NHSL Medicines Guidance
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Medicine | Tier -Impact level | Summary of Available Information | Expected Resolution Date | Link |
|---|---|---|---|---|
Acetylcysteine 600mg capsules | Tier 1 - low impact | Please see SPS for more information. | 05/02/2027 | |
Ixiaro (Japanese encephalitis) vaccine suspension for injection 0.5ml pre-filled syringes | Tier 1 - low impact | Please see SPS for more information. | 31/08/2026 | |
Diclofenac (Voltarol® Ophtha) 0.1% eye drops 0.3ml unit dose preservative-free
| Tier 2 - medium impact | Please see MSN for more information. | 15/01/2027 | |
Estradiol valerate 2mg tablets | Tier 1 - low impact | Please see SPS for more information. | 21/08/2026 | |
Nifedipine modified release tablets | Tier 2 -medium impact | Please see SPS for more information on available alternatives to support increased demand. Please note the discontinuation of Adanif XL 30mg and 60mg tablets.
| Dexipress MR 20mg tablets: 06/11/2026 Adalat LA 30mg tablets: 23/11/2026 Neozipine XL 30mg tablets: 10/08/2026 Neozipine XL 60mg tablets: 10/08/2026 Tensipine MR 10mg and 20mg tablets: TBC | |
Hyoscine butylbromide 20mg/1ml solution for injection ampoules | Tier 1 - low impact | There are sufficient supplies available to cover demand. Please see SPS for more information. | 04/09/2026 | SPS - Hyoscine butylbromide 20mg/1ml solution for injection ampoules |
Calcitriol (Silkis) ointment | Tier 2 - medium impact | Please see SPS for more information | 31/08/2026 | |
Dexamethasone 0.1% eye drops preservative free (6ml) | Tier 1 - low impact | Please see SPS for more information | 14/08/2026 | |
Ixchiq (chikungunya) vaccine powder and solvent for solution for injection 0.5ml vials | Tier 2 - medium impact | Please see SPS for more information | 04/09/2026 | SPS - Ixchiq (chikungunya) vaccine powder and solvent for solution for injection 0.5ml vials |
Betamethasone 0.1%/Neomycin 0.5% (Betnesol-N) ear/eye/nose drops | Tier 2 - medium impact | Please see SPS for more information | 01/01/2027 | SPS - Shortage of Betamethasone 0.1%/ Neomycin 0.5% (Betnesol-N) ear/eye/nose drops |
Ketotifen (Zaditen) 250micrograms/ml eye drops | Tier 2 - medium impact | Please see SPS for more information | 22/01/2027 | SPS - Shortage of Ketotifen (Zaditen) 250micrograms/ml eye drops |
Nabilone 1mg capsules | Tier 2 - medium impact | Please see MSAN for more information | 21/08/2026 | |
Latanoprost 50micrograms/ml / Timolol 5mg/ml (Fixapost®) preservative free | Tier 2 - medium impact | Please see MSAN for more information. | 29/01/2027 | |
Epilim Chronosphere (sodium valproate) 50mg, 250mg, 500mg modified-release granules sachets sugar free | Tier 2 -medium impact | Please see SPS and MSAN for more information. | 50mg: 28/08/2026 250mg: 15/01/2027 500mg: 02/10/2026 | SPS - Shortage of Epilim Chronosphere 50mg, 250mg and 500mg MR granules sachets SF |
Quinagolide 25mcg, 50mcg, 75mcg tablets | Tier 1 - low impact | Please see SPS for more information | Discontinuation | |
ChloraPrep solution (1ml, 1.5ml, 3ml applicators) | Tier 2 -medium impact | Please see SPS for more details | 31/10/2026 | |
Cyclophosphamide 500mg, 1g and 2g powder for solution for injection | Tier 2 - medium impact | Please see SPS for more details | 500mg: 24/08/2026 2g: 30/11/2026 | SPS - Shortage of Cyclophosphamide 500mg and 1g powder for solution for injection |
Bethanechol chloride 25mg tablets | Tier 1 - low impact | Please see SPS for more details | 02/10/2026 | |
Mesna 1g/10ml solution for injection ampoules | Tier 2 - medium impact | Please see SPS for more details | 10/08/2026 | SPS - Shortage of Mesna 1g/10ml solution for injection ampoules |
Co-magaldrox (Mucogel®) 195mg/220mg/5ml oral suspension sugar free | Tier 2 - medium impact | Shortage published January 2026. | Discontinuation | SPS - Discontinuation of Co-magaldrox (Mucogel) 195mg/220mg/5ml oral suspension SF |
U.L.T.H Cardioplegia Formula A Sterile solution, 500ml (Special order) | Tier 2 - medium impact | Please see SPS for more details | 14/08/2026 | SPS - Shortage of U.L.T.H Cardioplegia Formula A Sterile solution |
