Rectal route in the 21st Century to treat children

Abstract

The rectal route can be considered a good alternative to the oral route for the paediatric population because these dosage forms are neither to be swallowed nor need to be taste-masked. Rectal forms can also be administered in an emergency to unconscious or vomiting children. Their manufacturing cost is low with excipients generally regarded as safe. Some new formulation strategies, including mucoadhesive gels and suppositories, were introduced to increase patient acceptability. Even if recent paediatric clinical studies have demonstrated the equivalence of the rectal route with others, in order to enable the use of this promising route for the treatment of children in the 21st Century, some effort should be focused on informing and educating parents and care givers. This review is the first ever to address all the aforementioned items, and to list all drugs used in paediatric rectal forms in literature and marketed products in developed countries.

Efficacy and safety of intravenous thiopental for sedation during magnetic resonance imaging in pediatric patients: A retrospective analysis

“…[2021] In addition, there are barriers (patient, cultural, and traditional) concerning the use of the rectal route, especially for patients older than 6 years of age. [22] There are also different sociocultural norms, attitudes, and preferences between various countries. While it is favored in certain countries, it is unthinkable to others.…”

Microfabricated Drug Delivery Devices: Design, Fabrication, and Applications

“…[288] A hollow-type suppository was developed by Watanabe and co-workers to solve some drawbacks of conventional solid suppositories, such as poor dose-volume control and undesired interaction of the drug with base materials during preparation. [288] A hollow-type suppository was developed by Watanabe and co-workers to solve some drawbacks of conventional solid suppositories, such as poor dose-volume control and undesired interaction of the drug with base materials during preparation.…”

“…The rectal route is considered a good alternative to the oral route for certain groups of patients with difficulties of dysphagia such as vomiting, nausea, or unconscious condition, especially for children and the elderly. [288] A hollow-type suppository was developed by Watanabe and co-workers to solve some drawbacks of conventional solid suppositories, such as poor dose-volume control and undesired interaction of the drug with base materials during preparation. [289] The shell of the hollow-type suppository was made of oleaginous base alone or with gel agents of sodium alginate (Alg-Na), sodium polyacrylate (PANa), or polyacrylate-PANa copolymer (PA-PANa).…”

A mini-review of non-parenteral clonidine preparations for paediatric sedation

“…Another enteral route, the rectal route, has many advantages in the delivery of medicines to children because there is no need to swallow or mask the taste of the dosage form. However, there are also challenges associated with the development and use of rectal drug formulations, which may explain the paucity of commercially available rectal preparations . Rectal administration can lead to erratic absorption and, because of this, must be fully evaluated for safety and efficacy in addition to bioavailability studies.…”

“…However, there are also challenges associated with the development and use of rectal drug formulations, which may explain the paucity of commercially available rectal preparations. [63] Rectal administration can lead to erratic absorption and, because of this, must be fully evaluated for safety and efficacy in addition to bioavailability studies. Further, there are issues surrounding patient perception, including cultural barriers, understanding and attitudes.…”