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 Formulary Chapter 23: Oral Nutritional Supplements (ONS) - Full Chapter
Notes:

Introduction

  • Malnutrition can lead to:
    • Poor immune function
    • Poor wound healing
    • Muscle wastage and increased risk of falls and fractures
    • Increased care needs
    • Reduced independence
    • Increased risk of hospitalisation
  • An estimated 1 in 10 people over the age of 65 are malnourished or at risk of malnutrition[1]
  • We have ~140,984 residents on the Isle of Wight2
  • 38,488 (27.3%) of those residents are over 65 years old[2]
  • Therefore, potentially ~3,850 people on the Isle of Wight are malnourished or at risk of malnutrition.
  • Around 35% of people admitted to care homes are malnourished/at risk of malnutrition1
  • These estimates do not account for people with increased social or mental health needs, learning disabilities or people with disabilities

[1] BAPEN (2017) Malnutrition: The Facts. CN Vol.17 No.3 Jul/Aug 2017

[2] Joint Strategic Needs Assessment (2019) – Demographics and Population (2017/18) [Online]. Available at https://www.iow.gov.uk/azservices/documents/2552-Isle-of-Wight-Demographic-and-Population-factsheet-2017-18-FINAL-SS.pdf

 

 Details...
23.02.03  Expand sub section  Ready-made compact ONS products
 note 

For patients who require fluid restriction, or who cannot tolerate large volumes.

Not to be routinely supplied to care homes without guidance from dietitian.

Fortisip ® Compact
View adult BNF View SPC online View childrens BNF
First Choice
Green plus

Alternative to Ensure® Plus Milkshake Style (200ml) in smaller volume

Available as Vanilla, Strawberry, Banana, Neutral, Apricot, Forest Fruit, Mocha and Chocolate

Recommended dose = 1 bottle twice a day

B.D. provides 600kcals, 24g protein.

 
Ensure ® Compact
View adult BNF View SPC online View childrens BNF
Alternatives
Green plus

For use under guidance from Dietitian

Alternative to Fortisip Compact

Available as Vanilla, Strawberry and Banana

Recommended dose = 1 bottle twice a day

 
   
Altraplen Compact ®
View adult BNF View SPC online View childrens BNF
Alternatives
Green plus

For use under guidance from Dietitian

Alternative to Fortisip Compact

Available as Vanilla, Strawberry, Banana, and Hazel Chocolate

Recommended dose = 1 bottle twice a day

 
   
Fresubin ® 2 kcal Mini Drink
View adult BNF View SPC online View childrens BNF
Alternatives
Green plus

For use under guidance from Dietitian

Alternative to Fortisip Compact

Available as Vanilla, Apricot-Peach and Fruits of the Forest

Recommended dose = 1 bottle twice a day

 
   
Fresubin ® 2 kcal Fibre Mini Drink
View adult BNF View SPC online View childrens BNF
Alternatives
Green plus

For use under guidance from Dietitian

Alternative toFortisip Compact, with added fibre

Available as Vanilla and Chocolate

Recommended dose = 1 bottle twice a day

 
   
Fortisip ® Compact Fibre
View adult BNF View SPC online View childrens BNF
Alternatives
Green plus

For use under guidance from Dietitian

Alternative to Fortisip Compact, 4.5g fibre/bottle

Available as Vanilla, Strawberry and Mocha. 

Recommended dose = 1 bottle twice a day

 
   
Fortisip Compact Protein
View adult BNF View SPC online View childrens BNF
Alternatives
Green plus

For use under guidance from Dietitian

Alternative to Ensure® Plus in smaller volume

Available as Vanilla, Strawberry, Banana, Neutral, Berries, Hot Tropical Ginger, Cool Red fruits, Mocha and Peach-Mango

Recommended dose = 1 bottle twice a day

 
   
Fresubin ® 3.2Kcal Drink
View adult BNF View SPC online View childrens BNF
Alternatives
Green plus

For use under guidance from Dietitian

Alternative to Ensure® Plus in smaller volume

Available as Vanilla-Caramel, Hazelnut and Mango

Recommended dose = 1 bottle twice a day

 
   
 ....
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Green

Drugs that may be initiated, stabilised and maintained by primary, secondary or tertiary care Secondary and tertiary care prescribing may be continued by primary care. [this does not indicate first/second line choice]  

Green Hospital

Items used by the Hospital but would not normally be continued into primary care. Primary care prescribers can change to GREEN first or second.   

Green plus

Initiation of drugs by primary care following written advice from secondary/ tertiary care advice.  

Yellow

Drugs that may be continued in primary care following initiation and stabilisation in secondary/tertiary care  

Amber

Items requiring a shared care agreement. These items should be initiated and stabilised by secondary or tertiary care. The GP should only be asked to take over prescribing through a formal shared care agreement. Secondary care will be expected to continue prescribing until the agreement is made.  

Red

Hospital/ Trust ONLY. These are items the secondary and tertiary care are responsible for prescribing and will need to continue to prescribe for long term maintenance. These items will NOT be prescribed in primary care. But primary care should be informed the patient is receiving these items. This will include NHSE funded items requiring repatriation.  

GP - Black

Items covered by NHSE ‘Should not prescribe in primary care list’ – See CCG policy on Drugs of limited clinical value  

GP - Grey

Grey List: Items covered by NHSE ‘Should not prescribe in primary care list’ that are not to be routinely prescribed but may be suitable in a defined population – See CCG policy on Drugs of limited clinical value  

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