Disopyramide (Rythmodan®) 100mg capsules and disopyramide (RythmodanRetard®) 250mg modified-release tablets | Tier 2 - medium impact | Please see MSAN for more details | 100mg capsules: 09/04/2027 250mg modified-release tablets: 14/08/2026 | |
Fresenius unlicensed Levobupivacaine /Fentanyl infusion bags (Steriflex) | Tier 2 -medium impact | Please see SPS for more details | Various - please see MSN for more details | MSN/2026/026 - Fresenius unlicensed Levobupivacaine /Fentanyl infusion bags (Steriflex) |
Flumetasone 0.02% / Clioquinol 1% ear drops | Tier 2 - medium impact | Please see SPS for more details | 04/12/2026 | SPS - Shortage of flumetasone 0.02% /clioquinol 1% ear drops/ |
Prednisolone 1mg gastro-resistant tablets | Tier 1 - low impact | Please see SPS for more details | 01/09/2026 | |
Methylprednisolone 100mg tablets | Tier 1 - low impact | Please see SPS for more details. | 21/08/2026 | |
Minocycline 100mg tablets | Tier 2 - medium impact | Existing shortage with extended resupply date from 05/06/2026 to 30/12/2026. Please see SPS for more details. | 30/12/2026 | |
Oxybutynin 5mg tablets | Tier 2 - medium impact | 5mg & 10mg MR tabs remain available. 2.5mg IR remain available and are more cost effective but cannot support increased demand. | 11/09/2026 | |
Betamethasone valerate 0.1%/ Clioquinol 3% ointment | Tier1 - low impact | Betamethasone valerate 0.1%/ clioquinol 3% cream remains available and can support increased demand | 31/07/2026 | SPS - shortage of Betamethasone valerate 0.1%/ Clioquinol 3% ointment |
Doxepin 5% cream | Tier 1 - low impact | Please see SPS for more details | 21/08/2026 | |
Geloplasma 3% infusion 500ml Freeflex bags | Tier 1 - low impact | Please see SPS for more details | Discontinuation 07/01/2026 | SPS - discontinuation of Geloplasma 3% infusion 500ml Freeflex bags |
Verteporfin 15mg powder for solution for infusion vials | Tier 2- medium impact | Please see SPS for more details | 27/11/2026 | SPS - shortage of Verteporfin 15mg powder for solution for infusion vials |
Vitamin B compound tablets | Tier 1 - low impact | Please see SPS for more details | 02/04/2027 | |
Midazolam (Epistatus) 7.5mg/0.75ml oromucosal solution pre-filled oral syringe sugar free | Tier 2 - medium impact | Midazolam (Epistatus) 7.5mg/0.75ml oromucosal solution pre-filled oral syringes are unavailable. | 29/05/2026 | |
Primidone 125mg tablets | Tier 1 - low impact | Please see SPS for more details | 21/08/2026 | |
Varilrix vaccine powder and solvent for solution for injection 0.5ml vials | Tier 1 - low impact | Please see SPS for more details | 15/09/2026 | |
Flupentixol (Psytixol) solution for injection ampoules | Tier 1 - low impact | Psytixol 20mg/1ml and 40mg/2ml are unavailable. Psytixol 200mg/1ml, 100mg/1ml and 50mg/0.5ml have been discontinued | 01/01/2028 | SPS - shortage of Flupentixol (Psytixol) solution for injection ampoules |
Erythromycin 40mg/ml/ zinc acetate 12mg/ml lotion | Tier 2 - medium impact | Please see SPS for more details | 01/01/2027 | SPS - shortage of Erythromycin 40mg/ml/ zinc acetate 12mg/ml lotion |
Ramipril 1.25mg capsules | Tier 2 - medium impact | Please see MSAN and SSP for more details. N.B. tablets currently unavailable | 24/07/2026 | |
Lidocaine 5% ointment | Tier 1 - low impact | Please see SPS for more details | 02/10/2026 | |
Ropinirole 250microgram tablets | Tier 2 - medium impact | Please see SPS for more details | 31/07/2026 | |
Dinoprostone 1mg/2.5ml vaginal gel and 3mg vaginal tablets | Tier 3 - high impact | Refer to the National Patient Safety Alert (NatPSA/2026/003/DHSC) for full details. A maternity memo was issued on 2 April 2026 outlining the use of dinoprostone 10mg vaginal delivery system (formerly branded as Propess®) as the primary alternative. 2mg/2.5ml vaginal gel is back in stock as of 23/07/2026. | 1mg/2.5ml vaginal gel: 12/08/2026 3mg pessaries: 14/09/2026 | SPS - shortage of dinoprostone 3mg vaginal tablets and 1mg/2.5ml, 2mg/2.5ml vaginal gel |
Capimune 25mg and 50mg capsules | Tier 2 - medium impact | Please see SPS for further details | TBC | |
