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Oral Nutritional Supplements Formulary- for Adults
Version No: 3 Date of issue: September 2015 Review date: September 2016
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Oral Nutritional Supplement formulary – for Adults section development process
Document Name: Oral Nutritional Supplements Formulary – for Adults
Document Type: Formulary section
Relevant to: Coastal West Sussex (CWS) GP practices, all primary care prescribers working within CWS, Sussex Community NHS Trust (SCT), Sussex Partnership NHS Foundation Trust (SPFT) and Western Sussex Hospitals NHS Trust (WSHT) and care home staff.
Details of document development:
This document has been developed by the Coastal West Sussex Clinical Commissioning Group (CWS CCG) Medicines Management Team, in conjunction with the Dietitians from Western Sussex Hospitals NHS Trust (WSHT) and in consultation with CWS primary care prescribers, WSHT-pharmacy, Sussex Community NHS Trust, West Sussex County Council, Sussex Partnership Foundation NHS Trust, West Sussex Forum (care homes) and hospices.
Recommendations have been made based on the advice of the Dietitians and local adaption of national tools, Malnutrition Universal Screening Tool (MUST).
Version No.
Date Author(s) of original development or review Details of document development
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16/05/2013
07/11/2013
09/09/2015
Anne Corkhill – Pharmaceutical Adviser CWS CCG.
Gloria Omisakin – Medicines Management Pharmacist CWS CCG
Sue Durrant – Chief Dietitian WSHT
Kirsty Jukes – Specialist Community Dietitian & Team Lead WSHT
Gloria Omisakin – Medicines Management Pharmacist CWS CCG
Gloria Djamaluddin - Medicines Management Pharmacist CWS CCG
Versha Talati - Prescribing Project Support Dietitian
Sue Durrant – Chief Dietitian WSHT
Kirsty Jukes – Specialist Community Dietitian & Team Lead WSHT
Laura Perkins- Specialist Community Dietitian WSHT Rebecca Mapson - Specialist Home Enteral Feeding Dietitian WSHT
Original development
Review due March 2014 then annually thereafter
Review earlier in light of change of legislation or national guidance
Contact details for Dietitians at Crawley Hospital amended.
Updated oral nutritional supplement formulary
Updated ‘MUST’ screening tool and referral form
‘Food first’ advice information added
Approval for organisational use
Formulary section authorised for use in Coastal West Sussex by:
Coastal West Sussex Area Prescribing Committee (APC)
23/09/2015
Feedback
Please send any relevant feedback/comments to the CWS CCG Medicines Management Team: [email protected]
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Contents
Page
Introduction 4
How To Use This Guidance 5
Malnutrition Universal Screening Tool (MUST) and Action Plan 6
Oral Nutrition Support Care Pathway 7
Preferred First Line Oral Nutritional Supplements (to achieve at
least 600 calories/day)
8
Alternative First Line Oral Nutritional Supplements (to achieve at
least 600 calories/day)
9
Referral to dietitians Form 12
Glossary of Terms 13
References 13
Contact details for further dietetic advice 13
Appendix.1. Oral Nutritional Supplements in this section should
only be prescribed on the NHS within CWS if recommended by a
Dietitian.
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Appendix.2. Oral Nutritional Supplements in this section should
only be prescribed on the NHS within CWS if recommended by a
Dietitian or Speech and Language Therapist (SALT)
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Appendix 3. ‘Eat Better, Feel Better’ Leaflet 19
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Introduction This document provides guidance on the prescribing of oral nutrition support (ONS) for adult patients (≥18 years) in Coastal West Sussex (CWS). ONS includes sip feeds and nutritional supplements. This formulary does not include enteral tube feeds, specialist feeds and nutritional supplements for disease specific conditions. The guidance is intended for use by CWS GP practices, care home staff and all primary care prescribers working within CWS, Sussex Community NHS Trust (SCT), Sussex Partnership Foundation NHS Trust (SPFT) and Western Sussex Hospitals NHS Trust (WSHT). Malnutrition is often under recognised and under treated. The National Institute for Health and Clinical Excellence (NICE CG32) has shown substantial cost savings can result from identifying and treating malnutrition. Cost savings are based on conservative estimates of reduced hospital admissions, length of stay for admitted patients and reduced demand for GP and outpatient appointments.
