Three versions of the well-known painkiller Dafalgan are currently available: tablets that you have to dissolve in water, pills that you simply have to swallow and lozenges that you can take without water.
Are they absorbed by the body in different ways and which way works the fastest / most effectively? For example, I’ve read that alcohol can also enter the bloodstream through the palate. Can Dafalgan lozenges be absorbed in this way?
Answer
The speed of appearance of a painkiller in the blood, here paracetamol, partly depends on the route of administration (injection faster than oral administration than administration with suppo/suppository). Strangely enough, we do not yet fully know how paracetamol works (already > 100 years on the market), but the analgesic effect depends on the paracetamol concentration in the brain. This means that a ‘blood’ concentration does not tell you everything about the pain-relieving effect.
When we limit ourselves to ‘oral’ administrations, paracetamol has to reach the first part of the small intestine in dissolved form ‘as quickly as possible’ because it is there that it is absorbed from the intestine into the bloodstream. That is why ‘powders’ are more effective than ‘small hard tablets’ and that is why paracetamol is mainly sold as an effervescent tablet. If the drinking solution is also somewhat basic (pH > 7), this also promotes gastric emptying, which in turn results in faster availability.
A melting tablet held in the mouth is therefore not a good option for paracetamol, but it is for other types of drugs, and in general terms ‘sublingual’ administration results in rapid absorption of the drug into the bloodstream. The paracetamol of a melting tablet must also pass through the stomach to the small intestine before resorption occurs.
Regards,
Karel Allegaert
Answered by
prof dr karel allegaert
neonatology clinical pharmacology in children
Old Market 13 3000 Leuven
https://www.kuleuven.be/
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