Domperidone 1mg/ml oral suspension sugar free | Tier 1 - low impact | Please see SPS for further details | 04/09/2026 | SPS - shortage of Domperidone 1mg/ml oral suspension sugar free |
Aztreonam 1g and 2g powder for solution for injection vials | Tier 2 -impact level | Please see SPS for further details. | 03/07/2026 | SPS - shortage of Aztreonam 2g powder for solution for injection vials |
Chlordiazepoxide 5mg and 10mg capsules | Tier 2 - medium impact | Please see MSAN for further details. | 14/08/2026 | |
Cefixime (Suprax®) | Tier 2 - medium impact | Please see MSAN for further details | 16/10/2026 | |
Trazodone 100mg/5ml oral solution sugar free | Tier 1 - low impact | Please see SPS for further details | 15/07/2026 | SPS - shortage-of-trazodone-100mg-5ml-oral-solution-sugar-free |
Aprepitant 125mg oral powder sachets | Tier 2 - medium impact | Please see SPS for further details, including a list of specialist importers. | Discontinuation 28/01/2026 | SPS - discontinuation of Aprepitant 125mg oral powder sachets |
Dequalinium chloride 10mg vaginal tablets | Tier 1 - low impact | Originally published on 17/03/2025 as unavailable. Product has now been discontinued. | Discontinuation | |
Aceclofenac 10mg tablets | Tier 2 - medium impact | Please see SPS for further details | 21/08/2026 | |
Ramipril 1.25mg capsules | Tier 2 - medium impact | Please see SPS for further details | 30/10/2026 | |
Gastrografin® (meglumine amidotrizoate 3.3g/5ml / sodium amidotrizoate 500mg/5ml)oral solution | Tier 2 - medium impact | Please see MSN for further details | 25/06/2027 | |
Menitorix (Haemophilus influenzae type b + Meningococcal group C) vaccine powder and solvent for solution for injection 0.5ml vials | Tier 2 - medium impact | Please see SPS for further details | Discontinuation 31/12/2025 | |
Reslizumab (Cinqaero® | Tier 2 - medium impact | Reslizumab market withdrawal rescinded; 100mg/10ml vials now expected to be in shortage from 31 August to 31 December 2026. | 31/12/2026. | SPS - Reslizumab 100mg/10ml solution for infusion vials
|
Palforzia® initial dose escalation pack, level 1-11 two week dosing packs, 0.5/1/10/20/100mg oral powder in capsules for opening, maintenance pack 300mg oral powder sachets | Tier 2 -medium impact | Please see MSN for further details. | Discontinuation between March 2026 - March 2027 | |
Sytron (sodium feredetate iron 27.5mg/5ml) oral solution sugar free | Tier 1 - low impact | Shortage published February 2024. An alternative brand of sodium feredetate 27.5mg/5ml oral solution sugar free (SodiFer) remains available. | 07/08/2026 | |
Baclofen 10mg/5ml oral solution sugar free | Tier 1 - low impact | Baclofen 5mg/5ml oral solution sugar free remains available and can support increased demand. | 05/02/2027 | |
Apraclonidine (lopidine) 5mg/ml (0.5%) eye drops | Tier 2 - medium impact | Please see SPS for further details | Discontinuation | SPS - discontinuation of apraclonidine (Iopidine) 5mg/5ml eye drops |
Crisantaspase (Erwinase) 10,000unit powder for solution for injection/infusion vials | Tier 2 - medium impact | Please see MSN for further details | Discontinuation 30/10/2026 | MSN_2026_013 Crisantaspase (Erwinase) 10,000unit powder for .pdf |
Phenobarbital 60mg tablets (Accord-UK Ltd) brand | Tier 2 - medium impact | Phenobarbital is a category 1 anti-epileptic drug so ideally patients should be maintained on a specific manufacturer’s product. Patients should be monitored after a switch in manufacturer’s product for loss of seizure control and/or adverse effects.Please see SPS for further details. | Please see SPS | |
Lamotrigine Desitin 10mg/ml oral suspension sugar free | Tier 2 - medium impact | Please see SPS for further details. | 04/09/2026 | |
Sulfadiazine silver (Flamazine) 1% cream | Tier 2 - medium impact | Please see MSAN for further details | Discontinuation | |
Mefenamic acid 50mg/5ml oral suspension | Tier 2 - medium impact | It has been out of stock since 2024. Tabs and caps remain available. | Discontinuation | SPS - Discontinuation of mefenamic acid 50mg/5ml oral suspension |
