Polycal Powder is also suitable for those with the following conditions: Alzheimer's Disease, Cancer / Oncology, Cerebral Palsy, Cow's Milk Allergy, Critical Care: Burns etc, Crohn's Disease / IBD, Cystic Fibrosis, Dementia / Alzheimers, Gastrointestinal problems, Leg Ulcers / Wound care, Malabsorption / Maldigestion, Malnutrition / Undernutrition, Neurological: Multiple Sclerosis etc., Parkinson's Disease, Poor appetite / Anorexia, Respiratory Disease / COPD, Stroke / CVA, Swallowing Problems / Dysphagia, Weight Loss in Older Adults. Specialist is defined by the APC as a clinician who has undertaken an appropriate formal qualification or recognised training programme within the described area of practice and has a working experience and knowledge within a speciality area Grey / Non-Formulary (no formal assessment): APC has not formally reviewed this medicine or indication because it had never been requested for formulary inclusion. Often used for drugs new to market.

Grey / Non-Formulary: Medicines, which the Nottinghamshire APC has actively reviewed and does not recommend for use at present due to limited clinical and/or cost effective data.

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Medicines that should be initiated by a specialist and prescribed by primary care prescribers only under a shared care protocol, once the patient has been stabilised. No new patients to receive prescriptions in primary care. Patients already receiving Red Medicines in primary care should be handled on a case by case basis with the support of the Medicines Optimisation team. Collect a further blood sample 2 hours after the Polycal drink was started. Label tube with full patient identification detail, "2 hour sample" and actual time of sample.

bottle of POLYCAL [manufactured by Nutricia Clinical Care] - 113 mL of Polycal is equivalent to 75g of anhydrous glucose.

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In hospital, liquidused for the Glucose Tolerance Test. 75g of glucose can be given as 113ml Polycal® liquid diluted with water to a total volume of 200-300ml (see BNF). Take blood into a grey top fluoride-oxalate tube and label with specimen time and as "FASTING" as well as the usual patient identification requirements. Please note that parcels weighing over 2kg may be sent via courier due to Royal Mail weight restrictions.

Medicines suitable to be prescribed in primary care / general practice after specialist* recommendation or initiation. mL of Polycal is required for each kilogram body weight up to a maximum volume of 113 mL of Polycal Grey / Non-Formulary (undergoing assessment): Work is ongoing and will be reviewed at a future APC meeting.Once opened, use contents within 1 month. Replace lid firmly after use. Prepare the food per serving and use within 2 hours. Polycal Powder is fat and protein free and low in minerals so is suitable for patents with such dietary restrictions. It is also free from sucrose, lactose, fructose and galactose, so is suitable for patients with such carbohydrate intolerances.

The majority of Nutricia's ONS are suitable for vegetarians as defined by The Vegetarian Society. Carminic Acid, a colouring derived from cochineal, may not be acceptable to some patients and is used in the following ONS: Product name Sugar content reduced by 50% from 1st April 2017 so no longer recommended for glucose tolerance tests - consider Polycal®. Polycal Powder dissolves readily in hot and cold drinks. It has a neutral taste and can therefore be added to both sweet and savoury foods or drinks without significantly altering flavour or texture. It is also suitable for use in cooking.A supporting prescribing guideline may be requested which must have been agreed by the relevant secondary care trust DTCs and approved by the Nottinghamshire APC. Important notice and declarationBreast milk is best for babies. Professional advice should be followed before using an infant formula. Introducing partial bottle feeding could negatively affect breast feeding. Good maternal nutrition is important for breast feeding and reversing a decision not to breast feed may be difficult. Infant formula should always be used as directed. Proper use of an infant formula is important to the health of the infant. Social and financial implications should be considered when selecting a method of feeding. The supporting prescribing guideline must have been agreed by the relevant secondary care trust D&TC(s) and approved by the Nottinghamshire APC.