The Advisory Committee on Borderline Substances (ACBS) recommends products on the basis that they may be regarded as drugs for the management of specified conditions; disease-related malnutrition, intractable malabsorption, pre-operative preparation of malnourished patients, dysphagia, proven inflammatory bowel disease, following total gastrectomy, short-bowel syndrome, bowel fistula.

Gluten-free foods are non-formulary (December 2016)

Feed thickeners

Addition of a polyethylene glycol (PEG)-based laxative to a liquid that has been thickened with a starch-based thickener may counteract the thickening action, placing patients with dysphagia at a greater risk of aspiration. See Polyethylene glycol (PEG) laxatives and starch-based thickeners: potential interactive effect when mixed, leading to an increased risk of aspiration (MHRA drug safety update April 2021)

See NHS Somerset Nutrition and hydration website.

See NHS Somerset Prescribing and Medicines Management website for link to specials guidance.

Therapeutic areaFormulary ChoicesCost (per pack size stated)Rationale for decision / comments
First lineThick and Easy Clear®£6.50 (126g)For thickening of liquids or foods in dysphagia, and for the dietary management of conditions such as stroke, Parkinson’s disease, muscular dystrophy, motor neurone disease, multiple sclerosis, malignancies of the oral cavity and throat, neurological disorders caused by injury or disease. Not suitable for use in child under 3 years. Gluten-free and lactose-free.
Second line Nutilis Clear®£8.46 (175g)For thickening of liquids or foods in dysphagia. Not suitable for use in child under 3 years.
Gluten-free and lactose-free.
Resource ThickenUp Clear®£8.46 (127g)For thickening of liquids or foods in dysphagia. Not suitable for use in child under 3 years.
Gluten-free.