Hydrocortisone sodium phosphate 100mg/1ml solution for injection ampoules | Tier 2 - medium impact | Originally published 20/01/2025 as unavailable. Now discontinued. | Discontinuation | Discontinuation of Hydrocortisone sodium phosphate 100mg/1ml solution for injection ampoules |
Cobicistat 150mg tablets | Tier 1 - low impact | Please see SPS for further information | Discontinuation 19/12/2025 | |
Chloroquine phosphate 250mg tablets | Tier 1 - low impact | Please see SPS for further information | Discontinuation 01/10/2025 | |
Ifosfamide 1g and 2g powder for solution for injection vials | Tier 3 - high impact | Ifosfamide 1g and 2g powder for solution for injection vials are in limited supply. | 1g - 17/08/2026 2g - 12/08/2026 | |
Lanreotide 60mg/0.5ml, 90mg/0.3ml and 120mg/0.5ml solution for injection pre-filled syringes | Tier 2 - medium impact | Please see MSAN for further information. | 60mg - 15/12/2026 90mg - 15/12/2026 120mg - 15/11/2026 | |
Asenapine (Sycrest®) 5mg and 10mg sublingual tablets | Tier 2 - medium impact | Please see SPS for further information. | Discontinuation 30/01/2026 | Asenapine (Sycrest) 5mg and 10mg sublingual tablets - SPS NHS |
Thalidomide 50mg capsules (Bristol-Myers Squibb Pharmaceuticals Ltd) | Tier 1 - low impact | Please see SPS for further information. | Discontinuation 30/01/2026 | Thalidomide BMS 50mg capsules (Bristol-Myers Squibb Pharmaceuticals Ltd) - SPS NHS |
Olanzapine (Zypadhera®) 210 mg, 300mg, 405mg powder and solvent for prolonged release suspension for injection | Tier 2 - medium impact | Please see SPS for further information. | 210mg: 30/09/2026 300mg: 31/07/2026 405mg: 30/09/2026 | |
Itraconazole 250mg/25ml concentrate and solvent for solution for infusion | Tier 2 - medium impact | Itraconazole capsules and oral solutions remain available. | 25/09/2026 | Shortage of Itraconazole 250mg/25ml concentrate and solvent for solution for infusion – NHS SPS |
Emerade® 150mcg/0.15ml, 300mcg/0.3ml and 500mcg/0.5ml solution for injection auto-injector pens | Tier 2 - medium impact | Status updated from shortage to product discontinuation. Please see SPS for further information. | Discontinuation 19/01/2026 | |
Steriflex No.177, No.101, No.178, No.132, No.134, No.139, No.19, No.26 and No.151 bags (licensed and unlicensed IV fluids) | Tier 2 - medium impact | Please see SPS for further information. | Various - see SPS for more information | |
Buprenorphine/Naloxone (Suboxone®) 2mg/500microgram and 8mg/2mg sublingual tablet | Tier 2 - medium impact | Please see MSAN for further information. | Discontinuation 05/01/2026 | |
Co-magaldrox (Mucogel®) 195mg/220mg/5ml oral suspension sugar free | Tier 2 - medium impact | Shortage published January 2026. | 03/07/2026 | Shortage of Co-magaldrox (Mucogel) 195mg/220mg/5ml oral suspension sugar free – NHS SPS |
Steriflex No.109 (1L) and No.171 (2L): Potassium Chloride 0.15%, Sodium Chloride 045%, Glucose 2.5% Bags. | Tier 3 - high impact | Refer to the NPSA Alert issued on 14 January 2026 for a full set of actions. This alert is for action by acute care hospitals and any other organisations involved in prescribing Steriflex No.109 and No.171 IV fluid bags. | 28/08/2026 | |
Co-codamol 30mg/500mg tablets | Tier 3 - high impact | Please see SPS and MSAN for further information. | 02/10/2026 | |
Mefloquine (Lariam®) 250mg tablets | Tier 2 - medium impact | Please see SPS for further information. | 21/08/2026 | |
Atenolol 5mg/10ml solution for injection ampoules | Tier 2 - medium impact | There is limited stock available at wholesalers and trust’s should only order what they need until the shortage has been resolved. Metoprolol 1mg/ml injection remains available and can support increased demand. | 25/09/2026 | Shortage of Atenolol 5mg/10ml solution for injection ampoules – NHS SPS |
Pen device for Genotropin® (Somatropin) 5.3mg and 12mg powder and solvent for solution for injection | Tier 2 - medium impact | Do not initiate new patients on the Genotropin® Pen reusable device until the supply issue has resolved. See Medicine Supply Notification (MSN/2025/072) for possible alternatives. | 30/01/2026 | |
