If it is still soft, place it in the refrigerator for a few minutes. 
3. Lie on your left side with the right knee slightly bent.  
4. Unwrap the suppository and insert it into the rectum as deeply as possible. 
5. Remain in the position for about 5 to 10 minutes after insertions to prevent the suppository from slipping out or leaking.

 The same principle applies to vaginal administration, with the exception of the position. Most manufacturers recommend lying on one’s back and using a pillow to prop up the buttocks when inserting the suppository.

Conclusion

It is clear that CBD suppositories can offer a number of advantages particularly in relieving local pain. It is also one of the best ways to take CBD because of its higher bioavailability and faster onset, and the fact that there is no need to add other chemicals into it to mask the taste also makes it more economical.  

1. Wikipedia contributors. “Suppository”[Wikipedia]
2. van Hoogdalem E1, de Boer AG, Breimer DD. Pharmacokinetics of rectal drug administration, Part I. General considerations and clinical applications of centrally acting drugs.[PubMed]
3. Wikipedia contributors. “First pass effect”[Wikipedia]
4. Rectal drug administration in adults: how, when, why[Nursing Times]
5. Jiro Hirota, Shinya Shimizu. Routes of Administration[ScienceDirect]
6. Susan Hua 1 , 2 , * Physiological and Pharmaceutical Considerations for Rectal Drug Formulations[PMC]
7. Wikipedia contributors. “History of medical cannabis”[Wikipedia]
8. Aungst BJ1, Rogers NJ, Shefter E. Comparison of nasal, rectal, buccal, sublingual and intramuscular insulin efficacy and the effects of a bile salt absorption promoter.[PubMed]
9. Julie Ries. Do CBD ‘Tampons’ Ease Pain? Here’s What You Should Know.[HuffPost]