ODT/RDT vs. Troche: Maximizing Oral Drug Absorption

In the world of pharmaceuticals, the quest for effective drug delivery methods is a never-ending endeavor. When it comes to oral administration, two innovative approaches have gained attention for their ability to enhance drug absorption: Orally Disintegrating Tablets (ODT) and Rapidly Dissolving Tablets (RDT) versus Troches. These methods offer distinct advantages and can make a significant difference in the bioavailability of certain drugs, particularly those seeking to bypass gastrointestinal (GI) metabolism, such as ketamine.

This article explores the differences between ODT/RDT and Troches and their implications for optimizing oral drug absorption.

Orally Disintegrating Tablets (ODT) and Rapidly Dissolving Tablets (RDT)

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Ketamine Rapidly Dissolving Tablets (RDTs)

Orally Disintegrating Tablets (ODTs) and Rapidly Dissolving Tablets (RDTs) are designed to disintegrate quickly in the mouth, often within seconds, without the need for water. They offer several advantages, including convenience and improved patient compliance, making them particularly useful for pediatric and geriatric populations. These tablets disintegrate when they come into contact with saliva, and the drug is then held in the mouth for oral absorption or swallowed for intestinal absorption.

Advantages of ODT/RDT:

1. Quick absorption: ODTs and RDTs disintegrate rapidly, allowing for fast absorption of the drug, which can be ideal for medications that require quick onset of action.

2. Improved patient compliance: The ease of administration and the avoidance of swallowing large pills with water can improve patient adherence to medication regimens.

3. Suitable for drugs with low bioavailability: For drugs that are poorly absorbed in the GI tract, ODTs and RDTs can help bypass first-pass metabolism, improving overall bioavailability.

Drawbacks of ODT/RDT:

1. Limited control over absorption: The quick disintegration may not be ideal for drugs that require slower, controlled absorption to achieve therapeutic effects.

2. Accumulation of saliva and missed oral mucosa absorption: With ODTs and RDTs, patients often accumulate saliva in the mouth before swallowing, which can lead to the unintended swallowing of the drug. This can reduce the drug's contact time with the oral mucosa, potentially diminishing its absorption in this area.

Troches

Ketamine troches

A troche, also known as a lozenge or buccal tablet, is a solid dosage form that is meant to be held in the mouth and allowed to dissolve slowly. Unlike ODTs and RDTs, troches do not disintegrate as rapidly and are more akin to a candy or lozenge in terms of administration.

Advantages of Troches:

1. Controlled absorption: Troches allow for a slower, more controlled release of the drug. This controlled absorption is particularly valuable for medications that require sustained release or prefer to avoid rapid spikes in plasma concentrations.

2. Localized drug action: Troches are especially suitable for drugs that need to act locally in the mouth or throat, as they keep the drug in contact with the affected area.

3. Bypassing GI metabolism: For drugs like ketamine that are susceptible to GI metabolism, troches offer the advantage of absorption in the oral mucosa, allowing for a higher bioavailability and avoiding the first-pass effect.

Drawbacks of Troches:

1. Slower onset of action: Due to the slower dissolution and absorption process, troches may have a delayed onset of action compared to ODTs or RDTs.

2. Potential for limited patient compliance: Some patients may find the extended dissolution time less convenient, and troches may not be suitable for individuals who have difficulty holding them in their mouths for an extended period.

3. Refrigeration: Troches are heat sensitive and require refrigeration and shipment on ice to protect the product.

Conclusion

The choice between ODT/RDT and troches depends on various factors, including the specific drug's properties, desired pharmacokinetics, and patient preferences. ODTs and RDTs offer the advantage of quick absorption and improved compliance, making them suitable for certain medications. In contrast, troches provide a controlled release and an effective way to bypass GI metabolism, making them ideal for drugs that benefit from localized action or sustained release. Remember, troches and Rapid Dissolve Tablets (RDTs) are both produced by compounding pharmacies, which means that they are subject to the individual protocols and practices of each pharmacy. As a result, there can be variability in the formulation, potency, and overall quality of these medications, depending on the specific compounding process used by the pharmacy. Anecdotally, patients tend to tolerate RDTs better and often find them more potent than troches.

For drugs like ketamine, which are rapidly active by bypass of GI metabolism to achieve therapeutic effects, troches may be a preferable choice due to their ability to maintain drug contact in the oral mucosa for an extended period. Ultimately, the selection of the appropriate dosage form is a crucial consideration for optimizing oral drug absorption and achieving the desired therapeutic outcomes with ketamine.

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Discreet Ketamine provides ketamine therapy for at-home treatment to Florida residents.

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