Cilazapril: to be delisted mid 2024
Cilazapril is used in New Zealand much more than any other country. To reduce the risk of supply issues, we plan to stop funding cilazapril by mid-2024.
On this page
6 October 2024 update: Delist date moved from end of 2023 to mid 2024.
What’s happening
Cilazapril will be delisted from the Pharmaceutical Schedule.
We know many people taking cilazapril have complex health conditions. We want to minimise any disruption. We are moving slowly as we encourage the shift away from cilazapril.
Why is this happening?
Cilazapril is used in New Zealand much more than any other country. There is only one place in the world that makes the active ingredient for cilazapril.
Because cilazapril is not used much in other countries – If there were a manufacturing or supply issue that affected New Zealand’s supply, it would be impossible for us to find enough cilazapril for everyone who takes it.
To reduce the risk, we want to support people to move away from using cilazapril. Our first step was to stop new people starting on cilazapril.
Key dates
- 1 May 2021 – Cilazapril was restricted to existing patients only
- 1 October 2022 – Perindopril 8 mg tablets listed on the Schedule
- 1 December 2022 – Ramipril listed on the Schedule
- mid 2024 – Proposed delist of cilazapril from the Schedule.
Prescribers: What you need to do
Identify patients using cilazapril and discuss transitioning them to alternative treatments as soon as practical.
When prescribing an ACE inhibitor or angiotensin II antagonist (ARB), do not start any new patients on cilazapril.
Schedule listings for all funded agents affecting the renin-angiotensin system(external link)
Tools to support prescribers to switch patients from cilazapril
Help finding an alternative treatment:
Changing ACEs: The new line up - He Ako Hiringa(external link)
BPAC’s advice on prescribing ACE inhibitors(external link)
Treating hypertension and heart failure in the NZ Formulary(external link)
He Ako Hiringa has a dashboard that lets prescribers view data about patients dispensed cilazapril, nationally and by both prescriber and practice.
Listing of perindopril 8 mg and ramipril
Ramipril was funded with no restrictions from 1 December 2022. It is an angiotensin converting enzyme (ACE) inhibitor used to treat hypertension, heart failure, diabetic renal disease, and post myocardial infarction.
Ramipril monograph in the NZ Formulary(external link)
Another angiotensin converting enzyme (ACE) inhibitor, Perindopril 8 mg tablet, was funded from 1 October 2022. Perindopril 2 mg and 4 mg tablets were already funded. This offers a once-daily treatment option for those patients that need a higher therapeutic dose.
Decision to fund perindopril 8 mg tablet
Perindopril monograph in the NZ Formulary(external link)
Patients: What you need to do
Do you take cilazapril?
If you are currently taking cilazapril you will be able to continue on cilazapril until mid-2023. We recommend you talk to your prescriber about moving to a different medicine before mid-2023.
Cilazapril remains a safe and effective medicine. We are making this change to reduce the risk of supply issues affecting people.
Treatment options available
About angiotensin II antagonists (ARBs) - Healthify(external link)
About ACE inhibitors - Healthify(external link)
Pharmacists: What you need to know
The existing patient endorsement for cilazapril has been in place since May 2021.
If you have patients still taking cilazapril, we ask that you encourage them to talk to their prescriber about changing treatment before mid-2024.
We know that changing the Schedule in this way may create additional work for you. This is currently the main lever we have to change prescribing behaviour. We appreciate you and the work you do.
Who to contact
If you take cilazapril, talk to person who prescribes your medicine about changing to an alternative treatment option.
If you have questions about the funding of any of these medicines, email enquiry@pharmac.govt.nz