Preparation H suppositories are inserted into the rectum to temporarily shrink swollen hemorrhoidal tissue and relieve itching, discomfort, and swelling. You can use up to four suppositories per day. The process is straightforward once you know the correct positioning and insertion depth, and most people get comfortable with it after the first use.
Before You Start
Suppositories are made with a cocoa butter base, which means they soften quickly at body temperature. That’s by design (it helps the medication disperse once inside), but it also means a warm suppository can be difficult to handle. If yours feels soft through the wrapper, hold it under cool running water for a minute or place it in the refrigerator for a few minutes. Do this before you unwrap it so the medication stays clean.
Gather what you need: the suppository, a water-soluble lubricant like K-Y Jelly, and optionally a disposable glove or finger cot. Do not use petroleum jelly (Vaseline) as a lubricant because it is not water-soluble and can interfere with the suppository’s absorption. If you don’t have lubricant on hand, moistening your rectal area with cool tap water works as a substitute.
Wash your hands thoroughly with soap and water, then unwrap the suppository.
Step-by-Step Insertion
Lie on your side with your bottom leg straight and your top leg bent forward toward your stomach. This position opens the rectal area and makes insertion much easier than standing or squatting. Put on a glove or finger cot if you’re using one, then apply a small amount of water-soluble lubricant to the pointed tip of the suppository.
Use one hand to lift your upper buttock, exposing the rectal opening. With your other hand, gently insert the suppository pointed end first. Push it in with your finger about one inch past the opening, which means it needs to pass the ring of muscle just inside. If you don’t insert it far enough past that muscle, the suppository will slide back out.
Once the suppository is in place, hold your buttocks together for a few seconds. Stay lying on your side for a few minutes to let the suppository begin dissolving. You may feel a slight cool sensation or mild urge to push it out, both of which are normal and usually pass quickly. Discard any used materials and wash your hands again.
How Often to Use Them
Insert one suppository up to four times daily. The most useful times are in the morning, at night before bed, and after each bowel movement, since those are the moments when hemorrhoid symptoms tend to flare. You don’t need to use all four doses every day. Many people find that twice daily (morning and bedtime) is enough to keep symptoms manageable.
If your symptoms haven’t improved within seven days, or if you notice rectal bleeding at any point, stop using the product and talk to a doctor. Bleeding can be a sign of a more serious condition that looks and feels like hemorrhoids but needs different treatment.
How the Suppository Works
The active ingredient is phenylephrine at a 0.25% concentration. It’s a vasoconstrictor, meaning it narrows the small blood vessels in hemorrhoidal tissue. That temporarily reduces the swelling, which in turn eases the itching, pressure, and discomfort. The cocoa butter base melts at body temperature, coating the surrounding tissue and providing a soothing, protective layer as the medication absorbs.
These suppositories treat symptoms, not the underlying cause of hemorrhoids. They won’t eliminate a hemorrhoid permanently, but they can make flare-ups significantly more comfortable while you address contributing factors like straining, low fiber intake, or prolonged sitting.
Who Should Check With a Doctor First
Because phenylephrine constricts blood vessels, it can interact with certain health conditions. You should talk to a doctor before using Preparation H suppositories if you have heart disease, high blood pressure, thyroid disease, diabetes, or difficulty urinating due to an enlarged prostate. If you currently take a prescription medication for high blood pressure or depression, check with a doctor or pharmacist first, since phenylephrine can reduce the effectiveness of some blood pressure drugs and interact with certain antidepressants.
For pregnant or breastfeeding women, no formal safety studies have been conducted on topical hemorrhoid treatments. However, because the doses are small and very little of the medication is absorbed into the bloodstream, these products are generally considered low-risk during pregnancy. Hemorrhoids are extremely common in the third trimester, and topical treatments are typically the first option offered.
Storage and Handling Tips
Store suppositories at room temperature, ideally between 68°F and 77°F. A bathroom medicine cabinet works for most climates, but if your home runs warm, keeping them in a cooler spot (or even the refrigerator) prevents them from softening in the wrapper. A chilled suppository is actually easier to insert and can feel soothing on inflamed tissue.
If you need to use only half a suppository, cut it lengthwise (not across the middle) with a clean single-edge razor blade. Cutting lengthwise preserves the tapered shape on both halves, making either piece easier to insert. Wrap the unused half in its original foil and store it in the refrigerator for your next dose.
Making the Process Easier
Timing matters. Many people find insertion most comfortable right after a warm bath or shower, when the muscles around the rectum are naturally relaxed. Using the suppository after a bowel movement is also practical because the rectum is relatively empty, which helps the suppository stay in place longer and absorb more effectively.
If you’re worried about leakage, wearing a thin panty liner afterward can catch any residue as the cocoa butter base melts. This is especially useful for morning doses when you’ll be up and moving. Nighttime doses tend to stay in place well since you’re lying down.
Keeping your fingernails trimmed makes the process more comfortable and reduces the chance of irritating already sensitive tissue. A disposable glove isn’t required, but it makes cleanup simpler and can feel more hygienic, especially if you’re using the suppository multiple times a day.