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Suppositories are often the butt of many jokes and puns, but rectal administration of marijuana has many advantages. In addition to being a viable option for patients who can’t ingest or inhale cannabis, cannabis suppositories also begin to work quickly and last for a long time. Best of all, suppositories are efficient: up to 70 percent of the medicinal compounds in a suppository are bioavailable.
What Are Cannabis Suppositories?
Cannabis suppositories are usually conical or torpedo-shaped masses that are administered rectally. They are around an inch in length and made of either cannabis-infused coconut oil or cocoa butter infused with FECO Oil (Full Extract Cannabis Oil).
How Do Cannabis Suppositories Work?
Suppositories are in several ways more effective than traditional methods of cannabis
medication administration. Once inside the anus, the medicinal compounds in suppositories are quickly absorbed through the intestinal wall directly into the bloodstream, which results in “superior bioavailability” over other forms of administration. That means you get more of the medicinal effects of the product using a suppository than if you smoked or ate the same amount.
Inhaled cannabis starts working almost immediately, but it wears off quickly unless you keep doing it periodically. The effects of oral cannabis might not be felt for 30–90 minutes because it has to travel through the intestine and liver. Although it can take 10–15 minutes for rectally inserted cannabis to kick in, effects can last four to eight hours.
Inhaling cannabis is 10–25 percent efficient, depending on how much and how frequently you continue to smoke it. Eating cannabis is around 20 percent efficient, and it has varying effects every time. In contrast, rectal administration of cannabis is 50–70 percent efficient, and its effects are predictable from patient to patient and from dose to dose.
ARTICLE: Rectal Absorption of Cannabinoids by Dr. Allan Frankel of GreenBridge Medical
Who Should Use Cannabis Suppositories?
Suppositories are an ideal choice for many patients, such as chemotherapy patients who experience severe nausea and can’t keep oral cannabis down, elderly and babies who can’t smoke or swallow pills, surgery patients who are not allowed to ingest anything immediately before or after a procedure, and patients in severe distress who can’t wait for oral cannabis to take effect. There are also some people who just have sensitive stomachs that are irritated by ingesting cannabis.
How Do You Use Cannabis Suppositories?
Most cannabis suppositories are available in a two gram size for adults and a one-gram 
size for children. They are wrapped in wax paper and stored in refrigeration. Before insertion, make sure the suppository is firm; if it’s not, put it in the refrigerator or freezer, or run the package under cold water, until it reaches the desired consistency. Wash your hands thoroughly, and make sure your nails are trimmed. It is recommended to use medical gloves. If you want to use a partial dose, cut the suppository lengthwise with sterile scissors.
Lie on your side and pull your upper leg towards your chest. Use your index finger to insert the suppository into your rectum, pointy end first. Place the suppository 1–1½ inches into the rectum, past the inner sphincter.
To prevent the suppository from sliding out, hold your buttocks together and squeeze your sphincter muscles tightly for a few seconds. Stay lying on your side for at least a few minutes. When you feel ready, you can get up, dispose of the glove if you used one, and wash your hands thoroughly. Be aware, though, that there’s a risk of slippage for the next several hours, so plan your activities accordingly.
What Should You Expect from Cannabis Suppositories?
You will likely feel a warm, relaxing sensation wash over your body starting from the pelvic region. You may feel pain relief almost immediately, without anxiety or a “head high” lasting for hours. Most patients greatly enjoy the effects of cannabis suppositories, even more than other methods of ingestion.
VIDEO: Sharon Kelly’s Remission by way of rectal administration
Also stated in Chemistry & Biodiversity, Volume 4, Issue #8, pages 1770 – 1804, August 2007 publication by Marilyn A. Huestis –
Human Cannabinoid Pharmacokinetics
2.1.4. Rectal
Several different suppository formulations were evaluated in monkeys to determine the matrix that maximizes bioavailability and reduces first-pass metabolism [40][41]; THC-hemisuccinate provided the highest bioavailability of 13.5%. Brenneisen et al. evaluated plasma THC concentrations in two patients who were prescribed THC-hemisuccinate suppositories or Marinol® for spasticity [42]. THC did not accumulate in the blood following 10−15 mg daily doses. THC concentrations peaked within 1−8 h after oral administration, and ranged between 2.1 to 16.9 ng/ml. Rectal administration of 2.5−5 mg of THC produced maximum plasma concentrations of 1.1−4.1 ng/ml within 2−8 h. The bioavailability of the rectal route was approximately twice that of the oral route due to higher absorption and lower first-pass metabolism.
