Table 1.

Medications that have been observed with advantages of one route over the other route

Medications	Priority	Main reasons
Trastuzumab	SC > IV	Higher patient preference in addition to comparable efficacy and safety profile10–12
Rituximab	SC > IV	Reduced active health care professional time, declined total mean staff costs, as well as reduced patient time in the treatment room15
Anti-TNF medications	SC > IV	Higher patient preference (SC anti-TNF agents versus IV anti-TNF agents) and superior efficacy (SC golimumab versus IV golimumab)17–19
Bortezomib	SC > IV	Lower incidence of neuropathy in the treatment of multiple myeloma, more time efficient for the patient and institution, and higher patient preference20,22
Amifostine	SC > IV	Significantly lower acute toxicity (hypotension, skin rash, and local pain)27–29
rhGM-CSF	SC > IV	IV dose of rhGM-CSF was less potent at inducing a leukocytosis than equivalent SC doses and was associated with a higher incidence of generalized rash and first-dose reactions30,31
G-CSF	SC > IV	Shorter time to neutropenia resolution and lower dose in alleviating neutropenia with SC G-CSF compared with IV G-CSF32,33
Recombinant human interleukin-2	SC > IV	More patients with metastatic renal cell carcinoma experience stable disease, and fewer patients undergo disease progression and lower clinical and hematologic toxicity35,36
Immunoglobulin	SC > IV	Pharmacoeconomic advantages37–40
Epoetin alfa	SC > IV	Substantially reduced costs of epoetin due to dose saving in hemodialysis patients48,50–54
Heparin	SC > IV	Significantly less discomfort at the injection site, better mobility and patients’ overall preference, and more cost-effectiveness compared with IV heparin therapy55,56
Opioids	SC > IV	Regarding major adverse events, adjusted odds ratio (95% confidence intervals) in IV and SC group relative to the oral group was 6.10 (4.43–8.39) and 2.07 (1.48–2.89), respectively
Vitamin K1	IV > SC	Compared with SC vitamin K1, IV vitamin K1 caused a more prompt reduction in the INR. For patients excessively anticoagulated with warfarin, small doses of SC vitamin K1 may not correct the INR as rapidly or as effectively as when administered IV59,60
Abatacept	IV > SC	Among patients with rheumatoid arthritis who receive SC abatacept after the switch from IV administration, SC abatacept shows a risk of relapse in 27% of cases, and return to the IV administration quickly reinstates disease control6
Insulin	SC > IV	Compared with the traditional continuous IV infusion method, continuous SC insulin infusion using an insulin pump can achieve better glycemic control and significantly lower daily insulin requirements among patients in medical intensive care unit44
Insulin	IV > SC	IV insulin could achieve glycemic target for more time in noncritically ill patients with parenteral nutrition-associated hyperglycemia than those on the SC regimen.45 Compared with sliding-scale-guided intermittent SC insulin injections, continuous IV insulin infusion induced a significant reduction in perioperative blood glucose levels and the incidence of deep sternal wound infection in diabetic patients after cardiac surgical procedures46
Ketamine	IV > SC	For postoperative analgesia following a dose of 0.5 mg/kg, IV route provides analgesia for 24 hours after surgery without significant side effects, whereas SC ketamine only controls analgesia within the first 6 hours after surgery57
Ketamine	SC > IV	For dissociative conscious sedation following a dose of 0.6 mg/kg, SC ketamine was as effective as, but safer than, IV ketamine (a significantly lower rise in systolic blood pressure and rate-pressure product)58
Epinephrine	IM > IV	Lower occurrence rate of adverse cardiovascular events and overdose65
Hepatitis B immunoglobulin	IM > IV	Lower costs, significantly better HRQOL scores on the flexibility, and negative feelings scales in patients on IM HBIG compared with patients on IV HBIG66–68
Pegasparaginase	IM > IV	Lower occurrence rate of allergic reactions and a significantly less rapid onset of allergic reactions70,71
Antibiotics	IM > IV	IV group has significantly greater costs of the mean total drug therapy compared with the IM group72,73
Ketamine	IV > IM	Sedation was longer in the IM group, whereas IV group experienced shorter time from drug administration to patient discharge77,78
Morphine	IV > IM	IV infusion gave better pain relief and significantly faster onset of analgesic effect than the IM injections80–82
Antivenom	IV > IM	The proportion pain-free at 24 hours in the IV group was better compared with the IM group; antivenom could not be detected in serum following IM administration83,84
Epinephrine	IM > SC	IM epinephrine can achieve Cmax significantly faster compared with SC epinephrine85
Interferon-beta-1a	SC > IM	Higher efficacy in preventing relapses among patients with relapsing multiple sclerosis, and faster and more pronounced effects in decreasing new cortical lesions development and cortical atrophy progression90,91
Methotrexate	SC > IM	Self-administration could reduce hospital visits and improve patient satisfaction95
hCG	SC > IM	SC administration achieves higher hCG level in serum and follicular fluid, as well as less patient inconvenience compared with IM group97,98
Hepatitis B immunoglobulin	SC > IM	Higher patient preference due to effectively maintaining anti-HBs levels while substantially reducing patient discomfort and improving patient satisfaction99,100
Hydrocortisone	SC > IM	Higher patient preference102
Morphine	SC > IM	Postoperative analgesia by SC morphine bolus injection is as effective as IM injection with a similar side-effect profile but with greater patient acceptance and less risk103

Abbreviations: SC, subcutaneous; IV, intravenous; TNF, tumor necrosis factor; rhGM-CSF, recombinant human granulocyte-macrophage colony-stimulating factor; G-CSF, granulocyte colony-stimulating factor; INR, international normalized ratio; IM, intramuscular; HRQOL, health-related quality of life; HBIG, hepatitis B immunoglobulin; hCG, human chorionic gonadotropin.