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Do not use thickening agents to thicken ANY medicines.
Nutilis Clear®; a gum based thickener is the preferred product in NHS GG&C and is licensed to thicken food and drinks but not medicines.
There is no data about how the thickening agent impacts on the pharmacokinetics of the liquid medication. Therefore crushing a tablet/opening a capsule and mixing with a soft food is generally the best option (where available and recommended in guidance below).
If the patient is aware that the medication is in the soft food, this does not require the use of the covert pathway. This approach is simply making it more palatable and/or safe for patients with swallowing difficulties.
Licensed liquids should only be used if they are of the appropriate fluid consistency without the need for thickener.
Liquid specials should only be considered if thickener is not required and the patient is unable to manage any solid dosage forms.
Liquid specials should NEVER be given covertly (unlicensed medication given in an unlicensed manner) unless the medication is essential and a pharmacist has provided advice stating that this is the most appropriate formulation to give covertly, as part of a covert pathway.
Advice on commonly used medicine may be found in the full guidance.
Last reviewed: 26 May 2020
Next review: 01 May 2021
Approved By: MH-PMG
Reviewer Name(s): Lead Clinical Pharmacist, Clinical Effectiveness Pharmacist