The bottom line: cannabis suppositories can be an excellent way to medicate.
My sister has Krukenburg tumor in the pelvic cavity. She has a colostomy and an ileostomy. Her bowel is stitched closed. Can and would it be beneficial to use the suppository method via the vagina? She has orally taken almost 60g is cannabis oil, but the tumor has grown. She has been on chemotherapy at the same time. Please help with any advice. Thank you.
Irum,
There are quite a few questions that need to be answered before we can give you advice. Some believe that you can overload the receptors if too much oil is taken over a short amount of time. The ratio of CBD to THC is imperative as well.
If you would like to discuss these particulars in private with one of our medical professionals, please click our consultation link below to schedule yourself in. The charge is $150 for the consult.
I hope this helps!
UPG
https://www.vcita.com/v/unitedpatientsgroup
Are you 100% positive that the cannabis oil is of high quality? The sad truth is that over 75 % of the oil that people are selling is low grade. Just be sure if possible that she is getting the oil from a honest compassionate source. 60 grams of high quality oil produced correctly should of showed a positive effect not a negative one.. Hope all is well. Stay gold.
well …..yes and I would add that the same size capsule would be Ideal for a dental “swishing” having Cannabis extract infused into any type of animal fat or vegetable oil the one interesting idea is that having the medicine in a cap form still allows you the option of using the contents as a topical like for your teeth and gums or dropping a cap into a pot of mac and cheese just before you stir in the cheese flavor packet. the cap will dissolve But dissolve it in a spoon full of butter ….. the point is caps of cannabis extract store and handle easily much better than sticky messy cups but infused extract still means your dependent on someone else’s compound…….. making extract yourself is the best idea. how you put it is your business.
The people at cannabisdigest.ca aren’t telling you the whole story.
Take a CLOSE look at that graph showing 70% availability. Notice how it says “THC-HS”? You can’t just ignore those last two letters. What they’re showing there is the absorption of a chemical variant of THC, called tetrahydrocannabinol-hemisuccinate. This variant DOES NOT OCCUR NATURALLY in the plant. It has to be made in a lab. Regular, natural THC of the kind you get in cannabis oil is not absorbed at all rectally.
I tried to post a comment there explaining it, but they moderated it out. They don’t want people to know the truth, because they’re happy to sell them a useless product that doesn’t work. If you want to know the truth, you can check these scientific studies:
http://www.ncbi.nlm.nih.gov/pubmed/1664466
“Rectal bioavailability of delta-9-tetrahydrocannabinol from the hemisuccinate ester in monkeys.”
http://www.ncbi.nlm.nih.gov/pubmed/2985774
“Disposition and bioavailability of various formulations of tetrahydrocannabinol in the rhesus monkey.”
See also Health Canada’s advice for medical professionals at http://www.hc-sc.gc.ca/dhp-mps/marihuana/med/infoprof-eng.php#chp2215
“Cannabis (marihuana, marijuana) and the cannabinoids
Dried plant for administration by ingestion or other means
Psychoactive agent”
Dave,
Our belief is that this industry is very young and the findings are ever changing. We always appreciate additional information and hope that more research on a larger scale will follow. Thank you again for your links.
