A review of ZTlido (topical lidocaine), Zalviso and Dsuvia (sublingual sufentanil), and Wafermine (sublingual ketamine). By Jordan O'Leary, PharmD, Jayne Pawasauskas, PharmD, BCPS and Dmitry M. Arbuck, MD Pages 55-59 Overview For some patients, traditional oral or intravenous (IV) formulations may not be sufficient for pain control, come with undesirable adverse effects, or may not be clinically optimal. Therefore, alternative routes of delivery must be considered.