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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 9 - Nutrition and blood 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing
Links:
BLMK ICB: Oral nutritional supplements guidance Vitamin and Mineral Supplementation Post Bariatric Surgery Guideline
09.04 Oral nutrition
BLMK Adult Oral Nutritional Supplement (ONS) Prescribing Guidelines NICE CG32: Nutrition support in adults

Food First Approach

GREEN
First Choice

Give ‘Food Enrichment’ leaflet or other Food First resources for 1 month before prescribing ONS.

 

Entry reviewed: July 2025

BNF BNFc SPC

Powdered Oral Nutritional Supplements

GREEN
Second Choice

Adults

Do not prescribe based on a hospital discharge summary unless advised by a Dietitian

Always remember to refer to local dietetic service to ensure any ONS are appropriate.

Consider if food first advice does not meet weight goal (gain or maintenance) after 1 month

Complan Shake  (2 per day recommended)

If unable to tolerate large volumes consider prescribing: Aymes Shake Compact

If requires vegan / non-milk based product consider prescribing: Aymes Actasolve Smoothie

See link for alternative diluents for Actasolve smoothies

 

Entry reviewed: July 2025

BNF BNFc SPC

Ready Made Oral Nutritional Supplements

GREEN
Third Choice

Adults

Do not prescribe based on a hospital discharge summary unless advised by a Dietitian.

Always remember to refer to local dietetic service to ensure any ONS are appropriate.

Use only if service user cannot make up a powdered supplement.

EnergieShake Complete 1.5Kcal is the most cost effective ready made ONS

Suitable alternatives for taste preference is Altraplen Energy

If unable to tolerate large volumes, consider prescribing: Altraplen Compact Daily.  (1 per day recommended)

If requires juice based product, consider prescribing: Aymes ActaGain Juce or Fortijuce. (2 per day recommended) 

If requires vegan product, consider prescribing Fortisip Plant Based 1.5kcal (2 per day recommended) 

 

Entry reviewed: July 2025

BNF BNFc SPC

Powdered Oral Nutritional Supplements

Amber SPA
Formulary

Paediatrics

Acceptability and flavour preferences will be checked by the dietitian team.

 

3-6 years

Aymes ActaJuni Shake

Scandishake

>6 years

Aymes ActaSolve Smoothie

Aymes Shake or Aymes Shake Compact

Aymes Shake Fibre

Complan Shake

Foodlink Complete or Foodlink Complete Compact

Foodlink Complete Fibre

Foodlink Smoothie

 

Entry reviewed: July 2025

BNF BNFc SPC

Ready Made Oral Nutritional Supplements

Amber SPA
Formulary

Paediatrics

Acceptability and flavour preferences will be checked by the dietitian team.

 

1-6 years

Resource Junior 

Fortini

Fortini 1.0 Multi Fibre

Fortini Multi Fibre

PaediaSure Compact

PaediaSure Plus Juce

PaediaSure Plus Fibre

>3 years

Fortisip Plant Based

>6 years

Altraplen Energy

Altraplen Compact

Altrajuce

Aymes ActaGain Juce

Ensure Plus Milkshake

Ensure Compact

Fortisip Compact 

Fortisip Bottle

Fortijuce

Fortisip Compact Protein

Fortisip Compact Fibre

PaediaSure

PaediaSure Fibre

Frebini Energy

Frebini Energy Fibre

Fortini Compact Multi Fibre

Fortini Smoothie Multi Fibre

 

Entry reviewed: July 2025

BNF BNFc SPC

Fibre Containing Oral Nutritional Supplements

Amber SPA
Formulary

Paediatrics

Acceptability and flavour preferences will be checked by the dietitian team.

 

1-6 years 

Fortini Compact Multi Fibre

>6 years (powder)

Aymes Shake Fibre

>6 years (ready-made)

Fresenius Energy Fibre

 

Entry reviewed: July 2025

BNF BNFc SPC

Fresubin Pro Compact®

Amber SPA
Formulary

 For dietitian initiation only.

  • Not suitable for children under 7 years old
  • Use with caution in children under 10 years old

 Fresubin Pro Compact is a cost-effective alternative to Fortisip Compact Protein.

 

Entry reviewed: September 2025

BNF BNFc SPC

Juice Based Oral Nutritional Supplements

Amber SPA
Formulary

Paediatrics

Acceptability and flavour preferences will be checked by the dietitian team.

1-6 years 

PaediaSure Plus Juce

>6 years

Actagain 1.5 Juce 

 

Entry reviewed: July 2025

BNF BNFc SPC

Low Volume Shots

Amber SPA
Formulary

Paediatrics

Acceptability and flavour preferences will be checked by the dietitian team.

 

>6 years 

Altrashot 

 

Entry reviewed: July 2025

BNF BNFc SPC

Vegan Oral Nutritional Supplements

Amber SPA
Formulary

Paediatrics

Acceptability and flavour preferences will be checked by the dietitian team.

 

> 3 years 

Fortisip PlantBased 1.5

>6 years

Aymes ActaSolve Smoothie

 

Entry reviewed: July 2025

BNF BNFc SPC
Classifications
GREEN
May be initiated in any care setting
Amber SPA
Specialist to advise therapy and provide first 28 days supply, continuation in Primary Care
Amber SPIS
Specialist to initiate and stabilise medicine prior to continuation in Primary Care
SCG
To be prescribed as per Shared Care Guidance. If no SCG in place status reverts to red.
RED
Red medicines are designated as specialist only medicines which should only be prescribed by a specialist, usually within secondary care (either due to the requirement for specialist knowledge, long-term monitoring requirements, or restrictions that mean medicine supplies are only available to hospitals).
DNP
A decision has been made either locally and/or nationally not to routinely commission this preparation. Do not prescribe.
SELF
To be purchased over the counter. May be prescribed for chronic, long term conditions or on admission to hospital if essential.