I have done some research and cannot find an answer. Some say it by-passes the liver – however, others say it cannot, as it will go straight to the liver via the mesenteric veins.
I have also discovered this written from a pain management centre’s website: “Drugs administered into the proximal rectum are subjected to first-pass metabolism. However, drugs administered from a low rectal site reach the general circulation without first passing through the liver”…So, this would perhaps follow that it depends upon where in the rectum the suppository is placed. Can someone please tell me conclusively if this is so; or any other reason for why the psychoactive effects are not present if taken this way? Thank you.
Rose
