Estradot has been under Serious Shortage Protocols since December 2024, and in October 2026 those protocols were extended again, this time to 8 January 2027. For private prescribers, that has a practical consequence that is easy to miss: a patient you have prescribed Estradot can leave a community pharmacy with a different brand of patch, without anyone contacting you first.
This guide explains what the Estradot shortage protocols cover, how Serious Shortage Protocols (SSPs) work, why they apply to private prescriptions as well as NHS ones, and what it all means for the way your clinic prescribes.
Where does the Estradot shortage stand?
Four Estradot strengths are currently covered by an SSP. All four started in December 2024 or April 2025 and all four now run to 8 January 2027, following the extension reported by Community Pharmacy England on 2 October 2026.
| SSP | Estradot strength | Permitted alternative | Current expiry |
|---|---|---|---|
| SSP082 | 25 micrograms/24 hours | Evorel or Estraderm MX, same strength | 8 January 2027 |
| SSP079 | 50 micrograms/24 hours | Evorel or Estraderm MX, same strength | 8 January 2027 |
| SSP080 | 75 micrograms/24 hours | Evorel or Estraderm MX, same strength | 8 January 2027 |
| SSP081 | 100 micrograms/24 hours | Evorel or Estraderm MX, same strength | 8 January 2027 |
Two points are worth knowing. The 37.5 microgram strength is not covered by an SSP. And no official resupply date for Estradot has been published: the 8 January date is when the protocols expire, not when stock is expected back. Earlier resupply estimates in 2025 came and went, and official notices describe the cause only as significant ongoing disruption to supply.
What is a Serious Shortage Protocol?
A Serious Shortage Protocol is a written protocol, issued by ministers, that lets a pharmacist supply something other than what is on the prescription when a medicine is in serious shortage. The power was added to the Human Medicines Regulations 2012 (regulation 226A) in February 2019. Depending on the protocol, a pharmacist may supply a different strength, quantity or form, or a different medicine altogether, without going back to the prescriber for a new prescription.
Each SSP sets out exactly what can be supplied, to whom, where in the UK it applies and how long it lasts. The Estradot protocols apply across the UK, with Scotland and Northern Ireland issuing their own notices when the dates change.
Do SSPs apply to private prescriptions?
Yes. This is the point many private prescribers are unaware of. NHSBSA guidance states that a protocol covers both NHS and private prescriptions unless the SSP says otherwise, and the Estradot protocols state that they apply to all NHS and private prescriptions. The main exception in general is controlled drugs in Schedules 2, 3 and 4 (Part 1), where an SSP covers NHS prescriptions only. That does not affect HRT patches.
So if your patient takes a private Estradot prescription to a community pharmacy that has no stock, the pharmacist can use the SSP in exactly the same way as for an NHS prescription.
What can a pharmacist do under the Estradot SSPs, and what can't they?
The Estradot SSPs are narrow. Under them a pharmacist can:
- supply Evorel or Estraderm MX patches in place of Estradot
- at the same strength as prescribed
- in the same total quantity as prescribed, one patch for each Estradot patch
They cannot use these protocols to change the strength, switch to a gel or spray, or supply a different quantity. The decision to use the SSP rests with the individual pharmacist's professional judgement, and the patient (or their carer) has to agree. The protocols exclude patients under 18 and anyone with a known hypersensitivity to the alternative products or their excipients.
Pharmacists are asked to counsel patients on what to look out for after a switch, including breakthrough bleeding, skin irritation and problems with the patch staying on, and to refer anyone with persistent side effects back to the prescriber.
Will you be told when your patient's prescription is substituted?
Not beforehand. The prescriber does not need to authorise a switch under an SSP. The Estradot protocols do require the pharmacist to make sure the prescriber or practice is notified afterwards, usually by the next working day (Northern Ireland aims for within three working days).
If the patient does not want the alternative, they can refuse it. The pharmacist then refers them back to the prescriber and records that no supply was made.
What does SSP substitution mean for your clinic?
SSPs exist to keep patients supplied, and they do that. But for a private clinic the experience on the ground often looks like this:
- Your prescribing choice is changed after the fact. You chose Estradot for a reason, and the first you hear of a change may be a notification the next day, or a call from the patient.
- Patients come back with questions. A different-looking patch, different adhesive and new instructions all generate calls and follow-up appointments, particularly for patients who were stable.
- Some patients go without. If the patient refuses the alternative, or the pharmacy has neither Estradot nor the permitted alternatives, they are referred back to you to start again.
- Your team spends time chasing. Staff end up ringing round local pharmacies to find stock for individual patients, with no visibility of when supply will return.
None of this is anyone's fault at the counter. It is what happens when a prescription leaves the clinic with no agreed route to a pharmacy that can fill it.
How can a dispensing partner reduce the disruption?
The alternative is to send private prescriptions directly to a single pharmacy that dispenses them and delivers to the patient. When that pharmacy is set up to work with clinics, a shortage becomes something you plan around together rather than something your patients discover at the counter:
- The prescription goes to one known pharmacy, so you are not relying on whichever local pharmacy your patient happens to visit.
- Supply is discussed with you up front, by product and strength, before you route patients to it.
- If something needs to change, the pharmacy talks to you, rather than your patient finding out at the counter. [Ops to confirm before publishing]
- Medicines are delivered by tracked post, so patients do not need to go looking for stock.
We cover what to look for in a dispensing partner, and the practical steps clinics can take during HRT shortages, in our guide HRT shortages: how a dispensing partner keeps your patients on the prescription you chose.
Where can you check the current SSPs?
SSP dates change regularly, so check before relying on any date in this article:
- the NHSBSA Serious Shortage Protocols page, which lists active and expired SSPs with their documents
- the BSO page for Northern Ireland
- the SPS Medicines Supply Tool (free registration), for supply notifications and resupply updates
Information correct as of November 2026. Sources: NHSBSA SSP list and Q&A; SSP079–SSP082 protocol documents; Community Pharmacy England, 2 October 2026; Human Medicines (Amendment) Regulations 2019, regulation 9.
Prescribe through Molecule CloudRx
Molecule CloudRx is the pharmacy partner for UK private prescribers. You send private prescriptions straight to our GPhC-registered pharmacy, every prescription is clinically checked by our pharmacists, and we deliver to the patient by tracked post. It is free to use, with no setup or licence fees.
If Estradot supply is affecting your patients, see how we support prescribers during the Estradot shortage, or sign up to Molecule CloudRx.