Diamorphine 5mg, 10mg, 30mg and 100mg powder for solution for injection ampoules | Tier 3 - high impact | Ensure no new patients are started on diamorphine injection unless other opioid options are not considered suitable. Morphine sulfate 10mg/1ml injection is opioid of choice, reserve remaining stock of diamorphine for patients considered unsuitable for morphine. Do not switch patients to the 30mg strength of diamorphine injection as there is insufficient stock to support increased use. See Medicine Supply Notification (MSN/2025/071) for further information. | 30/09/2026 | |
Nifedipine (Adipine XL®) 30mg and 60mg modified-release tablets | Tier 2 - medium impact | Consider prescribing alternative brands of nifedipine 30mg and 60mg modified-release preparations (e.g. Coracten XL capsules, note contains gelatin). Refer to SPS for further options. MSAN available here NHS Scotland - Publications | Shortage changed to a Discontinuation on 15/01/2026 | |
Buprenorphine (Subutex) 0.4mg, 2mg and 8mg sublingual tablets | Tier 1 - low impact | See SPS for further information | Discontinuation 12/01/2026 | Discontinuation of buprenorphine (Subutex) 0.4mg, 2mg and 8mg sublingual tablets – NHS SPS |
Osmohale (mannitol) kit inhalation powder capsules with device | Tier 2 - medium impact | See SPS for further information | 27/11/2026 | Shortage of Osmohale (mannitol) kit inhalation powder capsules with device – NHS SPS |
Mitomycin 10mg, 20mg and 40mg powder for solution for injection vials | Tier 2 - medium impact | See SPS for further information | Date to be confirmed (previously was 24/04/26 and 29/05/26 respectively) | Shortage of Mitomycin 10mg, 20mg and 40mg powder for solution for injection vials – NHS SPS |
Epoetin beta (NeoRecormon®) 20,000units/0.6ml solution for injection pre-filled syringes | Tier 2 - medium impact | See MSN for further information | Discontinuation 15/12/2025 | |
Sotrovimab (Xevudy) 500mg/8ml solution for infusion vials | Tier 2 - medium impact | See SPS for further details | Discontinuation 27/02/2026 | MSN_2025_067 Sotrovimab (Xevudy) 500mg_8ml solution for infusion vials.pdf |
Prednisolone sodium phosphate 0.5% ear/eye drops | Tier 2 - medium impact | Consider prescribing betamethasone (Betnesol®) 0.1% ear/eye/nose drops. | 02/10/2026 | |
Tolterodine 2mg and 4mg MR capsules | Tier 2 - medium impact | In limited supply, see SPS for further information. | tbc | |
Adepend® | Tier 2 - medium impact | Prescribe generic naltrexone 50mg tablets (Aspire or Accord), noting that for the Aspire product use for alcohol dependence is off-label. See SPS for further supporting information. | tbc | |
Private supply of rabies vaccine | Tier 1 - low impact | Please see SPS for further details | tbc | |
Topiramate 100mg & 200mg tabs Accord. | Tier 2 - medium impact | Other manufacturers remain in stock of topiramate tablets and can support increased demand. | 100 & 200mg 19/02/2027. | |
Nifedipine (Fortipine LA) 40mg modified-release tablets | Tier 2 - medium impact | Prescribers should not initiate new patients on Fortipine LA 40. Please see SPS for further details | Discontinuation 16/01/2026 | Shortage of Nifedipine (Fortipine LA) 40mg modified-release tablets – NHS SPS |
Diclofenac (Akis) 75mg/1ml solution for injection ampoules | Tier 2 - medium impact | Alternative strengths and NSAIDs remain available | Discontinuation 12/12/2025 | Discontinuation of Diclofenac (Akis) 75mg/1ml solution for injection ampoules – NHS SPS |
Licensed & unlicensed epidural bags | Tier 3 - high impact | Please see National Patient Safety Alert (NatPSA/2025/007/DHSC). | 30/06/2026 | |
| Tier 3 - high impact | Anticipated resupply date of Pancrex V 125mg capsules changed from 2 January to 6 March 2026. | 06/03/2026 | |
Trandolapril 0.5mg capsules | Tier 2 - medium impact | Please see SPS for further details. Shortages of 1mg, 2mg and 4mg capsules have resolved. The 0.5mg capsule shortage remains ongoing. | To be confirmed. | |
Lopinavir/Ritonavir tablets | Tier 2 - medium impact | Please see SPS for further details. | Discontinuation 04/04/2026 | |
Mivacurium 2mg/ml solution for injection ampoules | Tier 2 - medium impact | Please see SPS and MSN for further details. | Discontinuation 29/05/2026 | Discontinuation of Mivacurium 2mg/ml solution for injection ampoules – SPS |
