A troche is a lozenge designed to deliver medications directly to the mucus membranes of the mouth by dissolving slowly when placed between the tongue and gums. A number of medications, including over-the-counter drugs, can be delivered this way. While placed in the mouth, these lozenges are not designed to be swallowed. They may be flavored to make taking the medication more pleasant.
The term for this form of medication delivery is derived from the Greek word for “wheel,” and troches are traditionally round in shape. The size of the medication can vary, depending on what is being delivered. This form of delivery is used when medications cannot be ingested because the digestive juices will damage or compromise the medication. An alternative might be a medication rubbed on the mucus membranes of the mouth, or a transdermal patch applied to the skin.
As the troche breaks down, the drug seeps through the porous mucus membranes in the mouth and rapidly enters the bloodstream. This allows for extremely rapid delivery of medications, which can be useful with medications like analgesic drugs. The blood levels of the drug will rise rapidly and then stabilize. Depending on the medication, doses can be repeated at varying levels to keep the level as stable as possible.
Several medications come packaged in this format and can be ordered this way by request. In other cases, a compounding pharmacy may need to make up the medication by order. Not all pharmacies offer this service, and patients with unique prescription needs may want to call around to find one that will meet their needs. There may also be a longer lead time when it comes to filling prescriptions that need to be compounded, something people should consider when submitting prescriptions to be filled.
When taking a troche, patients are generally advised to tuck the medication under the tongue or between the cheek and gums to allow it to dissolve slowly. It is important to avoid chewing the lozenge and to wait to eat or drink until it has completely dissolved, to keep the medication out of the digestive tract. Since timing doses carefully is often needed to keep levels of medication in the blood stable, patients should set up a schedule that will be easy to adhere to in order to avoid missing doses or taking them late.