How to Insert a Suppository: Rectal and Vaginal, Step by Step

Most insertion trouble comes from four skippable causes. Temperature: a soft suppository bends and smears; a firm one goes in cleanly. If it feels soft in the wrapper, chill it in the refrigerator for 15 to 30 minutes or hold it under cold running water before unwrapping (several labels print exactly this). Lubrication: moisten the pointed tip with a little water or a water-based lubricant. Petroleum jelly is the traditional mistake; it coats the suppository and can slow melting. Position: lying on your left side with the upper knee pulled toward the chest opens the angle for a rectal suppository; for a vaginal suppository, on your back with knees bent or standing with one foot on the toilet seat. Relaxation: the muscle at the opening tightens when you brace; breathe out slowly as you push.

Two housekeeping notes. Wash your hands before and after, and if you have long nails or simply prefer not to use a finger, a disposable finger cot or glove is fine for rectal insertion and an applicator is the standard for vaginal insertion. Unwrap only when you are ready; a suppository left on the counter in a warm room will soften. If one has already melted, our guide on what to do with a melted suppository covers re-firming it inside the wrapper.

The steps, in the order pharmacists teach them. Empty your bladder and, if you can, your bowels first. Wash your hands. Unwrap the suppository; if it is soft, firm it up first. Moisten the pointed end with water. Lie on your left side with your lower leg straight and your upper knee bent up toward your chest, or, if you prefer, stand with one foot on a chair. Lift the upper buttock to expose the anus, breathe out, and gently push the suppository in pointed end first with your index finger until it passes the muscle and you feel it move freely, about 1 inch. Withdraw your finger, squeeze your buttocks together for a few seconds, and stay lying down for about 15 minutes.

What happens next depends on the product. A glycerin suppository or a Dulcolax bisacodyl suppository is labeled for a bowel movement in 15 minutes to 1 hour, so plan to be near a bathroom and try to hold it for at least the first 15 minutes even when the urge comes early; the longer the base has to work, the more complete the result owners report. A hemorrhoidal suppository is not meant to produce anything; the Preparation H label directs use up to 4 times daily, especially at night and in the morning or after each bowel movement, and its melted base simply coats the tissue. Full rectal detail, including the liquid glycerin applicator, is in how to use a rectal suppository.

With an applicator (miconazole ovules, most boric acid brands sold with applicators): wash your hands, unwrap the suppository and place it in the cup end of the applicator. Lie on your back with your knees bent and apart, or stand with one foot raised on the toilet seat. Gently insert the applicator into the vagina as far as it comfortably goes, angled slightly toward your lower back rather than straight up, then push the plunger fully to release the suppository. Withdraw the applicator, discard it if disposable, and wash a reusable one with soap and warm water. Without an applicator: the same position, then push the suppository in with a clean finger as far as is comfortable; a capsule should sit high enough that it does not fall out when you stand.

Timing is on the label. The Monistat 3-Day Drug Facts label directs one ovule at bedtime for 3 consecutive nights; boric acid labels typically direct one suppository per day for the number of days printed on the box. Bedtime is not a suggestion so much as a leak-management plan: the base melts or dissolves over the next hour, and some of it comes back out, so lie down afterward and wear a liner. Boric acid deserves its own line here: it is for vaginal use only, poisonous if swallowed, never used in pregnancy or nursing, and not a treatment for anything; the box says so and so do we. The vaginal walkthrough, including reusable applicators, is in how to use a vaginal suppository, and applicators are compared in the applicators guide.

The pediatrician decides whether a child gets a suppository and which one; this section only covers the hand skills once that decision is made. Lay the child on their side with knees drawn up, or, for a baby, on their back with legs lifted the way you would for a diaper change. Use a pediatric-size suppository if the label offers one: the Pedia-Lax liquid glycerin label covers ages 2 to 5 and sends children under 2 to a doctor, and the FeverAll infant acetaminophen label covers 6 to 36 months and sends babies under 6 months to a doctor. Moisten the tip, insert it gently about half an inch (less for an infant; ask the pediatrician), and hold the buttocks together for a minute or two, since small children will push it out reflexively.

Never cut a suppository for a child to guess at a smaller dose unless the label prints that direction. The Dulcolax bisacodyl label does direct one half suppository for children 6 to under 12, and that is the only common label on this shelf that does. What each label states about ages, product by product, is in suppositories for babies and toddlers. The American Academy of Pediatrics says a fever in an infant under 3 months is a reason to call the doctor before giving anything.

Inserting a soft suppository. It bends, breaks or smears at the opening. Chill it first. Not going past the muscle. The suppository slides back out within minutes; the fix is about 1 inch of depth for an adult rectal suppository. Standing up immediately. The melted base runs out before it has worked; stay down about 15 minutes for rectal, and use bedtime for vaginal. Petroleum jelly as lubricant. Use water or a water-based product. Using the bathroom the moment the urge starts. For a laxative suppository, holding it for the first 15 minutes when possible gives the glycerin or bisacodyl time to act.

Cutting or opening a suppository. Unless the label directs a half, the dose is then unknown, and a boric acid capsule opened by hand exposes a powder that is poisonous if swallowed. Our page on whether you can cut a suppository goes product by product. Ignoring the stop lines. Every laxative label says stop and ask a doctor for rectal bleeding, no bowel movement after use, or any need to keep using a laxative beyond 1 week; hemorrhoidal labels say 7 days; vaginal antifungal labels say ask a doctor for a first or recurring infection and if symptoms last more than 7 days.

Normal: some leakage of melted base, especially from cocoa butter or hard-fat suppositories and from every vaginal product; a brief feeling of fullness or urgency after a laxative suppository; a mild burning or cramping sensation with bisacodyl, which its label lists as a possible effect. A glycerin or bisacodyl suppository that produces a bowel movement inside the labeled 15 minutes to 1 hour has done its job, and the label directs one per day at most.

Not normal, per the labels: rectal bleeding, no bowel movement after a laxative suppository, pain that persists, or vaginal symptoms that do not improve within 3 days or last beyond 7 days on an antifungal. Each of those is the label's own instruction to stop and ask a doctor, and we repeat it without softening it. For what to expect minute by minute, product by product, see how long a suppository takes to work.