Ramipril on a Serious Shortage Protocol, and a winter of scarce heart and cancer drugs

Britain imports around three-quarters of its medicines². The Independent Pharmacies Association has warned that blood-pressure and cancer treatments are running short as the Iran war and the Hormuz blockade add days to air-freight and raise shipping costs^1,2. Among products on the official shortage list shared with pharmacists are Lenzetto, a widely used HRT spray, and Propranolol, a beta-blocker for blood pressure, angina and abnormal rhythms².

The sharpest administrative tool in the present wave is a Serious Shortage Protocol on Ramipril 1.25 mg capsules, an ACE inhibitor dispensed more than 30 million times in England in 2025¹. The protocol lets community pharmacies limit dispensing to one month’s supply per prescription, overriding the usual multi-month routines, while tablet and liquid forms remain available for now¹. Other active notifications cover Propranolol modified-release capsules (immediate-release tablets still available), co-codamol, diamorphine injections and several specialist items¹.

Dr Leyla Hannbeck of the IPA says pharmacies are often forced to source scarce packs at a loss¹. The Royal College of GPs has backed giving pharmacists limited power to adjust prescriptions without a fresh GP letter each time a pack disappears¹.

For you, the useful moves are ordinary: order repeats a little earlier than usual, ask the pharmacist what is substitutable, and do not stockpile beyond what your clinician advises — hoarding is how a tight list becomes a worse one^1,2. The protocol is paperwork. Paperwork is how a strained supply chain stays fair.