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Pill swallowing difficulty is a serious issue. Here's your answer.

Between 15 and 33 percent of long-term care residents have swallowing difficulties.1

Swallowing problems are associated with increased age, cancer treatment, and conditions such as Alzheimer's disease, Parkinson's disease, or stroke.1 Crushing and mixing pills with juice, applesauce, or thickeners to ease swallowing remains common but can alter drug release2 and expose providers to occupational hazard and legal libility.1,3

Assure® Slide/Phazix® Pill Swallowing Gel (PSG) Level 3—the first purpose-designed medication lubricant—provides a safe, simple, well-accepted alternative.

Benefits

  • Easy and effective—just add a teaspoon of gel over a pill or tablet to ease swallowing
  • Pleasant vanilla flavor masks medication taste, smell
  • All-natural ingredients with half the sugar of Mott's applesauce (0.55g/1 tsp vs 1.06g/1 tsp)4

Reliability

  • No known effect on medication absorption rate5
  • Breaks down quickly in the stomach
  • Well-accepted by care providers6

Convenience

  • 60-day open shelf-life on a med cart, refrigeration not required4
  • Simplifies infection control protocols requiring refrigeration of foods (e.g., apple sauce)
  • Available in 2 IDDSI levels—Phazix® (Level 3 Moderately Thick) and Forte (Level 4 Extremely Thick)

Note: Assure® Slide/Phazix® Pill Swallowing Gel Level 3 is registered with the FDA as a Class I Medical Device.

Supporting evidence pill crushing should be avoided

Inadvertent crushing of controlled-release medications destroys their release characteristics, subjecting patients to risk of toxicity.7 Even when pill crushing is not contraindicated by the manufacturer, crushing may introduce a high risk of variable dosing or side effects.8 Mixing crushed medications with juice, applesauce-like foods, or thickeners is known to alter the drug effect of medications.2,9 The law requires that medicines be given in the correct form and dose.3 Pill crushing may expose care providers to occupational hazards associated with pulverized medications and legal liability related to off-label use.1,3

A PSG can reduce pill crushing
In a 2019 survey taken at the 160-bed Landsdowne Aged Care facility, Cabramatta NSW, Australia, use of a PSG reduced overall pill crushing in the facility by 38%.4 Adoption of a PSG was part of an improvement project to reduce incidence of medication crushing in the facility.

A PSG is well-accepted by care providers
A 2019 survey6 (n=355) of healthcare workers across Australia queried their experiences with a PSG.*  A majority (n=170) had used the product. This group was queried on responses to the statement: "A pill swallowing gel is an effective method to facilitate pill-swallowing in residents.” Nearly 90% strongly agreed, agreed, or tended to agree with the statement. Easier medication administration (48%), reduction in need to crush (34%), and better medication compliance (33%) were reported as main benefits.

*Australian trade name for the product was Gloup® 

References
  1. Morris H. Administering drugs to patients with swallowing difficulties. Nurs Times. 2005;101(39):28-30.
  2. Manrique Y, Lee D, Islam F, et al. Crushed tablets: does the administration of food vehicles and thickened fluids to aid medication swallowing alter drug release? J Pharm Pharm Sci. 2014;17(2):207-219.
  3. Griffith R, Griffiths H, Jordan S. Administration of medicines part 1: the law and nursing. Nurs Stand. 2003;18(2):47-56.
  4. ARKRAY data on file.
  5. Crino L, Manrique-Torres Y, Cichero J, Steadman K. Characterization of Gloup: is it suitable for medication delivery in dysphagic patients. Paper presented at: APSA-ASCEPT Joint Scientific Meeting. 2015.
  6. Halouh M, Forough A, Chicero J, Lau E, Nissen L, Steadman K. Experiences with using Gloup medication lubricant: What do Australian aged care facility healthcare workers think? APSA Annual Conference; Dec 1-4, 2019; Melbourne, AU.
  7. Schier JG, Howland MA, Hoffman RS, Nelson LS. Fatality from administration of labetalol and crushed extended-release nifedipine. Ann Pharmacother. 2003;37(10):1420-1423.
  8. Burridge N, Deidun D. Australian don't rush to crush handbook: therapeutic options for people unable to swallow solid oral medicines. Society of Hospital Pharmacists of Australia; 2011.
  9. Cichero JA. Thickening agents used for dysphagia management: effect on bioavailability of water, medication and feelings of satiety. Nutr J. 2013;12(1):54.

