What is a Troche ?

A troche is a small lozenge designed to dissolve between a person’s cheek and gum over a period of time; typically 30 minutes.

A troche is a small, hard tablet designed to dissolve slowly over 30 minutes or so when placed under the tongue, much like a long-lasting cough drop. Just like a standard pill it contains active medicinal ingredients. However the key difference between a troche and a standard pill is the way they’re processed by the body.

Medicines introduced into the body via a troche largely bypass the digestive system and instead deliver their active ingredients directly into the blood stream. Standard pills on the other hand head straight to the gut where they’re metabolized by digestive acids before heading to the liver where they’re processed further.

PDE5 Troches are growing very popular and can also be easily cut into halves because Troches are a semi-solid dosage form. Sildenafil, Tadafil and Vardanfil Troches are commonly prepared by our compounding pharmacy and are also are being combined with Oxytocin, also available through our compounding are the following formulations: Sildenafil 100mg/Oxytocin 125ius Troches as well as Tadafil 20mg/Oxytocin 50ius.

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. While placed in the mouth, these lozenges are not designed to be swallowed. They may be flavored to make taking the medication more pleasant.

Medicinal troches enter the blood stream thanks to the numerous blood vessels located very close to the surface of the skin in the tissue directly under the tongue and in the walls of the cheek.  The only other places on the body where the blood vessels are this close to the surface of the skin is the vagina and the rectum – however it’s not hard to figure out that troches under the tongue are much easier to administer!

It’s also not hard to figure out that not all of a troche’s active medicinal ingredients go directly into the blood stream. Some of it is swallowed as saliva and then enters the digestive system via the gut. Some report that the amount swallowed is as high as 50%, while others believe it is much lower. Whatever the correct percentage we know that at least half the medicine enters the blood stream which is still a significant amount.

As the troche dissolves in the patient’s mouth, the medication is absorbed through the oral mucosa and gradually  absorbs into the blood stream. Troches are commonly used to administer bioidentical hormones in a patient, and can be flavored to mask bitterness, if needed. Some of our most popular flavors are tangerine, vanilla, and peppermint.

What is the benefits of Troches ?

Better absorption
When used in hormone replacement therapy, the hormones in a slowly dissolving troche are absorbed more gradually into the blood stream, resulting in physiologically natural hormone blood levels.

Problems swallowing pills
For individuals who have difficulty swallowing pills or capsules, compounding medication into a troche is an excellent alternative to receiving your medication orally.

Difficulty with creams
Since skin types can have extreme variations in thickness, water content, and fat content, the absorption of medicated creams and lotions through a person’s skin can be very unpredictable, especially at menopause. Placing medication into a troche is a superb alternate option.

Alternative to suppositories
Vaginal suppositories can be an effective option for medication delivery in hormone replacement, especially when the hormone is meant to be exposed directly to the tissue of the vaginal wall,  but there is little convenience to utilizing these over medicated troches when the goal end result is higher levels of hormones throughout the body.

Medicines in the form of a swallowed pill head straight to the gut where they’re processed by digestive acids. In most cases this is fine, however some medications, in particular some hormones used in bioidentical hormone replacement therapy (BHRT), do not maintain their efficacy when they come into contact with digestive acids.

The stomach is not the natural home of hormones – they belong in the circulatory system. This is why some medical practitioners specialising in BHRT prefer troches.

Some believe that troches are also kinder on the liver. Everything that goes into the gut ends up being processed by the liver and some medicines are harsh on this hard-working organ.

This makes troches a more liver-friendly option for those with liver conditions. It should be pointed out that even medicines absorbed into the blood stream still end up in the liver however by the time this happens they have undergone more thorough processing than that conducted by the digestive system.

People who have irritable bowel syndrome often have sensitive guts that can be adversely affected by some harsh medicines. Troches may help in these cases by reducing the amount of medicine entering the digestive system.

Elderly people who have difficulty swallowing also benefit from having their medication administered via a troche rather than numerous pills.

Some downsides to using vaginal suppositories include exposure to a partner during intercourse, lost medication from leaking, and lack of higher dosages.

Due to the many advantages in convenience, effectiveness, and consistency, we recommend troches as an alternative delivery system for hormone replacement therapy for both women and men.

How to Take a Troche?

Place troche in mouth and gently push the troche as deep as it will go between the gum and cheek. The troche should stick to the gum or cheek. Do not swallow or chew the troche. It usually takes between 15-30 minutes for the troche to dissolve.

What’s the Difference Between Sildenafil and Tadalafil?

Both Erectile Dysfunction medications are taken as needed for sexual activity and work within 30-60 minutes after taking. However, the difference between the two is how long the medication works in your body. Sildenafil lasts up to 4-6 hours and Tadalafil can last up to 36 hours in your system.


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