Best,
UPG
The Effect Of Orally And Rectally Administered Delta-9-THC On Spasticity
Multiple doses of delta 9-tetrahydrocannabinol (THC) capsules (Marinol) and THC hemisuccinate suppositories were administered in 24- hour intervals to 2 patients with organically caused spasticity. After oral doses of 10-15 mg THC, peak plasma levels from 2.1 to 16.9 ng/ml THC and 74.5 to 244.0 ng/ml 11-nor-9-carboxy-delta 9- tetrahydrocannabinol (THC-COOH, major THC metabolite) were measured by GC/MS within 1-8 h and 2-8 h, respectively. After rectal doses of 2.5-5 mg THC, peak plasma levels from 1.1 to 4.1 ng/ml THC and 6.1 to 42.0 ng/ml THC-COOH were measured within 2-8 h and 1-8 h, respectively. The bioavailability resulting from the oral formulation was 45-53% relative to the rectal route of administration, due to a lower absorption and higher first-pass metabolism. The effect of THC on spasticity, rigidity, and pain was estimated by objective neurological tests (Ashworth scale, walking ability) and patient self- rating protocols. Oral and rectal THC reduced at a progressive stage of illness the spasticity, rigidity, and pain, resulting in improved active and passive mobility. The relative effectiveness of the oral vs. the rectal formulation was 25-50%. Physiological and psychological parameters were used to monitor psychotropic and somatic side-effects of THC. No differences in the concentration ability, mood, and function of the cardiovascular system could be observed after administration of THC.
You mean the RSO oil sold in dispensaries contains only THC and not THC-HS and thus not suitable for rectal administration? But what about the success stories of people who used regular RSO oil? Please explain. Thanks a lot!
What are sources of this information? And where are the citations?
Follow the links in the article. They lead to the information it was derived from.
So for my hormone positive (er+, pr+, HER2-) breast cancer with spread to lymph, where I take 2 different feco tincture doses of high CBD & 30 mins later the low THC ( 3:1 ), does the high absorption rate still work with the cbd and thc (not thc-hs) if administered rectally for this type of cancer?
Fay,
The jury is still out on suppositories. We have seen remission stories with rectal administration but researchers say that more studying is needed. We are not doctors or researchers here at UPG but we like to pass on information that may lead to better undersatnding.
If you would like to chat with a Oncology nurse (practioner) that works in the cannabis industry, we can make that introduction.
I hope this helps,
Best,
UPG
I would like to have a chat with an Oncology nurse involved in the utilization of cannabis treatments if possible. Much appreciated
Hello Gunner,
I have attached the nurses shceduling system here for your convenience.
Best,
Brent
Hi Fay!
That is the same cancer I have… I am also searching for the same answers as you… Will you email me and share anything you have learned?
Thank you!
Rain
Many people have weighed in on the subject of cannabis suppositories/rectal administration.
United Patients Group values all points of view, as it is our goal to provide as much information as possible for people battling disease.
Below is a review questioning our article and we believe that these points are valuable. The medcial cannabis industry is in dire need of clinical research and look forward to the day that large scale research becomes available.
United Patients Group
How Efficient are Cannabis Suppositories?
Jeffrey Hergenrather, MD, in response to a question from a cancer patient’s caregiver, February 7, 2015
http://www.beyondthc.com/on-cannabis-suppositories/
Nearly every medicine absorbed orally is equally or better absorbed rectally. I agree that we all need to do more studies -not very complicated and will be done soon, but I also have no doubt that cannabis well absorbed rectally – in virtually any medium.
Through our office, we have helped patients make up many different dose and ratio cannabis medicine as a suppository in MCT oil, Coconut oil, olive oil, glycerine and I am sure a number of other carriers.
In all cases, the clinical effect was just as clear, if not more clear, than oral doses in the same medium. I have also given CBD “only” suppositories to patients who had no response, only to do great on a 1:1 ratio med at the same CBD dose. So, the only difference was around 14 mg of THC in the suppository.
Granted, these are not blinded studies, but simple “blinded” rectal suppository testing is on the way. We have the ability to test cannabinoid and endo-cannabinoid plasma levels and the study method is obvious.
By the way, the REASON to consider rectal administration is NOT because there is less psychoactivity. Depending upon precisely where the suppository is place, the absorption may be more portal vs vena cava. Any cannabinoids that go through the portal system will be metabolized into more potent OH- activity metabolites. The cannabinoids that go through the vena cava will be treated pretty much like taking the medicine sublingually.
If ANYONE has any doubts, do the following with a friend who is an old stoner.
