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Rectal
The rectal route may be used when patients have nausea or vomiting or are fasting either preoperatively or postoperatively. The rectal route is contraindicated if there are lesions of the anus or rectum because placement of the suppository will cause pain. This route is also not useful if there is diarrhea or in elderly or infirm patients who are physically unable to place the suppository.
There are commercially available suppositories of morphine, hydromorphone, and oxymorphone. Medications can also be placed in a colostomy or similar stomp, provided that the flow of effluent is slow enough to allow the drug to be absorbed via the mucosa.311 When converting from the oral to the rectal route, start with the same amount as the oral dose and titrate as needed.
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