Cilazapril: to be delisted 1 January 2025
Cilazapril is used in New Zealand much more than any other country. To reduce the risk of supply issues, we will stop funding cilazapril on 1 January 2025.
On this page
What’s happening
Cilazapril will be delisted from the Pharmaceutical Schedule on 1 January 2025.
We understand that a small number of people are yet to move off cilazapril treatment. We encourage prescribers to identify people who are still taking cilazapril so they can be moved to an alternative treatment.
We also ask pharmacists to encourage those taking cilazapril to speak to their prescriber about changing treatment.
Stock situation
Based on current demand, the remaining stock of the cilazapril 5 mg presentation in New Zealand is expected to be exhausted by July 2024. Stocks of 0.5 mg and 2.5 mg presentations will expire in October 2024.
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.
Prescribers: What you need to do
Identify patients using cilazapril and discuss transitioning them to alternative treatments as soon as practical. We are delisting cilazapril on 1 January 2025, but stock of cilazapril will run out before then.
People will need a prescription for a new treatment before 1 January 2025.
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.
Patients: What you need to do
Do you take cilazapril?
If you are currently taking cilazapril, you will need to talk to your prescriber about a new treatment to replace cilazapril.
Supplies of cilazapril are expected to run out before the end of 2024 and your pharmacy might not be able to get any more. After 1 January 2025, cilazapril will no longer be funded by Pharmac.
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, please encourage them to talk to their prescriber about changing treatment as soon as possible.
We know that changing the Schedule in this way can create extra 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
Note: We briefly published 1 August 2024 as the delisting date. After receiving information from the sector, the date was changed to 1 January 2025.