Marketed vaginal estradiol suppositories were also used rectally. Compounding pharmacies can create boric acid vaginal suppositories. Local treatment may include vaginal suppositories or medicated douches. Scopolamine (Buscopan) rectal suppositories or injections and Gaviscon have been used to alleviate intestinal symptoms. Vaginal progesterone is available in the forms of progesterone gel, rings, and suppositories or pessaries. Clotrimazole creams and suppositories contain oil which may weaken latex condoms and diaphragms. The oily extract called Kukum butter is used in ointments and suppositories. Alprostadil pellets are urethral suppositories used for the treatment of severe erectile dysfunction. Rectal suppositories act within two hours. Some solids melt when they reach body temperature (e.g. rectal suppositories). Vaginal estradiol is available in the forms of tablets, creams, inserts or suppositories, and rings. Nonoxynol-9 is the active ingredient in most spermicidal creams, jellies, foams, gel, film, and suppositories. Accidental urethral placement of contraceptive suppositories has also caused hemorrhagic cystitis in several patients. Codeine suppositories are also marketed in some countries. Vaginal progesterone suppositories were first studied in women by Robert Greenblatt in 1954.