Storage and regulation of thickeners and thickened fluids

Karoline Brennan, Senior Medicines Information Pharmacist, North West Medicines Information CentrePublished

Thickeners and thickened fluids have different storage requirements and are regulated in a particular manner.

General advice

Defining and identifying thickness of fluids and food for patients with swallowing difficulties

How fluid thickness and food texture are defined for patients with swallowing difficulties, and how to find the recommended level for a patient.

How to store thickeners

A Patient Safety Alert was issued in 2015 following an incident where a care home resident died after accidental ingestion of thickening powder that had been left within reach. It advised that whilst it is important that products remain accessible, all those involved in patient care need to be aware of the potential risks to patient safety.

Most thickening agents come in tubs, with easily removable lids. It could be considered best practice to store as per other medications, but at the very least out of reach of vulnerable patients.

How to store thickened fluids

Check the thickener container for any instructions of storage of thickened fluids.

Some (but not all) thickened fluids can be kept for 24 hours in a fridge and it may be practical to keep for use throughout the day.

Label jugs of fluid clearly with the IDDSI Level and thickener used if storing jugs of thickened fluids in a shared fridge (e.g. care home).

Regulation of thickeners

Thickening agents are not licensed as medicines. Many are classed as Food for Special Medical Purposes (FSMPs) intended for the dietary management, under medical supervision, of individuals who suffer from dysphagia. The composition and labelling of FSMPs is regulated by the European Commission.

Specific advice

Thickening liquid medicines

Thickening liquid medicines should not be used routinely: it is difficult to check fluid consistency which can affect whether the medicine is swallowed safely.

Using thickeners of different types for patients with swallowing difficulties

Gum and starch based thickeners are available; drug-thickener interactions are possible and should be avoided.

Read more

Swallowing difficulties

All our advice on using medicines safely and effectively in patients with swallowing difficulties