Ramipril Supply Limit Extended to October

The one-month limit on ramipril 1.25 mg capsule supplies has been extended until 30 October, prompting pharmacists to renew calls to be allowed to use their professional judgement to substitute an alternative product. In April, the Department of Health and Social Care (DHSC) issued a serious shortage protocol (SSP) for ramipril 1.25 mg capsules, telling pharmacies to limit supplies to one month per prescription. Around 14 million adults in the UK have high blood pressure. Ramipril is an angiotensin-converting enzyme (ACE) inhibitor, taken by around 6 million people. It is the most commonly prescribed antihypertensive in the UK, and among the top 10 most-prescribed medications overall. It is often preferred over other drugs because its long half-life means it can be taken just once daily. The SSP was extended in May and again on 23 July. It applies to both NHS and private prescriptions across all four UK nations. When a reduced quantity compared with what was prescribed must be supplied under an SSP, no prescription charge is payable. Millions of Patients Affected Olivier Picard, chair of the National Pharmacy Association, described the ongoing shortage as concerning. “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,” he said in a press release. The SSP regulations limit pharmacists to supply only in a 1-month quantity when the prescription is for a longer duration of treatment. The protocol does not allow the supply of a different product according to pharmacists' professional judgement. The rules stipulate that if the pharmacist thinks that an alternative product would be suitable for the patient, they should either contact the prescriber to discuss this — with the patient’s consent — or direct the patient back to the prescriber. Picard urged the government to 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. Ramipril 1.25mg and 2.5mg tablets, plus an oral solution, remain available. However, the DHSC has warned that supplies could not meet increased demand if all capsule patients switched to these forms. Shortages the Worst Ever Experienced Ramipril is only one of many medicine shortages that pharmacies and patients have had to contend with in recent years, he pointed out. “Pharmacies are increasingly facing supply problems affecting everyday medicines on which millions rely every day, with some describing shortages as the worst they have ever experienced,” he said. “Fragility in the global supply chain is worsened by international instability,” Picard said. In the wake of new Prime Minister Andy Burnham’s Cabinet appointments, he called for a taskforce to be established “to fully grip this chronic problem”. Dr Sheena Meredith is an established medical writer, editor, and consultant in healthcare communications, with extensive experience writing for medical professionals and the general public. She is qualified in medicine and in law and medical ethics.