Rivastigmine 4.6mg/ 24hours and 9.5mg/24 hours transdermal patches | Tier 2 - medium impact | Please note the most up to date guidance for this shortage is NB: As of 13/01/2026, this shortage has been reclassified from Tier 3 (high impact) to Tier 2 (medium impact). | 30/09/2026 | MSAN (2026) 018 - Rivastigmine 4.6mg/24 hours and 9.5mg/24 hours transdermal patches - Update |
Levemir (insulin detemir) FlexPen and Penfill 100units/ml solution for injection 3ml pre-filled pens and cartridges | Tier 2 - medium impact | Clinicians should not initiate new patients on any Levemir product. The Lanarkshire Diabetes Service are developing a switch implementation plan for existing patients.
| 31/12/2026 | MSAN 2026 (14) Update: Levemir (insulin determir) FlexPen and Penfill |
Galantamine 24mg modified release capsules | Tier 2 - medium impact | Galantamine 8mg and 16mg capsules are now back in stock. | 16/10/2026 | |
Estradiol (Estradot) 25mcg, 37.5mcg, 50mcg, 75mcg, 100mcg/24 hours transdermal patches | Tier 2 - medium impact | Prescribers should not initiate new patients on Estradot 25micrograms/24hours, 37.5micrograms/24hours 50micrograms/24hours, 75micrograms/24hours and 100micrograms/24hours transdermal patches until the supply issues have resolved. | 02/10/2026 | |
Fiasp FlexTouch (insulin aspart) 100units/ml solution for injection 3ml pre-filled pens | Tier 2 - medium impact | Fiasp FlexTouch (insulin aspart) 100units/ml solution for injection 3ml pre-filled pens have been out of stock since 31 March 2024 and have subsequently been discontinued. | Discontinuation | |
Quetiapine 50mg, 150mg, 200mg, 300mg, 400mg modified-release tablets | Tier 2 - medium impact | Clinicians should not initiate new patients on quetiapine modified-release tablets until the supply issues have resolved. | Ongoing | |
Tresiba (insulin degludec) FlexTouch 100units/ml solution for injection 3ml pre-filled pens | Tier 2 - medium impact | Tresiba (insulin degludec) FlexTouch 100units/ml solution for injection 3ml pre-filled pens have been out of stock since 31 July 2023 and have subsequently been discontinued. | Discontinuation | |
Moviprep Orange oral powder sachets | Tier 1 - low impact | Please see SPS for further details | Discontinuation | Discontinuation of Moviprep Orange oral powder sachets – SPS |
Hydrocortisone butyrate (Locoid) 0.1% ointment | Tier 1 - low impact | Please see SPS for further details | Discontinuation | Discontinuation of Hydrocortisone butyrate (Locoid) 0.1% ointment – SPS |
Propranolol 80mg and 160mg MR capsules | Tier 2 - medium impact | Please see MSAN for full details. If an unlicensed preparation is required, refer to SPS guidance on specialist importers, SPS - propranolol shortage. | 80mg caps - 06/11/2026 160mg caps - 06/11/2026 | MSAN(2025)49 Propranolol 80mg and 160mg modified release capsules |
TOBI® (tobramycin) Podhaler 28mg inhalation powder capsules with device | Tier 2 - medium impact | Please see MSN for further details | 31/12/2026 | MSN/2025/013U TOBI (tobramycin) Podhaler 28mg inhalation powder, hard capsules |
Polihexanide 0.06% eye drops | Tier 2 - medium impact | Consider alternative unlicensed strengths of polihexanide containing eye drops, ensuring that the patient is not allergic to any of the excipients. | until further notice | |
Econazole (Gyno-Pevaryl®) 1% vaginal cream | Tier 2 - medium impact | Alternative antifungal treatments remain available. | Discontinuation | |
Cefalexin 125mg/5ml and 250mg/5ml oral suspension sugar free | Tier 2 - medium impact | Consider prescribing cefalexin non sugar free preparation in the first instance, if appropriate. If unsuitable, consider prescribing an alternative antibiotic liquid, with reference to local guidance and allergies. | 21/11/2025 | Shortage of cefalexin 125mg/5ml and 250mg/5ml oral suspension sugar free |
Tetracosactide (Synacthen Depot®) 1mg/1ml suspension for injection ampoules | Tier 2 - medium impact | please see SPS for further details | 25/09/2026 | Shortage of tetracosactide (Synacthen Depot) 1mg/1ml suspension for injection ampoules |
