Mesalamine suppositories are a form of localized medication used to manage inflammatory conditions, most commonly active ulcerative proctitis, which is inflammation confined to the rectum. This medication, a type of aminosalicylate, works directly on the rectal lining to reduce swelling and irritation. Since the treatment is local, proper administration is important to ensure the active ingredient, mesalamine, reaches the affected tissue effectively. Understanding the precise steps for preparation, insertion, and post-administration care allows for maximum therapeutic benefit.
Necessary Preparation Before Use
Wash your hands thoroughly with soap and water before and after handling the medication to prevent bacterial introduction. It is generally recommended to attempt a bowel movement just prior to using the suppository, as the medication is most effective when the rectum is relatively empty.
Next, prepare the suppository by removing it from its protective foil or plastic wrapper. Handle the suppository as little as possible before insertion, as body heat can cause it to melt prematurely. If desired, a small amount of water-based lubricating gel may be applied to the pointed tip of the suppository to ease entry, but petroleum jelly should be avoided.
Assume a comfortable position that allows for easy access and muscle relaxation. The most common position is lying on your left side with the lower leg extended and the upper leg bent toward the stomach. Alternatively, lie on your back with knees bent and legs slightly apart.
The Mesalamine Suppository Administration Process
With the suppository prepared and your body in a stable position, gently lift the upper buttock to expose the anal opening. Insert the suppository pointed end first, which helps it pass smoothly through the anal canal. The goal is to insert the medication past the internal sphincter muscle where it can begin to dissolve and release the mesalamine.
Using your finger, apply gentle, steady pressure to push the suppository into the rectum. The suppository should be fully inserted, typically about one inch or to the base of the finger, ensuring it does not slip back out. Inserting it past the anal sphincter helps prevent the body from immediately expelling the foreign object.
After insertion, remain lying down in the same position for a few minutes while holding your buttocks together. This brief period of stillness helps the suppository settle and begin to melt, minimizing the risk of accidental expulsion. Try to relax the muscles in the area, as muscle tension can sometimes make retention more difficult.
The 1000 milligram dosage is often prescribed once daily, typically at bedtime, to maximize the retention period. This timing allows the active ingredient to remain in contact with the inflamed rectal tissue for the longest duration.
Retention Time and Storage Guidelines
Mesalamine efficacy relies on retaining the suppository long enough for the medication to be absorbed. Patients are usually advised to retain the suppository for at least one to three hours, or longer if possible.
If you happen to pass the suppository within ten minutes of insertion, it is generally acceptable to insert a new one, as the original dose likely did not have time to dissolve. If a dose is missed, administer it as soon as you remember, unless it is nearly time for the next scheduled dose. Never use two suppositories at the same time to compensate for a missed dose.
Storage Guidelines
Proper storage maintains the stability and integrity of the unused medication. Mesalamine suppositories should typically be stored below 25°C (77°F) or refrigerated, depending on brand instructions. Keep them away from direct heat, light, and humidity to prevent premature melting.
Handling Precautions
Mesalamine can cause staining on various surfaces, including fabrics, flooring, and painted materials. Exercise caution when handling the suppository and consider wearing a sanitary pad to protect clothing and bedding after insertion. Maintaining adequate hydration by drinking plenty of fluids is recommended during treatment to mitigate the risk of developing kidney stones.