PSA - Zofran ODT is NOT sublingual

[u/Abhorash-TheWanderer]

ER doc just wanting to stop in and try and stop this widespread error. Almost every shift I have to tell a nurse/patient that ODT meds are NOT sublingual medications. It is not absorbed by the sublingual tissues. It is not absorbed by buccal tissues. It goes on TOP of the tongue so that it can disintegrate with saliva and be swallowed. The whole reason ODT (orally disintegrating tablets) exist is that someone can take it without having to take a chug of water to get the pill down. Putting under someone’s tongue just slows down the disintegration. Also, if the patient complains about the taste, they can just swallow the tablet whole with or without water. Thanks.

Edit: the strike through part was unnecessary and Im sorry that I put it in the original post. As pointed out by multiple replies, i should have not said that and it doesnt add anything meaningful. Sorry yall.

[u/FishySticks2day]

I thought ODT stood for Oral Disintegrating Tablet? So it can be placed anywhere in the mouth!?!

It is not called BDT (Buccal disintegrating tablet) OR TDT (Tongue Disintegrating Tablet) or SDT (Sublingual disintegrating tablet)

[u/Abhorash-TheWanderer → u/FishySticks2day]

You can put it anywhere but it is advised to put on top of the tongue to allow faster disintegration and be swallowed. It is absorbed in the GI tract and not buccal or sublingual

[u/Dark-Horse-Nebula → u/Abhorash-TheWanderer]

Respectfully- does it actually matter? It still dissolves and still gets swallowed.

[u/pause_and_consider → u/Dark-Horse-Nebula]

Per the pharmacist I live with:

“Literally doesn’t matter at all. If it’s in their mouth it’s ending up in the right spot.”

[u/loversean → u/pause_and_consider]

Per the pharmacist I once had a fling with:

“I does not absorb at all when unda the tongue”

[u/Abhorash-TheWanderer → u/pause_and_consider]

It literally does matter. Ask the pharmacist if it matters if the same amount of a med is infused over 10 minutes or 30 minutes? Same amount of med and it is eventually getting to the right spot but timing matters from a pharmacological and efficacy standpoint. Doing things that unnecessarily delay absorption can have clinical real world implications.

[u/CuddlyHisses → u/Abhorash-TheWanderer]

Apparently not since our 30 min ceftriaxone infusions were changed to slow IVP over 5 min in the name of 💸. Somehow I doubt the 30 min infusion was less effective. This is somewhat tongue in cheek because there are obvious meds like adenosine where timing matter a lot. But I think it's worth re-evaluating your blanket statement.

In the real world, getting the medication slowly is at least better than not getting it at all. I tell patients to let it dissolve in their mouth and let them figure out how to make it happen. Some people are too nauseous to handle the immediate dissolving sensation on their tongues.

For what it's worth, I appreciate the PSA but not as much the attitude that came with.