Which of the following is a primary advantage of buccal/sublingual tablets?

• A. Lipid soluble drugs rapidly absorbed (nitroglycerin)
• B. No first-pass effect (straight to blood)
• C. Very slow absorption
• D. Mouth pH neutral

Answer: (B)

Bypassing hepatic first-pass metabolism is the main advantage of buccal and sublingual tablets. These routes deliver the drug directly into the systemic circulation through the highly vascular oral mucosa, so more of the dose reaches the bloodstream intact and the onset of action is rapid. This is why sublingual nitroglycerin is used for quick relief, since it avoids liver metabolism that would reduce the dose if swallowed. Very slow absorption and mouth pH neutrality aren’t defining benefits of this route, and while lipophilicity can aid absorption, the key benefit is avoiding first-pass metabolism and achieving faster, more reliable systemic availability.