Take 1/4 gram of THC 60% oil and place in a glycerine suppository. Apply as directed. I bet this guy or gal will have the ride of their life…….probably too much for most. Then try the same dose in a capsule and compare.
Should the oil be decarboxylated?
PS
The real reason, in my opinion, to use rectal cannabis are two-fold:
1. No other route is as convenient
2. There is a desire to treat a local pelvic tumor or inflammatory condition where having the cannabinoids travel the same venous and lymphatic drainage area.
Hi UPG,
I thought I’d share another informative article on suppositories. We have used this method with our family member with success.
Thank you for all you do.
http://cannabisdigest.ca/preparing-cannabis-suppositories/
Jason R.
Thank you for your supportive sight! I am blessed by the inspiration!!!!!
Hello. I’m giving my toddler, who has cancer, canabis oil in small capsules rectally. It’s high quality oil. I noticed that his stool comes out with some oil along with the capsule (looking like “melted”) and it smells like cannabis. This worries me all the time as I wonder if he is not absorbing all the oil. Is this normal? I give him one capsule in the morning and one at night – total dosage is half a gram per day. Should I increase it to one gram per day? Thank you so much in advance for responding. Any additional advice to help me save my son using cannabis is very much appreciated.
Al,
There is varying opinions on dosing. Our suggestion would be to get guidance from our Oncology nurse. Her schedule is under the consultation tab on our home page. she charges a one time fee but can walk you thorugh dosing and whether you should ever increase. Current practices reflect a less is more approach.
I hope this helps you!
Yours in health,
UPG
Hi,
You want to make suppositories with coconut oil and the cannabis oil. Use suppository forms you can buy on line and keep in fridge until ready to use. I’m guessing the capsules you are using are regular oral gelatin capsules and are not meant to dissolve in the rectum, but in the stomach. Hope this helps your child heal quickly!
I have a question regarding the use of cannabis suppositories. Mixture of simpsons oil and coconut oil.
The patient using these for treatment of lung, head, neck and mouth cancers complained of a bad taste in her mouth after using the suppositories. I used the same exact suppositories right along side the patient and didnt experience this bad taste.
Has anyone had any experience with this? Could the bad taste be a result of dying cancer cells in the mouth or other areas?
Any information you can provide will be much appreciated. The patient is my mom and the doctors are giving her 6 months at best :-(
I know the taste isnt from additives in the suppositories because I am making them personally.
If you have any insight or experience with this please help.
Scott
Scott,
I would like to know the same information that you asked. My father has stage 4 Kidney Cancer in his lungs, and he cannot eat because everything tastes terrible. Did you ever find an answer about why the terrible taste?
Hey my mother has stage 4 cancer which consist of cancer of the colon, liver and I believe lung . My question is simply this, she suggested using these suppositories but not a lot of people in the Humboldt county area I reside in really has them available. Will these possibly help deteriorate her cancer and if so where can I obtain it ? Thank you.
Hello “Concerned Son”
There are quite a few companies that offer suppositories here in California. If your mom is a legal patient in California, these products can be sent to directly to her. If you would like more information, please call our offices at 415-524-8099.
Best,
Lauren
I asked and could not find my question so am reposting
I have afib, but was told rectal suppositories can help with pain and exhaustion I feel from sotalol and elequis. I also have fibromyalgia and am in constant pain. I read smoking it cause rapid heartbeat which I don’t need as I am in fear of another stroke.. my question is for rectal administration does it do the same, or does It not cause increased heartbeat.
Thank you
Patty,
Every patient is different as our DNA and reactions to all drugs vary. Many believe that rectal administration alleviates much of the psychoactive affects of cannabis but also choosing the correct formualtion is important. If you would like to discuss further, feel free to call our offices at 415-524-8099.
Sincerely,
Mary Ann
Suppository applicators can be a big help for administering suppositories. Plus, it’s cleaner and quicker than using your finger.
Thank you Alison for your input.
Does anyone have any thoughts or info on suppositories specifically for rectal cancer?
