The skin inside the mouth is highly vascularized and thin, making it a good route of administration to deliver medication into the bloodstream. Different oral medications may be optimally suited for sublingual (under the tongue), or buccal (between the cheek and gums) administration. These routes are designed to minimize first pass effect of the liver, which may be advantageous for some medications. These routes may also be used as an alternative for some topical dosage forms.
Whether you prefer a rapid dissolve tablet (RDT), a melting troche with vanilla flavoring, or a sublingual tablet, MedQuest can compound medication in a variety of doses and easy-to-take options.
A triturate is made of compressed powder, formed into tablets about the size of a pencil eraser. Administration routes include sublingual and buccal. Once placed in the mouth, they dissolve within 5-15 minutes.
To create triturates, the powder is moistened with ethyl alcohol to make it pliable, pushed into a mold, and then dried until all the alcohol has evaporated. The maximum amount of active ingredient is 100mg. Because triturates use lactose as a binder, they may not be a good choice for individuals who are lactose intolerant.
Rapid Dissolve Tablets (RDTs) are made of a powder that is baked at a low temperature with fillers to help the tablet hold its shape. RDTs are about the size of a mint and dissolve instantly. They are mainly used under the tongue, but can also be dissolved between the cheek and gums. RDTs are an excellent choice for patients who have difficulty swallowing pills.
The base ingredients in Rapid Dissolve Tablets are mainly isomalt, mannitol, and polyethylene glycol MW 3350. RDTs are lactose- and sucrose-free. The maximum amount of active ingredient is 200mg. They come in cards of 12, which keeps them from breaking during storage and transport. RDTs are always dye-free.
Most oral/sublingual troches are about the size of a small, round mint, and can hold up to 200mg of active ingredients. For a few oral medications, such as oxytocin, troches are compounded into a square and scored for easy splitting. Troches take various times to melt depending on the base ingredients and take longer to dissolve than RDTs or triturates. Administration routes include sublingual and buccal.
Sweeteners and flavors may be added to enhance the palatability and to suppress the bitterness of the active ingredients. Food dye may also be used to differentiate troche strengths and active ingredients. Both food dye and flavors are optional based on the physician’s or patient’s request.
Because troches melt at lower temperatures, they are usually shipped overnight with ice and require refrigeration.