The shortage of medicines represents a growing problem not only in Italy but throughout the world. One of these drugs, important for the therapy of some patients suffering from hypertrophic cardiomyopathy or other heart diseases (for example long QT syndrome), is nadolol.

But what exactly is a “drug shortage”? As explained by Professor Mugelli (in the interview given on the occasion of the disopyramide deficiency which you can read here: Drugs disappearing from the market: why they happen and how to avoid them), shortages occur when demand exceeds supply nationwide. Therefore, a “shortage drug” is a medicine that is not available throughout the country and for which a constant supply cannot be guaranteed.

However, it is important to underline that drug shortages are a phenomenon that affects all countries, not just Italy. In Italy, the AIFA (Italian Medicines Agency) constantly monitors the situation. The causes of the shortage can vary, often linked to production problems, such as the lack of the active ingredient or problems linked to health emergencies in the production countries. A clear example was the unexpected increase in requests for many drugs during the Covid pandemic. Furthermore, the actual shortage of a medicine should be distinguished from its temporary unavailability, caused by distortions in production or distribution dynamics.

One of the main distortion problems is parallel trade, where wholesalers may decide to export drugs to countries where the price is higher. Furthermore, some companies may decide to suspend the marketing of a drug if it is no longer profitable, regardless of its effectiveness.

AICARM, aware of the inconvenience caused by the lack of nadolol, has taken action to identify suppliers outside the national territory. We managed to find two suppliers, thus offering an immediate solution to the people who hire it. For those who decide to opt for this solution, it is important to know that a valid prescription is required, and the costs of the drug and its shipping must be covered. We hope that AIFA will find a solution as soon as possible that will prevent patients from incurring inconveniences and costs. In this case too, AICARM is monitoring the situation and is working to help reduce the inconvenience caused by the shortage of this drug.

The references for ordering the drug are as follows:


Pharmacy Contacts Country
International Pharmacy

dr. Merloni

Telephone: 004191-6901050


Vatican Pharmacy Complete the form:



Alternatively, it is also possible to find a pharmacy that can prepare "galenic" Nadolol tablets. Read the recent update (12 Nov 2023) on the new opportunities to purchase the drug here: NADOLOL, import of the drug and galenic preparation