An NHS Serious Shortage Protocol (SSP) is in place until 30 October 2026 for Ramipril 1.25 mg capsules, the UK's most prescribed blood pressure medication. Ramipril, an ACE inhibitor, is taken by roughly 6 million people in the UK. Under the protocol, pharmacists may provide a one-month supply if the patient agrees.
Scope of the Ramipril Shortage
According to MediWatch, all ramipril capsule strengths (1.25mg, 2.5mg, 5mg and 10mg) are in limited supply until the end of October 2026. An official notice published by the Department of Health & Social Care confirmed a UK-wide shortage.
Pharmacies have been instructed to advise patients to contact their prescriber or GP practice to reorder their medication on time when supplying in accordance with the SSP. Alternative ACE inhibitors and ARBs remain available, but routine switching is not recommended, as their usage is significantly lower than that of ramipril and could compromise other supply chains.
Propranolol Supply Issues
Meanwhile, there is an active shortage of propranolol 80mg and 160mg modified-release capsules, expected to last until November 2026. The medicine supply notification was originally issued by the Department of Health and Social Care (DHSC) in November 2025.
Prescribers are advised not to initiate patients on Propranolol 80mg or 160mg modified release capsules due to their unavailability. The Medical Supply Notification (MSN) recommends that prescribers consider the licensed immediate-release Propranolol 40mg and 80mg tablets, which remain available and can support increased demand. Switching requires a patient's prescriber (GP or specialist).
Persistent Medicine Shortages
According to Community Pharmacy England, medication shortages, including blood pressure treatments, have become a persistent problem in the UK. More than 1,500 medicine shortages were reported across England between May 2024 and April 2025.
Pharmacists have previously called on the government to change official guidance so they can offer patients an alternative drug without consulting their GP. Olivier Picard, chair of the National Pharmacy Association, said back in July: "Millions of patients rely on Ramipril, and although there are alternative medicines available, supplies of these must be managed carefully by the government to ensure subsequent demand can be met. The government should allow pharmacists to make appropriate substitutions to Ramipril prescriptions to ensure patients do not have to go back to their GP to find an alternative."
