In 2025, the NHS in England is still writing over a billion prescriptions a year. But what's striking is how a small handful of drugs make up a massive chunk of that total. Most of these medicines treat heart conditions, high blood pressure, and acid reflux - common issues in the UK’s aging population.

Still, this leads many people to ask: Are we prescribing these medications too much? Or are they simply what’s needed to meet modern health challenges?

Let’s explore the top 5 most prescribed medicines in England in 2025 - and what they reveal about our healthcare system.

The Big Five: Most Prescribed Drugs in 2025

According to NHS data, these are the top 5 drugs by the number of prescription items issued so far in 2025:^1,2

• Atorvastatin (cholesterol-lowering)
• Omeprazole (acid reflux treatment)
• Amlodipine (blood pressure control)
• Simvastatin (another cholesterol-lowering drug)
• Ramipril (for blood pressure and heart failure)

These medicines aren’t new - but they continue to dominate because they treat chronic conditions that affect millions of people across the UK.

1. Atorvastatin: The NHS's #1 Prescription

With over 73 million prescriptions in 2025,² atorvastatin tops the chart. That’s a dramatic jump from 59 million in 2022-23.³

Why the spike?

Updated NICE guidelines now recommend statins to a wider group of people - especially those at moderate risk of heart disease.⁴ It’s part of a national effort to prevent heart attacks and strokes through earlier intervention.

Atorvastatin has a strong evidence base showing it significantly reduces cardiovascular risk, especially in high doses.

Statins like atorvastatin are also relatively inexpensive, making them a smart choice for a stretched NHS budget.

2. Omeprazole: Treating Reflux - Sometimes for Too Long

Coming in second is omeprazole, with over 40 million prescriptions in 2025.² It’s a proton pump inhibitor (PPI) used for:

• Acid reflux (heartburn)
• Indigestion (dyspepsia)
• Stomach ulcers

Omeprazole works by reducing stomach acid, and it’s very effective. But there’s a catch…

Are we overusing PPIs?

Studies show that many patients remain on omeprazole for years, even when there’s no longer a medical reason.⁶

Long-term use can lead to side effects like nutrient deficiencies (e.g. low magnesium or vitamin B12), kidney issues, or increased risk of gut infections.

NICE has issued guidance recommending regular reviews to decide whether patients still need these medications.⁶

Long term use can cause osteoporosis and other side-effects. In many cases, patients could safely stop or reduce their PPI with the right support.

3. Amlodipine: A Blood Pressure Favourite

Amlodipine is a calcium channel blocker that helps lower blood pressure by relaxing blood vessels.

In 2025, around 35 million prescriptions were issued.⁵ It’s one of the first choices for:

• People with high blood pressure (hypertension)
• Especially effective in older adults
• Often used when people can’t tolerate ACE inhibitors

Amlodipine is widely prescribed because it’s cheap, well-tolerated, and proven to reduce risk of stroke and heart attack.

However, some people do experience swollen ankles, dizziness, or headaches - which can impact daily functioning and physical therapy.

4. Simvastatin: Fading Star, But Still Popular

Once the UK’s go-to statin, simvastatin has slowly been replaced by atorvastatin.

Why the shift?

Atorvastatin is more potent and works better at reducing cholesterol at lower doses. It also has fewer interactions with other drugs and food (like grapefruit juice).

Still, simvastatin remains in the top 5 because:

• It’s very cheap
• Some patients remain on it due to historical prescribing habits
• It’s often used in mild cases or for people with low cardiovascular risk

Prescribers are gradually switching patients over to atorvastatin, but change takes time.

5. Ramipril: A Longstanding ACE Inhibitor

Ramipril is an ACE inhibitor that helps treat:

• High blood pressure
• Heart failure
• People at risk of heart attack or stroke

It’s been a staple of NHS prescribing for over two decades. In 2025, it continues to be widely used because:

• It helps protect the heart and kidneys
• It’s especially helpful for patients with diabetes or kidney disease
• It’s backed by robust long-term studies

Like other ACE inhibitors, ramipril can cause a persistent dry cough or dizziness, especially when patients first start taking it.

Are These Drugs Overprescribed?

It depends on how you define “overprescribing.”

In favour:

• These drugs treat conditions that are very common - and untreated high blood pressure or cholesterol can lead to life-threatening events.
• Their use is often based on strong clinical guidelines (from NICE and other authorities).
• Statins, antihypertensives, and PPIs have helped millions of people live longer, healthier lives.

But there are concerns:

• Omeprazole and other PPIs are often used longer than necessary.⁶
• Some patients are on multiple drugs for the same condition (duplicate prescribing).
• Not all medication lists are regularly reviewed - leading to “prescribing inertia” where treatments are continued out of habit rather than need.⁸

NHS Responses: Prescribing Smarter, Not More

The NHS is actively working to improve prescribing through:

• Structured Medication Reviews (SMRs) for patients on multiple medicines.⁹
• Medicines Optimisation strategies that promote safe, effective, and evidence-based use of drugs.⁹
• Encouraging deprescribing when appropriate - especially in older adults or those on long-term medications.

These efforts aim to make prescribing more targeted, safer, and patient-focused.

Why This Matters for Physiotherapists and Frontline Clinicians

Understanding medication trends is important beyond the GP’s office.

For example:

• Statins can cause muscle aches, which may be mistaken for musculoskeletal problems.
• PPIs may impact calcium and magnesium levels, affecting muscle function and energy.
• Blood pressure medications can cause dizziness or fatigue, especially during rehab or exercise.

For physiotherapists, knowing which drugs are commonly used - and what they do - helps them plan safer, more effective treatments.

Final Thoughts: The Prescription Picture in 2025

High volumes of prescriptions don’t automatically mean overprescribing. Instead, they often reflect a large population living longer, with multiple long-term conditions.

That said, it’s vital that:

• All medications are reviewed regularly
• Prescribing is based on current evidence
• Patients are involved in decisions about what they take - and for how long

In 2025, the NHS is shifting the conversation from “How many drugs are we giving?” to “Are we giving the right ones, in the right way, for the right reasons?”

References

1. NHS Business Services Authority. Prescription Cost Analysis - England 2024/25. NHSBSA; 2025.
2. NHS Business Services Authority. Open data dashboard - Top dispensed drugs by volume. NHSBSA; 2025.
3. NHS Business Services Authority. Prescription Cost Analysis - England 2022/23. NHSBSA; 2023.
4. National Institute for Health and Care Excellence. More people are benefitting from NICE-recommended statins. NICE; 2024.
5. Chemist+Druggist. England’s most dispensed drugs revealed. Chemist+Druggist; 2025.
6. National Institute for Health and Care Excellence. GORD and Dyspepsia in Adults: Clinical Guideline [CG184]. Updated 2019.
7. NHS England. Statin prescribing trends in primary care. NHS England; 2024.
8. The King’s Fund. Overprescribing in the NHS: a hidden problem? The King’s Fund; 2022.
9. National Institute for Health and Care Excellence. Medicines Optimisation: Clinical Guideline [NG5]. NICE; 2015.