Rhubarb is a common herb used in traditional Chinese medicine. However, few publications exist about its pharmacokinetic profiles in animals or healthy volunteers. Whether retention enema administration of rhubarb extract affects its pharmacokinetics as well as its tolerability is unknown. Therefore, we set out to compare the pharmacokinetic parameters of rhein administered by retention enemas with those of conventional oral dosing of rhubarb extract. Eight healthy male volunteers were enrolled in a prospective crossover study. All subjects received a single dose of rhubarb extract (50 mg.kg(-1)) on two separate occasions, once orally, once by a retention enema. Rhein plasma concentration was measured by HPLC. The C(max), AUC(0-infinity), AUMC were significantly higher in oral administration than those in retention enema administration (p < 0.05), while V(d) of rhein after oral administration of rhubarb extract was significantly lower (p < 0.05) than that after retention enema administration. However, no statistically significant differences between the two treatments were observed for any of the other pharmacokinetic parameters (T(max), t(1/2), MRT(0-infinity), CL). Dosage adjustment is advisable for retention enema administration of rhubarb extract in patients.