Note when taking the medicine under the tongue

Sublingual drugs are not a dosage form but a use. To be placed under the tongue, the medicine must be released under the tongue quickly (2-3 minutes or tens of minutes), must not have an unpleasant taste, does not irritate the oral and tongue mucosa.

There are separate dosage forms such as sublingual tablets (subligual tablets), lozenges ( oral release tablets ), but there are also those that do not have their own preparation but can still be placed under the tongue if they meet the above requirements. For example, nifedipine capsules or capsules are a form of oral medication, but when necessary, the capsules can be broken or removed, and placed under the tongue.

There are two outstanding features of this usage:

Picture 1 of Note when taking the medicine under the tongue

Need to use the medicine under the tongue properly (photo: TTO)

- There are two large veins under the tongue, small blood vessels in the mouth. Put under the tongue, the drug will be absorbed into two large veins, or the drug in the mouth will go into the small blood vessels and can be large veins, then straight into the circulatory system without being destroyed by good gastric juice enzymes in the digestive tract, not metabolized by the liver as when taken.Alphachymotrypsin, progesteron, mehtyltestosteron tablets have applied this feature.

- Drugs go directly into the circulatory system, which is effective and fast, not inferior to that of injection.

For example , in acute hypertension, if not lowering blood pressure in time, the target organs will be damaged, which can lead to death. But if using a catopril 50mg tablet under the tongue, within 15 minutes the blood pressure drops by 60mmHg. Thus, by using this method, it is possible to bring blood pressure from a dangerous high level (above 200mmHg) to an acceptable level (150-160mmHg), avoiding events.

Similarly, in coronary atherosclerosis, sometimes blood does not come and provides enough oxygen to the heart muscle, leading to ischemia, causing angina. Placing nitroglycerin tablets under the tongue, will dilate the vein immediately, relax the vein system mainly in the vein, reduce blood return to the vein, and reduce the decrease in heart pressure and coronary artery redistribution into classes lower (sensitive to ischemia) in the heart; Myocardial oxygen consumption therefore decreases, reconstitutes the balance of supply - oxygen demand, destroys angina, avoids stroke stroke events.

There are drugs on the spot effect such as nystatin tablets used to treat oral fungi, metronidazole tablets for treating gingivitis, erythromycin tablets for sore throat. When used, do not place the medicine under the tongue but only put it in the mouth, close it, do not chew, do not swallow, let the medicine self-disintegrate have a lasting effect there. Many materials do not classify these drugs under the tongue.

There are drugs that cannot be placed under the tongue like a slow-release pill (after the name of the drug usually has abbreviations LA, CR, SR) or effervescent tablets, tablets with unpleasant taste, irritation. Many documents consider them to be illegal drugs placed under the tongue.

Thus, in a narrow range, correctly speaking, the sublingual drug is a drug that is placed under the roof of the tongue to avoid adverse effects when taken orally, in order to have a quick effect (as mentioned above).

How to use: Shrink tongue on upper palate. Put the medicine under, then lower the tongue. If the tablet is large, dry, difficult to absorb, it can be absorbed first, or a little boiled water is allowed to cool, wait for the tablet to absorb enough water (but not disintegrate), then swallow the water, then leave the tablet drugs that dissolve under the tongue.

If you do not work well, moisten the medicine too much or suck in too much water, let it stay for too long, the medicine will disintegrate.

Using the medicine under the tongue is not difficult, but it is necessary to practice it when you need to be able to use it on your own.

DS. BUI VAN UY