The guidance aims to:
Improve the management of patients who are malnourished or identified to be at risk of malnutrition
Ensure appropriate cost-effective ONS prescribing
Stop repeat prescriptions without regular review
Reduce wastage The aims are addressed by:
Use of an Oral Nutrition Support Care pathway – screen, treat, monitor
Regular nutrition screening using the Malnutrition Universal Screen Tool (MUST) and implementation of the action plans
A formulary of oral nutrition sip feeds and supplements
Appropriate referral to Dietitians Disclaimer The information contained within is intended for use by healthcare professionals within Coastal West Sussex. We have made every effort to check that information is correct at the time of publication. Coastal West Sussex Clinical Commissioning Group does not accept any responsibility for loss or damage caused by reliance on this information. Please read ONS directions before administration
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How To Use This Guidance 1. Screen – your patient using the MUST screening tool 2. Treat – follow the action plan linked to the MUST score
Always use the ‘Food First’ approach before considering oral nutritional supplements.
Diet and information sheets to support the action plans for patients at medium and high risk of malnutrition are available from http://www.westernsussexhospitals.nhs.uk/services/dietitians/ Click on Food Facts and then Improving Nutrition for specific information on the ‘Food First ‘approach. See Appendix 3 for ‘Eat better, Feel better’ leaflet.
If a supplement is required, use the Oral Nutrition Support Care Pathway to identify the most appropriate product. All requests received by primary care prescribers to write an FP10 for ONS should be accompanied with a MUST history and score, and be made in line with the MUST action plan on page 6 and the Oral Nutrition Support care pathway on page 7.
Oral nutritional supplements can only be prescribed on an FP10 prescription for specific indications as agreed by the Advisory Committee on Borderline Substances (ACBS). All prescriptions for oral nutritional supplements should be endorsed with ACBS. Standard ACBS indications are: Disease-related malnutrition, intractable malabsorption, pre-operative preparation of malnourished patients, dysphagia, proven inflammatory bowel disease, following total gastrectomy, short-bowel syndrome and bowel fistula. Other ACBS indications which may apply to specific products are: Continuous Ambulatory Peritoneal Dialysis (CAPD) and Haemodialysis. Where this applies, please see additional information for individual supplements in formulary. Advise patients with diabetes to drink supplements slowly and increase blood sugar monitoring. If you have any concerns, refer the patient to the dietitian.
There may be some occasions when a prescriber considers a non-formulary oral nutritional supplement may be required for an individual patient, in this instance the prescriber should seek dietetic advice. Patients prescribed ONS as part of their nutrition care plan whilst in hospital, will be discharged with 7 days supply as part of their TTO’s (if appropriate). The dietitians will arrange follow up for patients requiring on going dietetic support e.g. active oncology/gastroenterology patients. The dietitian will write to the GP to request an ongoing prescription and include a summary of care. Patients not requiring ongoing dietetic support will be given an advice sheet asking them to contact their GP if their nutritional intake does not return to normal and/or they continue to lose weight. If the patient presents, follow the pathway on page 7. 3. Monitor – your patient. Are the goals set being achieved? E.g. regaining weight ONS Formulary colour coding
Supplements to be prescribed as first line
Supplements to be prescribed as second line
Supplements to be prescribed only if assessed by and recommended by a dietician or speech and language therapist (SALT)
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Oral Nutrition Support Care Pathway
Which Supplement to prescribe to achieve 600 calories per day To improve compliance, ask patient which flavours they prefer:
FIRST LINE – PREFERRED OPTION If patient able to drink 2 x 200ml of milk drink and prepare powdered milkshakes or has carers/care home support.
Pre Prescribe 1 week: 1st line: 1 sachet Aymes shake or Ensure shake or initially* Fresubin Powder Extra b.d.
2nd line: 1 sachet Complan Shake b.d.
ALTERNATIVE OPTIONS If patient requires ready to drink supplement and able to drink 2 x 200ml milk-based supplement
Prescribe 1 week: 1st line: 200ml Aymes Complete b.d
initially* 2nd line: 200ml Fresubin Energy b.d.
OR 220ml Ensure Plus b.d. OR 200ml Resource Energy b.d. OR 200ml Fortisip Bottle b.d. If patient requires ready to drink,low volume supplement and able to drink 2 x 125ml milk-based supplement
Prescribe 1 week: 1st line: 125ml Nutriplen b.d.
initially* 2nd line: 125ml Fortisip Compact b.d.
OR 125ml Ensure Compact b.d. If patient would prefer a ready to drink, juice-style supplement (NB still contain milk proteins)
Prescribe 1 week: 1st line: 220ml Ensure Plus Juce b.d.
initially* 2nd line: 200ml Fresubin Jucy Drink b.d.
