Thousands of British people require epilepsy medicine, and the NHS has issued a drug shortage alert.
This is significant because when a seizure won’t stop on its own, adults and children with epilepsy utilise midazolam as one of their primary emergency therapies.
Pharmacy leaders say the disruption is linked to supply chain problems caused by the war in Iran and instability in the Strait of Hormuz, a major shipping route. They also warn that other medicines—including some cancer drugs, blood thinners, and blood pressure medications—are facing similar pressures.
The UK has about 633,000 people living with epilepsy, and about 30 per cent have uncontrolled seizures.
The shortage notice applies specifically to the 7.5mg pre‑filled oral syringes. Other formulations (e.g., nasal sprays, different strengths, non–pre‑filled solutions) may still be available, but supply is tight and varies by area.
Why is this serious? It references the 2025 death of Paul Nash, who died after missing three doses of his epilepsy medication due to supply delays.
Paul Nash, aged 58, died in October 2025 after suffering an epileptic seizure brought on by running out of his prescribed epilepsy medication, according to the coroner’s inquest.
The inquest into the death of Paul Robert Joseph Nash found that he had epilepsy secondary to HSV encephalitis, with significant brain injury dating back to 2014. His seizures had been well-controlled since 2016 with carbamazepine 500mg twice daily.
In September 2025, he did not request all of his repeat prescriptions.
On 21 October 2025, he told the charity Headway (Luton) that he had taken his last dose of medication. Headway contacted his GP urgently, but the prescription was not ready the next day.
He was found dead at home on 23 October 2025, with evidence indicating he had suffered a seizure during the night.
The coroner concluded that he “died following an epileptic seizure after running out of his epilepsy medication, which meant he had missed three doses”, though the exact trigger for the seizure remained unclear.
The coroner issued a Prevention of Future Deaths report highlighting systemic issues, which included communication failures because Headway had an urgent warning that Nash had no medication left and that was not passed onto the GP, so the prescription was not prioritised. Pharmacy delays in some areas, and some pharmacies were taking up to ten days to process repeat prescriptions. There was a national shortage, and his consultant neurologist reported that epilepsy patients across the UK were struggling to obtain sufficient medication, especially carbamazepine, and in 2025, research found that over 90 per cent of people reported shortages of the drug.
This incident became a well-known illustration of how administrative holdups and medicine shortages may put epileptics in danger of death.
This makes for some awful reading. The thought of having a treatable illness, but not being able to access medication, and presumably, it’s only going to get worse.
This is not a Brexit problem; it’s to do with the war in Iran, which has disrupted international shipping and air routes so harshly that the UK is now weeks away from shortages of essential medicines, particularly generics, painkillers and some cancer treatments.
The impact comes from supply‑chain choke points, not from Iran directly.
The Strait of Hormuz is virtually closed, blocking one of the world’s most significant shipping routes. This is critical because India — the source of a third of UK medicines and most generic drugs globally — ships APIs and finished medicines through this route.
Airports in Dubai, Doha, and Abu Dhabi, which are major transit hubs for pharmaceutical cargo, have been closed or are operating restricted schedules, causing rerouting.
Air freight costs have doubled, and sea freight is taking up to 14 extra days, adding about $1 million per journey in fuel costs.
UK distributors generally hold 6–8 weeks of stock, meaning lengthy disruption pushes the system toward shortages. This is why experts describe the problem as a “perfect storm” for the medicine supply.
What does this mean for UK patients?
Not all medications are affected. The risks are concentrated in people on long-term prescriptions with no easy substitutes. Cancer patients who need time-critical treatments. Patients using injectable or specialist formulations, and anyone relying on generic drugs, which make up the majority of NHS medicines.
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