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Instructions for use

Intended use: For people with swallowing difficulties, a gel that helps to swallow tablets, capsules and powders.

  1. Remove bottle cap and replace with pump assembly before initial use.
  1. Place tablet/capsule on spoon or in med cup.
  1. Add one complete pump (approximately ½ tbsp, 1 tsp, or 5mL) to cover tablet/capsule.
  1. Swallow.

Tips for Use

  • It may or may not be necessary to crush tablets or open capsules when using this product to help swallow.
  • May assist with the swallowing reflex if chilled.
  • If using for the first time, try it first without tablets.
  • Drink liquids as prescribed before or after swallowing tablets and capsules.
  • No gluten, dyes, allergens or gelatin.

Cautions

  • Store between 35-77°F (2-25°C).
  • Do not use if cap seal is broken or missing.
  • Use within 2 months of opening the bottle.
  • Keep out of reach of children.
  • Use medication as directed.
  • For all patients who can swallow independently and is not suitable for children younger than 2 years old.
  • Do not use in the case of known hypersensitivity to any of the ingredients.

FAQ

  • Assure Slide/Phazix Level 3 is a swallowing gel designed to help those with difficulty swallowing tablets, capsules, and powders.
    • If the text refers to `tablets and capsules' it is referring to all medications or supplements in solid form, such as pills, tablets, lozenges and capsules, as well as pre-packaged powders.
    • Assure Slide/Phazix Level 3 is not intended to be used with water soluble tablets, dispersible tablets, liquid medication, liquid supplements.
  • If you have questions about this information or this product, please contact ARKRAY.
  • Use medication as directed.
  1. Place tablet, capsule or powder to be taken on a teaspoon.
  2. Apply a full pump from the 500mL bottle onto the tablet, capsule or powder.
    • Approximately 1 teaspoon, one half tablespoon, or 5mL
  3. Place in your mouth and swallow at once.
Phazix Level 3 has a vanilla flavor. It contains the following ingredients: water, sugar, carrageenan, maltodextrin, potassium sorbate (preservative), calcium chloride, citric acid, natural flavor. It has a moderetely thick consistency.
Assure Slide Forte has a vanilla flavor. It contains the following ingredients: water, dried glucose syrup, sugar, maltodextrin, carrageenan, potassium sorbate (preservative),citric acid, and natural flavor. It has a extremely thick consistency.
  1. The gel is thick and smooth to allow for easy swallowing of medications or supplements and a smooth passing through the esophagus to the stomach.
  2. Assure Slide/Phazix Level 3 moistens the mucous membranes in the mouth and throat and may stimulate saliva due to citric acid, allowing the tablet, capsules or powders to pass smoothly through the esophagus.
  3. Assure Slide/Phazix Level 3 breaks down quickly in the stomach and does not affect the absorption rate of medication. Now your medication is available to be delivered the way the manufacturer intended.
  4. The fresh flavor and aroma of Assure Slide/Phazix Level 3 may mask the unpleasant taste and smell of tablets, capsules and powders.
Assure Slide/Phazix Level 3 breaks down quickly in the stomach therefore, your medication is now available for absorbtion the way the manufacturer intended. Consult with your physician or pharmacist for more information.
  • Assure Slide/Phazix Level 3 can be used by anyone who has difficulty swallowing tablets, capsules and powders but can swallow independently.
  • Assure Slide/Phazix Level 3 is suitable for anyone over the age of 2.
  • Assure Slide/Phazix Level 3 does not contain gluten, common allergens or gelatin. For a list of common allergens reviewed, contact ARKRAY for information.
  • Assure Slide Zero is sugar-free.
If it has been verified by a Pharmacist that the capsule can be opened, Assure Slide/Phazix Level 3 can be used to aid in swallowing.
If it has been verified by a Pharmacist that the capsule can be crushed, Assure Slide/Phazix Level 3 can be used to aid in swallowing.
  • Approximately 1 teaspoon of Assure Slide/Phazix Level 3 is the recommended dosage. With this volume of Assure Slide/Phazix Level 3, tablets, capsules and powders may go down smoothly.
  • A larger quantity of Assure Slide/Phazix Level 3 can be used with larger quantities of tablets, capsules and powders.
  • Assure Slide/Phazix Level 3 can also be used in several doses.
  • Chilling Assure Slide/Phazix Level 3 will thicken it and may make swallowing easier.
  • A maximum of three doses per day is recommended for children between two and six years of age.
  • It is recommended that Assure Slide/Phazix Level 3 is used by adults as often as pills are taken. Assure Slide/Phazix Level 3 is made with food-safe ingredients and presents a low health risk if consumed in large quantities in error.
It is not necessary to take water with Assure Slide/Phazix Level 3, but it may be necessary to take water with your medication after intake with Assure Slide/Phazix Level 3.
With Assure Slide/Phazix Level 3 you can swallow multiple pills at once. Consult with a pharmacist to learn if your medications can be mixed and taken together.
  • Assure Slide/Phazix Level 3 has not been developed specifically for patients with an impaired swallowing reflex.
  • Assure Slide/Phazix Level 3 is not a solution for patients who choke when eating solid food.
  • Assure Slide/Phazix Level 3 should not be used for swallowing medicines in liquid or effervescent form.
There is insufficient data available to establish the safety of Assure Slide/Phazix Level 3 during pregnancy or breastfeeding. Consult with your physician or pharmacist.
  • Keep out of reach of children.
  • Stored between 35°F and 77°F (2°C and 25°C).
  • Use Assure Slide/Phazix Level 3 by the Use-by date printed on the packaging.
  • Once opened (bottle seal broken), Assure Slide/Phazix Level 3 should be used within 60 days.
  • Assure Slide/Phazix Level 3 can be disposed of with ordinary household waste.
Healthcare professionals may consider the use of Assure Slide/Phazix Level 3 to address the concerns in this section, §483.45(f) Medication Errors, of the CMS Manual System, Pub. 100-07 State Operations, published by the DHHS, Centers for Medicare and Medicaid Services, effective November 28, 2017. See this section for further information: F760 The facility must ensure that its— §483.45(f)(2) Residents are free of any significant medication errors.1

