NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

Nutilis® Clear – Change in Labelling and Dosing

Nutilis® Clear – Change in Product Labelling and Dosing

Modification of fluids and diet following assessment by a speech and language therapist may be recommended in people with swallowing difficulties.  Currently, UK nationally agreed terminology is used for modified drinks and foods as follows –Stage 1, 2 and 3 for fluids and Texture B, C, D and E for diet.

New global terminology and definitions for texture modified foods and thickened liquids for people with swallowing difficulties have now been agreed.  This is known as the International Dysphagia Diet Standardisation Initiative (IDDSI).  It consists of a continuum of 8 levels (0-7) identified by text labels, numbers, and colour codes to improve safety and identification. This change will affect current and future patients.

NHSGGC intends to adopt the IDDSI system in a planned manner over the course of 2018.  An IDDSI steering group has been set up and has representation from all staff groups affected by the change. 

  • Phase 1 of implementation of IDDSI relates to communicating important information about the NHSGGC formulary preferred list gum based thickening powder Nutilis Clear (manufactured by Nutricia) as follows:
  • On 21st May 2018 NHSGGC plan to change over to tins of Nutilis Clear compatible with the new IDDSI labelling and dose instructions.  These will be available through local wholesalers for primary care, and via PECOS for use in secondary care. 
  • New tins are easily identifiable to health care professionals and patients because they will temporarily be marked with a red sticker on top of the lid.  Patients will also notice that there is a new green scoop in the tin (which will be smaller than the previous purple scoop).
  • The new IDDSI dose instructions will be on the side of the tin. These will be different from the previous instructions.
  • The product itself will be the same.
  • The method of mixing the product with fluids has not changed.

Educational and support materials will be distributed widely across all care settings prior to the launch of the newly labelled product.  Community pharmacists will help support information distribution and awareness-raising when dispensing the product.

If you are involved in prescribing, dispensing or preparing this product for patients in any care setting, please ensure that you and your patient are aware of the new dosing instructions. Preparing the product according to the previous instructions using the new green scoop will result in inadequate dosing, a thinner product and potential risk of choking.

An IDDSI elearning module developed by Nutricia is available here.

For general queries please contact the Nutricia Patient and Carer Helpline on 08457 623653.  For specific patient related enquiries contact local speech and language therapists.


Published 16/05/18