Hello Raven,
Here is a link to a discussion that touches on suppositories. There is a lot of speculation about suppositories so you should make sure to have a consultation with a person in the medical field as this is not a one size fits all protocol.There are different formulations for various conditions.
I hope this helps!
Mary Ann
Hi, found this article very interesting and would like to try them for Prostate cancer. I would like to know if you can supply these suppositories to Florida and would I need a licence for purchase. If so what would be the cost. Many thanks in anticipation, RG.
Roger,
We do not sell products, in addition, cannabis medicnes are illegal to ship across statelines. You would have to find a medical cannabis product line in Florida or come to California to obtain this legally.
If you have any further questions, please feel free to call our offices at 415-524-8099.
Best,
Brent
Is it possible to get these suppositories in the UK please?
Denise,
I’m sorry to say it is illegal to ship cannabis products across state lines and internationally. Additionally, United Patients Group does not sell product.
Best,
Mary Ann
Hi I was diagnosed with hairy cell in fall of 2014. Before I could have cladribine treatment it was discovered I had a tumor on a vocal cord. Long story short I had 20 radiation treatments on my throat and by the end could not eat, drink or swollow. My epiglottis was seized open. It finally came around and I was then given the chemo 24/7. I have had a bone biopsy as well as my throat scoped twice since all treatmen’s ended. I recently pur chased some phoenixtears oil with MCT oil in suringes. Can I make suppositorits out of this and how, what dosage should I use in any form, oral or rectal. I don’t know at this time whether I have other cancers manifesting but was for sure hoping to use it as a maintenance thing. Any suggestions or advise is greatly appreciated. Thanks!
I forgot add that the hair cell is in remission and my throat is clear so they say. Next scope is february 3rd.
Hello Hailfriend,
In order to find the correct formulation and dosing for you condition, you would need to speak with our oncology nurse via a consultation. Each patient may have a different formulation and protocol even if the diagnosis is the same. Much depends on height, weight, stage of disease, oast treatments, other meds/suppliments etc. I have attached our oncology nurses scheduling system here for you convenience.
If you have further questions, feel free to call our offices at 415-524-8099.
Wishing you all the best,
Mary Ann
Would cannibus suppositsitors have a positive effect on diverticulosis and diverticulitis? Surgery to remove lower intestine is imminent so this is very important. Thank you
Sam,
Many people have seen improvement of their diverticulitis. It is important to understand that there are various treatments/formulations for each patient and condition, this is not a one size fits all protocol. I would suggest making a consultation appointment with one of our nurse practitioners in order to get the correct formulation and dosing for your personal treatment. I have attached the nurses’ scheduling system here for your convenience. Also, where you live and if it is in a cannabis legal state will lay a large part in accessing treatment.
I hope this helps!
Lauren
We have been having a discussion on the bio-availability of Cannabis oil and would like to know where your are getting your statistics from for the bio-availability? What studies or research supports this amount? The rectum does not absorb oil very well at all and given that Cannabis oil is not water soluble how can it be absorbing this amount over orally. We cannot seem to find any actual scientific proof of this.
Matt,
Look up Dr. Christina Sanchez out of Madrid Spain. She has a video on this topic and has been stydying canniboids for 15 years.
Brent
Where in these videos is she backing up stating the bio-availability that you state in this article about suppositories? I must have missed that part. Does she have the clinical trials on the difference between orally and rectally?
What do you have to say about this article? It seems to me that there is not enough clear evidence to recommend rectal dosing outside of a few specific diseases. https://www.linkedin.com/pulse/rectal-absorption-cannabis-revisited-allan-frankel
Dana,
Yes, The medical cannabis industry in it’s entirety needs much more research. The discussions continue on the subject of suppositories and articles like Dr. Frankel’s are very helpful. As he mentions, he has had some success with suppositories in his practice but clearly states that research and trials are needed. This blog is quite old and there has been much more information since it was posted.
Please feel free to post new finding as you see them pop up!
Best,
Brent
https://www.youtube.com/watch?v=rnVisZVZfHc
Where can you buy the suppositories at? I have a stage 1111 non curable lung desease and want to try them. Please help!