OR 200ml Fortijuce b.d. OR 200ml Resource Fruit b.d. For additional products : Appendix 1 - for products to use on the advice of a dietitian ; or Appendix 2 - for products to use on the advice of a dietitian or speech and language therapist
Has MUST Score improved after 1 month?
MUST of 0 or 1 and improved - Continue with action plan
MUST of ≥ 2 and no improvement - Prescribe 600 calories/day from supplements in line with high risk action plan
MUST Screen
MUST = 0 Low Risk. Implement low risk action plan Re-screen Care Homes – monthly, Community - annually
MUST = 1 Medium Risk. Implement medium risk action plan Re-screen monthly
MUST ≥ 2 High Risk. Implement high risk action plan Re-screen monthly
Monitor
*Initial 1 week supply of supplements (use either starter pack or individual flavours) - continue for 3 weeks if tolerated
Review prescription and MUST score monthly:
MUST = 0, STOP supplements, follow low risk action plan
MUST = 1, STOP supplements, follow medium risk action plan
MUST ≥ 2, CONTINUE supplements, follow high risk action plan
Scre
en
Tre
at
Mo
nito
r
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Preferred First Line Oral Nutritional Supplements (to achieve at least 600 calories/day)
Powdered milkshake-style sip feed If patient able to drink 2 x 200ml of milk drink and able to prepare powdered milkshakes or has carers/care home support.
Name of supplement
Pip Code Flavours Size Energy (kcal)/
unit dose Cost/100k
cals Cost/unit
FIRST LINE
Aymes Shake
374-9017 Vanilla
57g sachet
388
20p
78p
374-9009 Strawberry
374-9025 Chocolate
374-9033 Banana
374-8993 Neutral
Aymes Shake Starter Pack
384-9643 Mixed flavours 5x57g 388 £4.78
Ensure Shake
383-1161 Vanilla
57g sachet
389 20p 78p 383-3936 Strawberry
383-3944 Chocolate
383-1187 Banana
Fresubin Powder Extra
372-8730 Strawberry
62g sachet
397 20p 80p 372-8714 Chocolate
372-8748 Vanilla
372-8722 Neutral
SECOND LINE
Complan Shake
328-6770 Original
57g sachet
387
22p
85p
324-3110 Vanilla
324-3102 Strawberry
324-3094 Chocolate
328-6762 Banana
Complan Shake Starter Pack
352-7801 Mixed flavours 5 x 57g sachet
387 £4.79
Recommended dose: 1 sachet mixed with 200ml full fat milk b.d.
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Alternative First Line Oral Nutritional Supplements (to achieve at least 600 calories/day)
Standard volume (200-220ml) ready prepared milkshake-style sip feed If patient requires ready prepared and able to drink 2 x 200ml of milk drink
Name of supplement
Pip Code Flavours Size Energy (kcal)/
unit dose
Cost/100kcals
Cost/unit
FIRST LINE
Aymes Complete
374-9587 Vanilla
200ml
300 47p
£1.40 374-9553 Chocolate
374-9595 Strawberry
374-9579 Banana
Aymes Complete Starter Pack
388-6439 Mixed flavours 4 x
200ml £5.60
SECOND LINE
Fresubin Energy
338-7529 Strawberry
200ml 300 49p £1.48
338-7511 Chocolate
338-7537 Vanilla
338-7479 Banana
338-7461 Tropical Fruit
338-7495 Cappuccino
338-7503 Blackcurrant
338-7487 Lemon
338-7453 Neutral
Ensure Plus
353-3619 Strawberry
220ml 330 61p £2.02
353-3601 Chocolate
353-3593 Vanilla
353-3692 Banana
353-3635 Coffee
353-3726 Fruits of the Forest
353-3684 Orange
353-3676 Peach
353-3650 Raspberry
353-3718 Neutral
Resource Energy
324-6766 Strawberry/Raspberry
200ml 300 64p £1.92
324-6741 Chocolate
324-6774 Vanilla
324-6733 Banana
324-6725 Apricot
324-6758 Coffee
Fortisip Bottle
309-2137 Neutral
200ml 300 69p £2.06
309-2087 Vanilla
309-2129 Chocolate
361-1985 Toffee/Caramel
309-2095 Banana
309-2152 Orange
309-2111 Strawberry
309-2145 Tropical
Recommended dose: 1 bottle b.d.
