Navigating Medication Supply Challenges: MHRA’s Alert on Salbutamol Nebuliser Liquid Shortage

28 March, 2024

The MHRA recently issued an alert regarding the shortage of salbutamol nebuliser liquid, a vital medication for respiratory conditions like asthma and COPD.

Learn about the implications for patient care and actionable steps healthcare providers can take to navigate this supply challenge and ensure patient safety.

In the realm of healthcare, ensuring continuous access to vital medications is paramount. However, recent alerts from the Medicines and Healthcare products Regulatory Agency (MHRA) shed light on a concerning shortage affecting the availability of salbutamol nebuliser liquid, a crucial treatment for respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD).

MHRA’s alert, issued on February 14, 2024, brings attention to the shortage of salbutamol nebuliser liquid and its potential impact on patient care. Manufacturing issues, compounded by increased demand on alternative suppliers, have contributed to this supply shortfall, creating challenges for healthcare providers and patients alike.

Understanding the Supply Shortage

The alert outlines the specifics of the supply issue, detailing the unavailability of Ventolin® (salbutamol) 5mg/ml nebuliser liquid (20ml) until at least mid-April 2024. While alternative options such as terbutaline, salbutamol with ipratropium, and ipratropium nebuliser liquids remain accessible, they may not adequately meet the surging demand caused by the Ventolin® shortage.

Impact on Patient Care

For individuals relying on salbutamol nebuliser liquid to manage respiratory conditions, this shortage poses significant challenges. Inhalation therapy is a cornerstone of asthma and COPD management, providing rapid relief during exacerbations and helping maintain long-term control of symptoms. Without access to their prescribed medication, patients may face increased respiratory distress, exacerbations, and potentially avoidable hospitalisations.

Addressing Patient Safety

In light of these challenges, healthcare providers must remain vigilant and proactive in ensuring patient safety. The MHRA alert emphasises the importance of effective communication and strategic planning to mitigate the impact of the supply shortage. Healthcare organisations are encouraged to review their current inventory, explore alternative treatment options, and implement contingency plans to minimise disruptions in patient care.


All healthcare providers must:

1. Liaise with local pharmacy teams and place urgent order for unlicensed imports of salbutamol nebuliser liquid – do not wait for supplies to be exhausted before placing orders for imports.

2. Wean all patients off nebulisers as soon as their condition has stabilised.

3. Consider use of a high-dose salbutamol pressured metered-dose inhaler (pMDI) via a large volume spacer in patients with mild to moderate asthma attacks or COCPD (see clinical information) ensuring the patient is issued with a new inhaler to avoid risk of using a near empty device and administer it effectively if not being administered by a healthcare professional.

Looking Ahead

While the current shortage presents immediate challenges, MHRA’s alert serves as a reminder of the ongoing importance of robust medication supply chains and contingency planning within healthcare systems. By fostering collaboration between regulatory agencies, manufacturers, healthcare providers, and patients, we can work towards sustainable solutions to address medication supply challenges and ensure uninterrupted access to essential treatments.

We work closely with our clients and suppliers to help minimise any potential disruption from stock shortages. This includes help with stock medication, dispensed medicines and specialist medicines that may be difficult to obtain.


The shortage of salbutamol nebuliser liquid underscores the fragility of medication supply chains and the importance of proactive management in mitigating its impact on patient care. By heeding MHRA’s alert and implementing appropriate strategies, healthcare providers can navigate this challenge while upholding the highest standards of patient safety and well-being. As we confront these supply challenges together, let us remain steadfast in our commitment to ensuring continuous access to essential medications for all who need them.

Access the full guidance:

National Patient Safety Alert – Shortage of salbutamol 2.5mg/2.5ml and 5mg/2.5ml nebuliser liquid unit dose vials

Read through some of our other resources here: Ashtons Resources – Improving quality and compliance in medicines management