A troche is a medicated lozenge designed to dissolve slowly in the mouth, delivering an active drug ingredient into the bloodstream. This method utilizes the rich blood supply of the oral lining, known as the mucosal membrane. This delivery route facilitates systemic absorption, meaning the medication is absorbed directly into the body’s circulation. Bypassing the digestive system and initial liver metabolism often results in a more efficient uptake.
Step-by-Step Administration
Before handling the medication, wash your hands thoroughly to maintain hygiene and avoid contaminating the troche. If your prescription indicates a partial dose, such as a half or quarter, carefully cut the troche along any scored lines before placement. Only use the specific portion prescribed by your healthcare provider.
Once the troche is ready, place it in the designated area of your mouth, either under the tongue or between the cheek and gum, as directed by your pharmacist. The medication is designed to dissolve slowly, typically over 15 to 30 minutes, allowing for gradual absorption. Resist the impulse to chew, crush, or swallow the troche whole, as this sends the drug through the digestive tract and reduces its effectiveness.
As the troche dissolves, saliva will mix with the medication. Hold this saliva in your mouth for as long as possible to maximize contact time with the oral mucosa. Swallowing the dissolved medication too quickly can lead to the dose being metabolized by the liver, which this method is designed to avoid. To ensure complete absorption, avoid eating, drinking, or rinsing your mouth for at least 15 to 30 minutes after the troche has fully dissolved.
Understanding Placement (Buccal and Sublingual)
The effectiveness of a troche relies heavily on its placement, utilizing two distinct drug delivery methods: sublingual and buccal. The sublingual method involves placing the troche directly under the tongue, where the tissue is thin and contains a high concentration of blood vessels. This vascularity allows for a relatively fast onset of action as the medication moves quickly into the systemic circulation.
The buccal method requires placing the troche between the cheek and the gum, typically in the upper part of the mouth. This area is less permeable than the sublingual region, resulting in a slower, more sustained release of the medication. The specific placement method is not interchangeable and is determined by the prescribing physician or pharmacist to provide the optimal absorption rate. It is beneficial to rotate the placement location, such as alternating sides of the mouth, with each dose to help prevent localized irritation.
Proper Handling and Preservation
Maintaining the structural integrity of the troche is necessary to ensure its potency and controlled dissolution rate. Troches are susceptible to environmental factors, particularly heat and moisture, which can compromise the medication’s stability. Therefore, they must always be stored in a cool, dry location, ideally kept in their original, tightly sealed packaging.
Exposure to high temperatures can cause the troche base to soften or melt, destroying the intended dosage form. Similarly, humidity can cause the lozenge to absorb moisture, altering its composition and dissolution characteristics. Generally, storing troches at room temperature is sufficient, but some formulations may require refrigeration; always check the specific instructions on the label. Unused or expired medication should be disposed of safely, often by taking them to a drug take-back location rather than flushing them.