Table 2. Profile of Analgesics Administered via the Sublingual Route.
| Drug | Available products | Pharmacokinetics | Equivalent dose to 15 mg of oral morphine | Adverse effectsa |
|---|---|---|---|---|
| Fentanyl [81-85] | Spray: available in 100, 200, 400, 600, 800, 1,200, and 1,600 µg strengths | Bioavailability: 70-76% | 100 µg | No AE specific to the sublingual route |
| Onset of action: 5 - 15 min | ||||
| Tablet: available in 100, 200, 300, 400, 600, and 800 µg strengths | Peak effect: about 60 min | |||
| Duration of action: about 180 min | ||||
| Sufentanil [72-77] | Tablet: available in 30 µg strengths | Bioavailability: 47-57% | 30 µg | No AE specific to the sublingual route |
| Onset of action: 15 - 30 min | ||||
| Peak effect: 40 - 75 min | ||||
| Duration of action: at least 60 min | ||||
| Buprenorphine [86, 88-90, 91] | Tablet: available in 2 and 8 mg strengths | Bioavailability: 12-94% | 0.4 mg | No AE specific to the sublingual route |
| Onset of action: 30 - 60 min | ||||
| Peak effect: 60 - 240 min | ||||
| Duration of action: 6 - 12 h (for doses < 4 mg) and 24 - 72 h (for > 16 mg) | ||||
| Oxycodone [92, 93] | 5, 10 mg soluble tablets, 20 mg/mL concentrated oral solutionsb | Bioavailability: < 20% | 10 mg | No AE specific to the sublingual route |
| Onset of action: N/A | ||||
| Peak effect: N/A | ||||
| Duration of action: N/A |
aAdverse events due to local effect of medication, medication-specific systemic adverse events not included. bNo sublingual formulations are available in the United States. AE: adverse events. N/A: limited information on the pharmacokinetics of sublingual oxycodone.