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Low volume (125ml) ready prepared milkshake-style sip feed If patient requires ready prepared and/or low volume 2 x 125ml milk drink
Name of supplement Pip Code Flavours Size Energy
(kcal)/ unit dose
Cost/100kcals
Cost/unit
FIRST LINE
Nutriplen
381-1460 Vanilla
125ml 300 48p £1.45 381-1460 Strawberry
394-9534 Hazelnut Chocolate
394-9526 Banana
SECOND LINE
Fortisip Compact
344-1904 Strawberry
125ml
300 67p
£2.02
344-1896 Vanilla
344-1920 Banana
344-1912 Mocha
354-2933 Apricot
354-2941 Forest Fruit
359-7424 Chocolate
Fortisip Compact Starter Pack
359-0999 Mixed flavours 6 x 125ml £12.12
Ensure Compact
383-1120 Vanilla
125ml 300 67p £2.02 383-1138 Strawberry
383-1146 Banana
Recommended dose: 1 bottle b.d.
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Ready prepared juice-style sip feeds If patient prefers juice type drink
Name of supplement
Pip Code Flavours Size Energy(kcal)/
unit dose Cost/100
kcals Cost/unit
FIRST LINE
Ensure Plus Juce
329-0665 Apple
200ml 330 60p £1.97
329-0624 Orange
329-0590 Strawberry
329-0632 Lemon & Lime
329-0616 Peach
329-0657 Fruit Punch
SECOND LINE
Fresubin Jucy Drink
370-3048 Apple
200ml 300 64p £1.93
370-3089 Cherry
370-3071 Blackcurrant
370-3063 Pineapple
370-3055 Orange
Fortijuce
322-3484 Lemon
200ml 300 67p
£2.02
322-3500 Apple
322-3534 Orange
322-3542 Strawberry
322-3559 Tropical
322-3567 Forest Fruit
322-3575 Blackcurrant
Fortijuce Starter Pack
500-8727 Mixed Flavours 4 x 200ml 300 £8.08
Resource Fruit
329-2463 Apple
200ml 254 72p £1.84
276-2979 Orange
276-3001 Pear & Cherry
276-2995 Raspberry & Blackcurrant
Recommended dose: 1 bottle b.d.
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Glossary of terms
ACBS Advisory Committee on Borderline Substances CCG Clinical Commissioning Group CWS Coastal West Sussex MUST Malnutrition Universal Screening Tool ONS Oral Nutrition Support WSHT Western Sussex Hospitals NHS Trust
References 1. Managing Adult Malnutrition in the Community. Produced by a multi-professional consensus panel.
Available from www.malnutritionpathway.co.uk
2. BMJ Group and Pharmaceutical Press. British National Formulary (BNF) 68th edition. London.
September 2014-March 2015. Available from: http://www.bnf.org/bnf/
3. Monthly Index of Medical Specialities (MIMS). September 2015. Available from: http://www.mims.co.uk/
4. Department of Health, Drug Tariff. September 2015. TSO: London. Available from:
http://www.ppa.org.uk/ppa/edt_intro.htm
5. Elia M, Russel C. eds (2009) Combating Malnutrition: Recommendations for Action. A report by British Association of parenteral and Enteral Nutrition. BAPEN
6. National Institute for Health and Clinical Excellence (NICE) Clinical Guideline 32, Nutrition Support in
Adults. February 2006. Available from: http://www.nice.org.uk/CG32
Further Dietetic Advice
St Richard’s Hospital, Chichester PO19 6SE, telephone 01243 788 122 ext: 2416 fax 01243 831497, email [email protected] Worthing Hospital, Worthing, BN11 2DH, telephone 01903 205111 ext: 4147 fax 01903 285235, email [email protected]
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APPENDIX.1 Oral Nutritional Supplements in this section should only be prescribed on the NHS within CWS if recommended by a
Dietitian
High energy, fibre-containing sip feeds Nutritionally complete. Useful if patient is suffering with constipation
Name of supplement
Pip Code Flavours Size Energy(kcal)/unit dose
Fresubin 2kcal Fibre
343-8264 Chocolate
200ml 400
344-2944 Vanilla