Chloramphenicol 250mg capsules | Tier 2 - medium impact | please see SPS for further details | 30/10/2026 | |
Mometasone (Asmanex Twisthaler®) 200micrograms/dose dry powder | Tier 2 – medium impact | do not initiate new patients on Asmanex Twisthalers® and consider switching existing patients prescribed an Asmanex Twisthaler® an alternative inhaled treatment | Discontinuation | |
Fentanyl (Durogesic® DTrans®) 12, 25, 50, 75 & 100 micrograms/hour patches | Tier 2 – medium impact | Changed from a shortage to a discontinuation. Consider prescribing an alternative brand of fentanyl matrix patch and monitor and clinically assess the person’s response and titrate dose if required. Formulary options can be found here. | Discontinuation | |
Exenatide (Bydureon® BCise® ) 2mg/0.85ml prolonged-release suspension for injection pre-filled pen | Tier 2 – medium impact | consider switching to alternative once weekly parenteral GLP-1 RAs or GIP/GLP-1 RA | Discontinuation | |
Semaglutide (Rybelsus®) 3 mg, 7 mg, and 14 mg tablets | Tier 2 - medium impact | New Rybelsus strengths (1.5mg, 4mg and 9mg) are NOT bioequivalent to previous strengths (3mg, 7mg and 14mg) and are NOT a straight mg for mg switch. New formulation has higher bioavailability, requiring lower milligram strengths for the same therapeutic effect. If switching from an older strength, follow the conversion guidance and review the patient's current dose and tolerance before prescribing. Conversion guidance: 3 mg → 1.5 mg (Initiation) 7 mg → 4 mg (Maintenance) 14 mg → 9 mg (Maintenance) | Discontinuation 31/01/2026 | |
Liothyronine 20microgram powder for solution for injection vials | Tier 2 – medium impact | Please see link for medicines shortage notification for further information | 31st July 2026 | MSN/2025/053 Liothyronine 20microgram powder for solution for injection vials |
Fluphenazine decanoate 25mg/1ml and 100mg/1ml solution for injection ampoules | Tier 1 - Low impact | Consider prescribing unlicensed fluphenazine decanoate 125mg/5ml solution for injection (multidose vial), only where licensed alternatives are not appropriate, ensuring the patient is not allergic to any excipients, the correct volume is administered, and injection volume >2ml for higher doses is acceptable to the patient |
| Shortage of Fluphenazine decanoate 25mg/1ml and 100mg/1ml solution for injection ampoules |
Benzylpenicillin sodium 600mg powder for solution for injection vials (Genus Pharmaceuticals Ltd) 2 vial | Tier 1 - Low impact | Alternative pack sizes (1 vial and 25 vial) of benzylpenicillin sodium 600mg powder for solution for injections vials remain available and can support increased demand | 01/05/2026 | Shortage of benzylpenicillin sodium 600mg powder for solution for injection vials (2 vial pack) |
Topiramate 50mg tablets (Glenmark) | Tier 2 – medium impact | Topiramate is an MHRA category 2 antiepileptic drug. Other manufacturers remain in stock of topiramate tablets and can support increased demand | 31.10.2025 | |
Mupirocin 2% cream 15 gram | Tier 2 – medium impact | Prescribers should not initiate patients on mupirocin 2% cream until the shortage has resolved. Bactroban 2% ointment and generic mupirocin 2% ointment 15g products remain available and can support increased demand. | 03.10.2025 | |
Admelog® (insulin lispro) 100units/ml solution for injection 3ml cartridges, 3ml pre-filled pens and 10ml vials | Tier 2 – medium impact | Clinicians should not initiate new people on Admelog®. Clinicians should review existing patients and consider switching to the originator insulin product, | Discontinuation | |
Procyclidine 10mg/2ml solution for injection | Tier 2 – medium impact | please see link SPS site for further information | Discontinuation | Discontinuation of procyclidine 10mg/2ml solution for injection |
Glucagon 500micrograms/0.1ml & 1mg/0.2ml solution for injection pre-filled disposable devices 1 pre-filled disposable injection (Ogluo) | Tier 1 - Low impact | Prescribers should not initiate new patients on glucagon (Ogluo) 500micrograms/0.1ml solution for injection pen or glucagon (Ogluo) 1mg/0.2ml solution for injection pre-filled pen. Please consider prescribing glucagon (GlucaGen Hypokit) 1mg powder and solvent for solution for injection vials | Discontinuation | Discontinuation of Glucagon 500micrograms/0.1ml & 1mg/0.2ml solution for injection pre-filled pens |