1. Department of Health & Human Services (DHHS), Centers for Medicare & Medicaid Services (CMS). (2017). Medication Errors of the CMS Manual System, Pub. 100-07 State Operations Manual.

Events

Events

Date

Location

September 2020    
HIDA Streamlining September 22nd-24th Virtual
Association of Health Facility Survey Agencies (AHFSA) September 27th-29th Virtual
IMCO National Sales Meeting September 29th- October 2nd         Virtual
     
October 2020    
American Home Care Association (AHCA) October 4th-7th Virtual Webinar Series
NDC October 14th-16th Virtual
Arkansas Health Care Association (AHCA-AALA) October 20th-21st Virtual
National Health Care (NHC) Annual Patient Care Conference and Tradeshow TBD TBD
Concordance Western national Sales Meeting TBD TBD
November 2020    
NADONA November 1st- 4th Virtual
NCCHC Fall Conference November 2nd- 4th Virtual
Kentucky Association of Health Care Facilities (KAHCF) November 11th- 12th Virtual
California Association of Health Care Facilities (CAHF)- Fall show November 17th-19th Virtual

Ordering Information

Product Flavor Oz Case Qty. Product # UPC 015482-

Phazix Pill Swallowing Gel Level 3

Vanilla 16.9 6 1000004 10004-9
Assure Slide Pill Swallowing Gel - Forte Vanilla 16.9 6 1000002 10002-5

Assure Slide/Phazix Level 3 Products are available through most national and regional distributors. To find a distributor call 800.818.8877

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