A troche is a specialized medication designed for absorption through the oral lining, not the digestive system. These small, dissolvable tablets are held in the mouth, allowing active ingredients to enter the bloodstream directly. Swallowing a troche can alter its effectiveness. This article explains what a troche is, how it’s used, the effects of swallowing one, and steps to take if it happens.
What a Troche Is and How It’s Meant to Be Used
A troche is a small, flavored lozenge or tablet designed to dissolve slowly in the mouth, often placed under the tongue (sublingually) or between the cheek and gum (buccally). This allows medication to be absorbed directly into the bloodstream through the oral mucosa. Troches generally take 15 to 30 minutes to fully dissolve.
This delivery method bypasses the digestive system and the liver’s initial processing. When absorbed directly from the mouth, medication avoids first-pass metabolism. This ensures a higher concentration of the active drug reaches systemic circulation, allowing it to exert its intended effects more efficiently.
The Effects of Swallowing a Troche
When a troche is swallowed, the medication enters the gastrointestinal tract, where it is subjected to digestive acids and enzymes. From there, it travels to the liver via the hepatic portal vein. In the liver, many drugs undergo first-pass metabolism, where enzymes break down a significant portion of the drug before it can reach general circulation.
This process leads to reduced bioavailability, meaning a smaller amount of the active drug enters the bloodstream in its intended form. Consequently, the medication’s effectiveness may be significantly diminished or absent. The onset of action might also be delayed or entirely prevented.
While reduced efficacy is the primary concern, some individuals might experience gastrointestinal upset, such as nausea or stomach discomfort, depending on the specific medication. However, for most medications, swallowing a single troche is not considered dangerous or life-threatening. The main issue is that the medication may not work as intended.
Steps to Take After Swallowing a Troche
If you accidentally swallow a troche, remain calm. Do not immediately take another troche or adjust your dosage without professional guidance, as this could lead to an incorrect dose or other complications. The medication you swallowed may still have some effect, even if reduced.
Contact your pharmacist or healthcare provider for specific advice. They can provide guidance based on the medication type, your health circumstances, and the drug’s typical effects when swallowed. They may advise you to monitor for any unusual symptoms or side effects, although severe reactions are uncommon.
To prevent future accidental ingestion, always store medications safely and follow instructions from your healthcare provider or pharmacist. Properly dissolving the troche in your mouth as directed ensures you receive the intended dose and maximizes the medication’s benefits.