What is sublingual?
Don't know what sublingual is or means? In simple terms, it refers to a method of administering medications or substances in which the product is first placed under the tongue.
From there, the drug is absorbed directly through the oral mucosa into the bloodstream.
As a result, this procedure allows for faster and more effective absorption. In addition, by using the sublingual route, the passage through the digestive system is avoided, which in turn accelerates the onset of the drug's action.
For these reasons, this method is ideal for medications that require a rapid effect or that could be degraded in the digestive tract.
What is it, what does sublingual mean and what is it used for in 2024?
"Sublingual" comes from the Latin words "sub," meaning under, and "lingua," meaning tongue. In medical terms, it refers to the route of administration of medications or supplements by placing the substance under the tongue .
The sublingual route is used to administer medications in emergency situations, such as in cases of a heart attack. In such situations, a drug called nitroglycerin is placed under the tongue and begins to work in about 1 to 2 minutes.
On the other hand, this route is equally effective for administering active substances that could be altered or degraded by gastric juices or hepatic metabolism, since they do not require digestion.
In addition, the sublingual route is a suitable alternative for the elderly and children who have difficulty swallowing tablets. However, it is crucial that the medications are specifically formulated to be administered in this way.
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How do you take sublingual tablets?
Sublingual tablets are taken as follows:
- Placement : Place the tablet under the tongue.
- Dissolution : Allow the tablet to dissolve completely without chewing or swallowing.
- Absorption : Keep the tablet in your mouth until it has completely dissolved, allowing the medication to be absorbed through the sublingual mucosa.
- Avoid eating or drinking : Do not eat or drink anything while the tablet is dissolving to ensure proper absorption of the medication.
This method allows the medication to quickly enter the bloodstream through blood vessels under the tongue, which may result in a faster effect than if it were taken orally and swallowed.
What happens if I take a sublingual medication orally?
Taking a sublingual medication orally, that is, swallowing it instead of letting it dissolve under the tongue, can affect its effectiveness and how quickly it works.
Here I explain what can happen:
Reduction in drug efficacy
First pass metabolism
When a drug is taken orally and swallowed, it passes through the digestive system and is then metabolized in the liver before entering the bloodstream.
This process is known as "first-pass metabolism." During this metabolism, part of the drug may be deactivated or modified, which reduces the amount of active drug that reaches the systemic circulation.
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Lower absorption
Some sublingual medications are specifically formulated to be absorbed directly through the sublingual blood vessels.
If taken orally, they may not be absorbed effectively in the stomach and intestine, which decreases their effectiveness.
Delay in the onset of action
Slower action
Sublingual medications are designed to provide a rapid effect because they are absorbed directly into the blood.
If taken orally, the medication has to pass through the digestive tract and liver before taking effect, which may take longer.
Possible side effects
Incorrect dosage
In some cases, swallowing a sublingual medication may result in an inappropriate dose, either insufficient or in some rare cases, excessive, depending on how it is metabolized in the body. This could lead to a lack of therapeutic effect or to unwanted side effects.
Specific cases
Nitroglycerine
For example, sublingual nitroglycerin used to relieve chest pain in angina may not provide adequate relief if swallowed, as its rapid absorption is crucial to its effectiveness in emergency situations.
What to do if you accidentally take a sublingual medication orally?
If you took a sublingual medication orally instead of letting it dissolve under your tongue, it is important to:
- Consult a doctor : If the medication is critical for an acute condition (such as nitroglycerin for angina), consult a health care professional immediately.
- Watch for effects : If you notice that the medication is not working as it should, or if you experience any unusual side effects, contact your doctor.
It is essential to follow the instructions for administering the medication to ensure that it works properly.
Important Considerations for Sublingual Medication
- Specific medications : Some medications that are commonly given sublingually include nitroglycerin (for chest pain), certain hormones, and some medications for anxiety or acute pain.
- Side effects : As with any medication, side effects may occur. Some may include mouth irritation or pain. If you experience any adverse effects, consult your doctor.
- Storage : Keep sublingual tablets in a cool, dry place as moisture can affect their effectiveness.
This method is especially useful when quick relief is needed or when the person cannot swallow pills easily.
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Benefits of sublingual medications
The use of sublingual medications, which are placed under the tongue, offers several benefits:
Rapid absorption
Sublingual medications are absorbed directly into the bloodstream through blood vessels under the tongue, allowing for faster action than medications taken orally.
Improved efficiency
Since the drug bypasses the digestive tract or liver, it avoids first-pass metabolism, which may increase the drug's effectiveness.
Easy to use
This route is convenient for people who have difficulty swallowing pills or who need quick relief.
Less gastrointestinal side effects
By bypassing the stomach and intestines, sublingual medications can reduce gastric irritation and other digestive side effects.
Precision in dosing
It offers more precise control of dosage, since the exact amount of medication is absorbed directly into the system.
In addition to the benefits mentioned above, there are other important aspects of sublingual use of medications:
Ideal for certain types of medications
Some medications, such as those used to treat heart conditions (e.g. nitroglycerin) and certain pain relievers, are particularly effective when administered sublingually.
This is due to the need for a rapid onset of action or the need to prevent the breakdown of the drug in the digestive system.
Lower risk of enzymatic degradation
By bypassing the liver and digestive tract, sublingual medications avoid enzymatic degradation that could reduce their effectiveness.
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Predictable effect
Rapid, direct absorption through the sublingual mucosa means that drug levels in the blood can be more predictable, which is useful in situations where precise monitoring is required.
Less interindividual variability
Sublingual absorption may be less variable between different individuals compared to oral absorption, which may be affected by factors such as the state of the intestines, the presence of food in the stomach, and enzymatic activity.
Convenient in emergencies
In emergency situations where time is critical, sublingual medications may provide faster relief than other delivery methods.
Discretion and comfort
For people who need to medicate in public, sublingual administration is discreet and easy to perform without the need for water or other implements.
In summary, sublingual administration is mainly used to achieve rapid action of the drug, improve its effectiveness by avoiding breakdown in the liver, and facilitate accurate dosing.
