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Advantage: Potential for higher bioavailability than standard oral ingestion Challenge: Peptides are poorly absorbed through intact mucosal membranes without transport mechanisms Evidence: No studies confirm enhanced sublingual bioavailability for Dihexa Standard oral (swallowed): Tablets swallowed with water, absorbed through the gastrointestinal tract

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Intranasal delivery represents the most significant methodological advancement because it bypasses hepatic first-pass metabolism entirely, but technique sensitivity (nasal cavity anatomy, administration volume, head positioning post-dose) introduces reproducibility challenges that subcutaneous injection avoids

Permitting compounding could improve manufacturing and medical supervision, but it might also give experimental treatments a legitimacy that the evidence does not support