Dosage Forms and Routes of Administration

Tablets

A compressed powder is administered orally (swallowed)

Sublingual or orally dissolving tablets (ODTs)

A compressed powder tablet is placed under the tongue and left to dissolve (NOT swallowed)

Capsules

A powder or liquid within a gelatin coating (capsules) is administered orally (swallowed)

Solutions

Medication is dissolved in a water-based liquid and administered orally (swallowed)

Suspensions

Medication is suspended in a liquid (NOT dissolved) and must be shaken before use to get an accurate dose. It is administered orally (swallowed).

Transdermal patches

A patch is placed on the skin, and medication diffuses through the patch and the skin and into the bloodstream.

Suppositories

Medication is incorporated into a waxy solid capsule that dissolves when exposed to body temperature. Can be inserted into the rectum, vagina, or urethra.

Ointments

Oily semisolid preparations containing medication. They are applied topically.

Creams

Water-based semisolid preparations containing medication. They are applied topically.

Inhalations

Medication is either dissolved in a liquid and sprayed into the mouth (metered-dose inhalers), or the medication is compressed into powder particles and inhaled (dry powder inhalers / DPIs).

Injections

Medication is dissolved in a sterile (no bacteria), water-based liquid and can be injected into the body.

Subcutaneous (SC, SubQ)

These medications are injected under the skin (“sub” means under, and “cutaneous” means skin). The skin near the injection site is pinched, and a needle is inserted into the fatty tissue beneath the skin. Most self-administered injectables, such as insulin, are administered subcutaneously.

Intramuscular (IM)

These medications are injected into the muscle. The advantages of IM administration are that larger volumes of medication can be administered and longer acting formulations can be used. Most IM injections are administered into the deltoid muscle of the upper arm, but some are injected into the buttocks.

Intravenous (IV)

These medications are injected directly into a vein. IV is the quickest way to get medication through your system, but administration requires medical training and is usually limited to hospital settings.

Intrathecal (IT)

This means injecting a medication directly into the space around the spinal cord. This route of administration is rare and dangerous and is generally reserved for chemotherapy medications, such as methotrexate.

Otic (ear) drops

These medications are manufactured in a clean environment, but they do not necessarily need to be sterile. For this reason, it is permissible to use an ophthalmic drop in the ear, but it is NOT permissible to use an otic drop in the eye.

Examples: Ciprodex, ofloxacin, Cortisporin (polymyxin, neomycin, hydrocortisone)

Ophthalmic (eye) drops

These medications must be sterilized during manufacturing because the eye is an environment that is free of bacteria.

Metered-dose inhalers (MDIs)

These medications contain a drug solution within a canister. When the patient presses down on the canister, a propellant (e.g., hydrofluoroalkane [HFA]) helps spray a set amount of drug solution into the patient’s mouth to be inhaled. Examples of MDIs include ProAir HFA, Ventolin HFA, Proventil HFA, Flovent HFA, Atrovent HFA, Advair HFA, and QVAR RediHaler.

Dry powder inhalers (DPIs)

These medications contain a drug within small granules of powder. Before inhaling, the patient must prep the device. Then, the patient must inhale deeply to draw the powder into their lungs. Examples of DPIs include Advair Diskus, Spiriva HandiHaler, and Symbicort Turbuhaler.

Nebulizer solutions

These are small vials/ampoules of drug solution that are designed to be inserted into a nebulizer machine. Nebulizers aerosolize the solution into small particles that can be inhaled into the lungs more quickly and efficiently than with inhalers. Examples include albuterol sulfate nebulization solution 2.5 mg/3 mL, sodium chloride inhalation solution, and tobramycin inhalation solution.

Non-refrigerated medications

These can be stored at room temperature which is defined as 20°C to 25°C or 59°F to 77°F. This includes most tablets, capsules, liquid solutions, creams, inhalers, and patches.

Refrigerated medications

These can be stored in the refrigerator between 2°C and 8°C, or 36°F and 46°F. Medications that usually require refrigeration include injectables, vaccines, and antibiotic suspensions.

Controlled medications

These medications are kept in a locked cupboard, but not all states require them to be locked away.

Hazardous drugs

These drugs should be kept separately from regular pharmacy stock. Examples include chemotherapy agents, including methotrexate. Pharmacy personnel who are handling these types of drugs should wear gloves. For some of these drugs, two layers of gloves (double gloving) are recommended. A separate counting tray should be used to count these drugs.

Hazardous waste

These should be stored separately from the rest of the pharmacy stock. They include expired medications, recalled medications, damaged products, and incorrectly compounded products. These products should be put in designated bins and labeled as hazardous.