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Commercial products which deliver drugs either buccally or sublingually are available for lorazepam for anxiety and insomnia, nicotine for smoking cessation and ergotamine for migraine treatment. The buccal route has been tried with variable degrees of success for several other drugs, including metronidazole, metoclopramide, phenazocine, propranolol, timolol, salbutamol, fenoterol and insulin. Calcium channel blockers (nifedipine, verapamil) both produce effects similar to oral doses when administered sublingually or buccally71 72. The buccal route has also been explored for the delivery of peptides since the mucosa is reported to lack surface-bound peptidases, and preliminary work in dogs demonstrated significant absorption of a hydrophobic lauroyl derivative of a tripeptide35. Thyrotropin-releasing hormone, vasopressin analogues and insulin have been investigated as potential candidates for buccal and sublingual drug delivery. Oxytocin can be delivered by the buccal route, but this is now not often used since absorption was variable, and it was of real benefit only when the cervix was already ripe73. Its use was therefore largely abandoned in favour of the intravenous route. Most research groups are concentrating on using the nasal route to deliver peptides since it is more permeable than the oral cavity74.

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