Co-trimoxazole 80mg/400mg/5ml oral suspension | Tier 2 – medium impact | Consider prescribing co-trimoxazole 40mg/200mg/5ml oral suspension sugar free, note different excipients. | 05.06.2026 | shortage of co-trimoxazole 80mg/400mg/5ml oral suspension Please see updated shortage information above to also include the 40mg/200mg/5ml oral suspension and MSN below |
Hydralazine 20mg powder for solution for injection | Tier 2 – medium impact | Unlicensed supplies of hydralazine 20mg injection can be sourced | 28.08.2026 | shortage of hydralazine 20mg powder for solution for injection |
Progynova TS 50micrograms/24hours and 100micrograms/24hours transdermal patches
| Tier 2 – medium impact | Clinicians should not initiate any new patients on Progynova TS patches and consider prescribing alternative estradiol patches, taking into account previous patches tried, dosing frequency, and intolerance to any of the patch excipients | Discontinuation | Estradiol (Progynova® TS) 50micrograms/24hours and 100micrograms/24hours transdermal patches |
Rifampicin 150mg and 300mg capsules Rifampicin 600mg IV solution for infusion Rifampicin 100mg/5ml oral suspension Rifinah® 300 tablets (rifampicin 300mg / isoniazid 150mg) Rifater® tablets (rifampicin 120mg / isoniazid 50mg/ pyrazinamide 300mg) Voractiv® tablets (rifampicin 150mg/ isoniazid 75mg / pyrazinamide 400mg / ethambutol 275mg) Pyrazinamide 500mg tablets | Tier 3 – high impact | Please see the MSN for further information | Varied - TBC Rifabutin 150mg capsules - 31/10/26 | MSN/2025/058 Antimicrobial Agents Used in Tuberculosis (TB) Treatment |
Humulin® I (insulin isophane human), Humulin® M3 (insulin isophane biphasic human 30/70), Humalog® Mix25 (insulin lispro biphasic 25/75) & Humulin® S (insulin soluble human) 100units/ml solution for injection 10ml vials | Tier 2 – medium impact | Vials of Humulin® I, Humulin® S, Humulin® M3, and Humalog® Mix25 are being discontinued. Supplies of Humulin® I and Humalog® Mix25 vials are anticipated to be exhausted by the end of April 2026; and Humulin® M3 and Humulin® S vials by the end of May 2026. Humulin® I, Humulin® S, Humulin® M3, and Humalog® Mix25 in cartridges (for use with HumaPen® Savvio® reusable pen) remain available, and can support increased demand (see Supporting information). Humulin® I, Humulin® M3 and Humalog® Mix25 in disposable KwikPens® remain available and can support increased demand (see Supporting information). Insulatard® (insulin isophane human) 100units/ml suspension for injection and Actrapid® (insulin soluble human) 100units/ml solution for injection 10ml vials remain available but cannot support increased demand | Discontinuation | |
Hypurin® Porcine Isophane (insulin isophane porcine), Hypurin® Porcine Neutral (insulin soluble porcine) & Hypurin® Porcine 30/70 Mix (insulin isophane biphasic porcine 30/70) 100units/ml suspension for injection 10ml vials | Tier 2 – medium impact | Vial presentations of Hypurin® Porcine Isophane, Hypurin® Porcine Neutral and Hypurin® Porcine30/70 Mix are being discontinued with supplies anticipated to be exhausted by the end of September 2025, mid-February 2026, and end of July 2026, respectively. The cartridge presentations of these products remain available and can support increased demand. Hypurin® Porcine cartridges are compatible with the AutoPen® Classic, and with the new mypen®2, which will be available from late September 2025. Note: AutoPen® Classic has been discontinued but limited stock remains available and can be used until mypen®2 is available | Discontinuation | |
Nicardipine 10mg and 20mg (Cardene®) | n/a | Marketing Authorisation Holder (MAH) has decided to cease marketing this product in the UK. The Marketing Authorisation (MA) remains valid and will be withdrawn upon the expiry of the final product batches, scheduled for the end of August 2025. | discontinuation | alerted via email from manufacturer |