Route Bioavailability Advantages Disadvantages Examples

Parenteral Routes
Intravenous Complete (100%) Drug is given for immediate Increased chance for adverse (sodium bicarbonate)
bolus (IV) systemic drug effect. reaction. Possible Sellymin
absorption. anaphylaxis.
Rate of bioavailability (verapamil HCl)
considered Calan
instantaneous.

Intravenous Complete (100%) Plasma drug levels more Requires skills insertion of (meperidine HCl)
infusion (IV inf) systemic drug precisely controlled. infusion set. Demerol
absorption. May inject large fluid. Tissue damage at site of
Rate of drug absorption May use drugs with poor lipid injection (infiltration, necrosis (amikacin) Amikin
controlled by infusion solubility and/or irritating or sterile abscess).
rate. drugs.

Subcutaneous Prompt from aqueous Generally, used for insulin Rate of drug absorption (naloxone HCl)
injection (SC) solution. Slow absorption injection. depends on blood flow and Narcan
from repository injection volume. Insulin
formulations. formulation can vary from (nalbuphine HCl)
short to intermediate and long Nubain
acting.

Intradermal Drug injected into Often used for allergy and Some discomfort at site of (tuberculin purified
injection surface area (dermal) of other diagnostic tests, such as injection. protein) Tubersol
skin. tuberculosis. (leuprolide) Eligard

Intramuscular Rapid from aqueous Easier to inject than Irritating drugs may be very (metoclopramide
injection (IM) solution. Slow absorption intravenous injection. Larger painful. Different rates of monohydrochloride)
from non aqueous (oil) volumes may be used absorption depending on Reglan
solutions. compared to subcutaneous muscle group injected and
solutions. blood flow. (morphine sulfate)
Astramorph
Intra arterial 100% of solution is Used in chemotherapy to Drug may also distribute to (floxuridine) FUDR
injection absorbed. target drug organ. other tissues and organs in
the body.

Intrathecal 100% of solution is Drug is directly injected into (methotrexate) Rasuvo

injection absorbed. CSF for uptake into brain. (cytarabine) Cytosar-U

Intraperitoneal In laboratory animals, Used more in small laboratory Drug absorption via
injection (eg, rat) drug absorption animals. Less common mesenteric veins to liver, may
resembles oral injection in humans. Used for have some hepatic clearance
absorption. renally impaired patients on prior to systemic absorption.
peritoneal dialysis who
develop peritonitis.

Enteral Routes
Buccal or Rapid absorption from No first-pass effects. Buccal Some drugs may be (clotrimazole) Mycelex
Sublingual (SL) lipid soluble drugs. route may be formulated for swallowed. Not for most drugs Troche
local prolonged action. Eg, or drugs with high doses. (lorazepam) Ativan
adhere to the buccal mucosa
with some antifungal. Buccal
 is different from sublingual
which is usually placed under
tongue.

Oral (PO) Absorption may vary. Safest and easiest route of Some drugs may have erratic (omeprazole) Prilosec
Generally, slower drug administration. May use absorption, be unstable in the
absorption rate immediate-release and GI tract, or be metabolized by (amphetamine)
compared to IV bolus or modified-release drug liver prior to systemic Adderal XR
IM injection. products. absorption.

Enteral Routes
Rectal (PR) Absorption may be vary Useful when patient cannot Absorption may be erratic. (bisacodyl) Dulcolax
from suppository. swallow medication, used for Suppository may migrate to
More reliable absorption local and systemic effects. different position. Some (hydromorphone)
from enema (solution). patient discomfort. Dilaudid

Other Routes
Transdermal Slow absorption, rate Transdermal delivery system Some irritation by patch or (clonidine) Catapres-
may vary. Increased (patch) is easy to use. Used drug. Permeability of skin TTS
absorption with occlusive for lipid-soluble drugs with low variable with condition,
dressing. dose and low MW. anatomic site, age and (fentanyl) Durogesic
gender. Type of cream or
ointment base affects drug
release and absorption.

Inhalational and Rapid absorption. Total
Intranasal dose absorbed is
variable.
May be used for local or Particle size of drug (ipratropium bromide)
systemic effects. determines anatomic Atrovent
placement in respiratory tract.
May stimulate cough reflex. (budesonide)
Some drug may be Rhinocort
swallowed.

Common Routes of Drug Administration

Reference: Applied Biopharmaceutics and Pharmacokinetics by Shargel and Yu