344-2803 Cappuccino
344-2795 Lemon
365-5545 Apricot Peach
365-5537 Neutral
343-8264 Chocolate
Resource 2.0 Fibre
329-1051 Apricot
200ml 400
329-1069 Coffee
329-1077 Neutral
329-1085 Strawberry
329-1093 Summer fruits
329-1101 Vanilla
Ensure TwoCal
346-3114 Banana
200ml 399
346-3122 Neutral
346-3130 Strawberry
346-3106 Vanilla
344-2795 Lemon 400
Fortisip Compact Fibre
359-4595 Vanilla
125ml 300 359-4595 Strawberry
361-0656 Mocha
Fortisip Compact Fibre Starter Pack
378-3909 Mixed flavours 4 x125ml 300
Ensure Plus Fibre
329-0459 Banana
220ml 310
329-0442 Chocolate
329-0467 Vanilla
329-0426 Raspberry
329-0418 Strawberry
High protein sip feeds High in protein, but not all are nutritionally complete. Useful in patients with chronic wounds, burns or fistulae
Name of supplement
Pip Code Flavours Size Energy(kcal)/unit
dose
Nutriplen Protein 381-1486 Vanilla
200ml 300 381-1478 Strawberry
Fresubin 2kcal
343-8231 Vanilla
200ml 400
343-8256 Cappuccino
344-2977 Toffee
344-2969 Apricot-Peach
343-8249 Forest Fruits
Fortisip Compact Protein
371-5091 Vanilla
125ml 300 371-5109 Banana
371-5125 Strawberry
371-5117 Mocha
Fortisip Compact Protein Starter Pack
378-3917 Mixed Flavours 4 x 125ml 300
Resource Protein
322-4383 Apricot
200ml 250
322-4375 Chocolate
322-4367 Forest fruits
322-4359 Strawberry
322-4342 Vanilla
Fresubin Protein Energy
338-7545 Wild Strawberry 200ml 300
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Yogurt-style sip feeds Nutritionally complete. Less sweet, useful for patients with taste fatigue or taste changes
Name of supplement
Pip Code Flavours Size Energy(kcal)/unit dose
Fortisip Yogurt Style
330-5604 Raspberry
200ml 300 330-5596 Vanilla & Lemon
330-5638 Peach & Orange
Ensure Plus Yogurt Style
329-0780 Orchard Peach 220ml 330
329-0772 Strawberry Swirl
High energy powdered milkshake-style sip feed High in calories, but not nutritionally complete.
Name of supplement
Pip Code
Flavours Size Energy(kcal)/
unit dose Serving Instructions
Scandishake
229-9253 Strawberry
85g sachet
589
Reconstitute with 240ml full fat milk
229-9204 Chocolate 586
229-9261 Vanilla 588
306-2015 Caramel 588
277-7282 Unflavoured 587
306-2007 Banana 588
Enshake
297-4715 Banana
96.5g sachet 600 Reconstitute with 240ml full fat
milk
297-4699 Chocolate
297-4707 Strawberry
297-4681 Vanilla
Calshake 275-8175 Strawberry 87g sachet 600 Reconstitute with 240ml full fat milk
Savoury sip feeds
Name of supplement
Pip Code Flavours Size Energy(kcal)/
unit dose Serving Instructions
Vitasavoury 200
316-4787 Leek and Potato
Cup ‘n’ sachet 33g
200 Reconstitute with 100ml hot
water
316-4779 Mushroom
316-4795 Golden Vegetable
316-4761 Chicken
378-7421
24 x 33g sachet (6 x each flavour)
Vitasavoury 300
270-2579 Leek and Potato
50g sachet 300 Reconstitute with 150ml hot
water
270-2587 Mushroom
316-4910 Golden Vegetable
259-4190 Chicken
Vitasavoury Starter Pack
379-8493
Vitasavoury 200 (1 x each flavour)
4 x 33g cup ‘n’ sachet
See above See above Vitasavoury 300 (1 x each flavour)
4 x 50g sachet
Ensure Plus Savoury
362-3949 Chicken 220ml 330 Can be heated but do not boil
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Semi-Solid desserts Often used for patients with dysphagia. Nutritionally complete, but not recommended as a sole source of nutrition
Name of supplement
Pip Code Flavours Size Energy(kcal)/unit
dose
Nutricreme
381-1445 Vanilla
125g 225 381-1437 Strawberry
394-9666 Chocolate Orange
Resource Dessert Energy
279-8056 Caramel
125g 200 279-6316 Chocolate
279-6308 Vanilla
