Administration route | Advantages | Limitations |
---|---|---|
Intravenous | Likely effective (clinical evidence) Likely rapid onset of action (clinical evidence) Precise control of the administered dose Avoidance of first-pass hepatic metabolism | Subject to blood-brain barrier Requirement for hospitalisation Requirement for medically-trained staff Hard to establish during seizures Not for at-home use |
Intramuscular | Likely favourable pharmacokinetics Avoidance of first-pass hepatic metabolism | Subject to blood-brain barrier Requirement for training or medical staff Needle/syringe misuse by non-trained caregivers Less suitable for at-home use Soft tissue or nerve damage risk Infection risk Painful |
Transdermal | Painless Easy to use Suitable for home No requirement for medical training Avoidance of first-pass hepatic metabolism | Subject to blood-brain barrier Slow release not suitable for emergency |
Buccal | Painless Ease to administer Suitable for home No requirement for medical training Avoidance of first-pass hepatic metabolism | Subject to blood-brain barrier Potentially unfavourable pharmacokinetics Delivery of limited drug amount If swallowed, functions as oral Dog’s compliance is needed Incorrect administration during seizures |
Sublingual | Similar to buccal | Similar to buccal |
Oral | Painless Easy to use No requirement for medical training Suitable for home | Subject to blood-brain barrier Potentially unfavourable pharmacokinetics Slow absorption not suitable for emergency Potential for gastrointestinal degradation Subject to first-pass hepatic metabolism Dog’s compliance is needed |
Rectal | Minimal pain/discomfort Relatively easy to use No requirement for medical training Suitable for home | Subject to blood-brain barrier Variability in effectiveness (clinical evidence) Variability in pharmacokinetics Partially subject to first-pass hepatic metabolism Likely slow onset of action Socially unacceptable |
Intranasal | Likely effective (clinical evidence) Likely rapid onset of action (clinical evidence) Likely favourable pharmacokinetics Avoidance of first-pass hepatic metabolism Avoidance of blood-brain barrier No requirement for medical training Relatively easy to use Painless Suitable for home | Need for high concentration drug Potentially affected by mucosal factors Potentially affected by drug formulation Need for a veterinary nasal device |