Judy,
Are you in California? Are you a legal cannabis patient? It is important to understand that lung cancer does not need to be treated with suppositories. There are quite a few organizations that sell suppositories, we would just need to know where you are locAted and if you are a legal patient. If you would like a quick briefing, please call our offices at 415-524-8099.
Best,
Beth
Hi,
Is there any new information about how sharon kelly is doing? I havent seen any updates in over a year and am wondering and hoping that she is well!
Any info is appreciated!
Sam,
We are unable to speak about people’s medical records. My apologies!
Beth
Hi everyone,
I have read up on this a fair amount. For the record – I have a brain tumor.
Conventional medicine has limited my seizures in terms of severity, and somewhat in terms of frequency. But there are no prospects of further improvement.
I have tried a very diluted mix orally. It had basically no effect after 3 months. I keep exact records of everything. Even that diluted mix, gave me a really unwanted “high”. I have no interest in that, and I think that “high” could even lead to a seizure.
Anyways – I managed to get 100% pure oil. From what I hear, even the smallest amount taken orally will give me a “high”.
So I have switched to rectal, about a week ago. Even at a fairly big dose, there is very conveniently no “high”.
For me this is paramount. I can only imagine the “effect” of taken that size dose orally.
So regardless of the different schools of thought, I simply cannot go the oral route. I have a syringe full of 100% oil. Getting that into my system orally is impossible at best.
That is my story. My seizures are not frequent – perhaps 2 – 3 times per month. The longest interval being 34 days.
So that is my goal. Breaking that record, which to me, will be the beginning of some kind of proof that firstly the oil works, and secondly that rectal administration works.
And hopefully – along the way – the oil will actually start to have an effect on the tumor itself.
Early days – but I will post my findings here.
Rhaine
Hi, my husband has pancreatic cancer, stage 3 last we knew. The chemo isn’t working and the tumor is growing. They want to do radiation next. Would something like this possibly help?
Thank you.
Karen
Hello Karen,
Cannabis oil in the proper formulation and dosage can address Pancreatic cancer. Each patients and their protocol can very so it is important to consult with a medical professional about which firmulation and dosage would be best for your husband. If you have further questions, please feel free to call our offices at 415-524-8099.
Best,
Beth
I’m a cancer survivor who has rectal problems caused by the chemo and radiation. I live in Washington state and my Dr. has recommended cannabis suppositories. The problem is I can not find this product. Most medical shops don’ carry or know where to get the suppositories, I’ve been on line for hours and seem to go in circles. Can someone give me a clue as who to contact
Paul
Hello Paul,
Feel free to call our offices to discuss. 415-524-8099
Brent
Hi Paul, Don’t know if you’ve had any luck with the suppositories? You can make the rectal ones and can get the molds, but someone has said it’s just as easy to use a 1 gram syringe with 1/2 oil and 1/2 coconut oil.
So not enough research to decide if rectal absorption occurs. What about vaginally? I have a rare form of papillary adenocarcinoma and have been given a suppository of whole plant harlequin. Am I wasting my time and money using this rectally or vaginally? Opinions? Thank you.
I have cronic pain very (debilitating ) can’t sit or laying down on my back , burning pain hands and feet that makes me home bound ! Pain meds don’t help much! Do you think this suppository with help me ? Can you please help ? appreciate .
Mary,
Please feel free to call our offices to get more direction. 415-524-8099
Best,
Beth
I have severe ulcerative colitis and the medications I’ve been taking haven’t really been working for me. Would a cannabis suppository be a viable option for me? Has this ever treated someone with ulcerative colitis?
Rachel,
The clients that we have worked with see results via sublingual tinctures. The medicine enters the blood stream quickly this way.
Please let us know if you have further questions!
Brent
We are Canadians. My adult daughter has severe ME-CFS, and she has had 7 GI haemorrhages,and recently surgery.
Doctor suggested cannabis suppositories CBD to THC ratios of 4:1
She has a serious sleep dysfunction since becoming ill.
Where can we obtain these.
Hello Francis,
I believe you have access to cannabis medicine in Canada. It is best to contact your health department for information about products.
Best,
UPG Staff