Resource Dessert Fruit
326-7838 Apple
125g 200 326-7853 Apple- Strawberry
326-7846 Apple-peach
Fresubin Crėme
344-2837 Wild Strawberry
125g 225
344-2829 Chocolate
344-2811 Vanilla
344-2845 Cappuccino
344-2852 Praline
Forticreme Complete
232-4143 Chocolate
125g 200 232-4135 Vanilla
232-4168 Banana
232-4150 Forest Fruit
Fresubin YOcrème pudding
367-2490 Lemon
125g 187
367-2508 Raspberry
367-2540 Apricot-Peach
367-2524 Biscuit
367-2482 Neutral
Nutilis Fruit Stage 3 374-8480 Apple
150g 206 374-8472 Strawberry
Nutilis Complete Stage 2
374-8506 Vanilla
125g 306 374-8498 Strawberry
386-2620 Chocolate
Ensure Plus Crème 334-8943 Banana 125g 171
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Modular supplements Fat based: high energy, typically low protein
Name of supplement
Pip Code Flavours Size Energy(kcal)/unit dose
Polycal
027-6816 Unflavoured 400g tin powder 19kcal/5g scoop
326-8166 Neutral 200ml bottle 494
326-8174 Orange
Pro-Cal Powder
369-9832
Unflavoured
1 x 12.5kg tub catering pack
100kcal/15g sachet 270-1381 1x 1.5kg tub
270-1399 1x 510g tub
270-1407 25 x 15g sachet
Pro-Cal Shot 394-3909 Neutral
120ml bottle
100kcals/30ml shot 394-3891 Strawberry
ProCal Shot Starter Pack
394-5086 Both flavours 2 x 120ml
Calogen
327-3380 Neutral
500ml
135kcal/30ml
327-3398 Strawberry
327-3406 Banana
327-3414 Neutral
200ml 327-3422 Strawberry
327-3430 Banana
Fresubin 5kcal shot 358-7250 Neutral
120ml 150kcal/30ml 358-7243 Lemon
Calogen Extra 346-3882 Neutral
200ml 160kcal/40ml 346-3890 Strawberry
Calogen Extra shots 373-1684 Neutral
6 x 40ml 160kcal/40ml 373-1866 Strawberry
Modular Supplements Protein based: high protein
Name of supplement
Pip Code Flavours Size Energy(kcal)/unit dose
Protifar 040-1653 Unflavoured 225g tin 9.5kcal/2.5g scoop
ProSource Plus 390-9124 Neutral 30ml sachet 100 (15g protein)
ProSource jelly 378-2042 Orange
118ml 90 (20g protein) 378-2034 Fruit Punch
ProSource Liquid Protein
348-9622 Original
30ml sachet
100 (10g Protein)
359-9214 Citrus Berry 100( 10g protein)
360-0228 Orange Crème 100(10g protein)
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APPENDIX.2
Oral Nutritional Supplements in this section should only be prescribed on the NHS within CWS if
recommended by a Dietitian or Speech and Language Therapist (SALT)
Pre-thickened milk-shake style Used in patients with dysphagia. Nutritionally complete.
Name of supplement
Pip Code Flavours Size Energy(kcal)/unit dose
Nutilis complete Stage 1
359-0981 Strawberry 125ml 306
359-0973 Vanilla
Fresubin Thickened Stage 1
352-9625 Vanilla 200ml 306
352-9633 Strawberry
Fresubin Thickened Stage 2
352-9641 Vanilla 200ml 306
Pre- thickened fruit drinks
Name of supplement
Pip Code Flavours Size Energy(kcal)/unit dose
Resource Thickened Drink
257-7195 Apple Custard
114ml
101
257-7187 Apple Syrup 101
257-7179 Orange Custard 102
257-7161 Orange Syrup 102
Dysphagia food and fluid thickeners
Name of supplement
Pip Code Flavours Size Energy(kcal)/unit dose
Nutilis
359-3241 Unflavoured 300g tin
14kcal/4g scoop 359-3233 Unflavoured 20 x 12g sachet
Resource Thicken up
267-8381 Unflavoured 227g tin 17kcal/4.5g sachet
Thick and Easy
219-6343 Unflavoured 4.5kg pack
17kcal/4.5g scoop 086-3282 Unflavoured 12 x 225g tin
249-0563 Unflavoured 100 x 9g sachet
Nutilis Clear 373-1908 Unflavoured 175g Tin 12kcal/4g scoop
Resource Thicken Up Clear
355-4433 Unflavoured 125g tin 3.7kcal/1.2g scoop
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APPENDIX.3
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