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Administration Methods
The speed of onset and duration of action for any opioid depend on the specific drug chosen and its formulation (tablet, elixir, etc.). Most are well absorbed after oral or rectal administration, yet absorption may not be complete. Further, drugs absorbed from the gut are subject to first-pass metabolism in the liver and, hence, should be given at higher doses than when given parenterally. Although dosage requirements for different parenteral routes (intravenous, subcutaneous, and intramuscular) are comparable or equivalent, the onset of drug action is typically most rapid after intravenous dosing because there is no delay in absorption. Therefore, drug dose and frequency should be titrated to the individual patient's response and analgesic needs when changing the route of administration or the type of formulation.
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