By Doha Elbasha, Clinical Pharmacist
Ramadan is a sacred month marked by fasting, sacrifice, worship, and spiritual reflection. Many people who fast live with health conditions that require daily medications.
This often raises important questions about which medicines may break the fast, which are permissible to use, and how to manage treatment safely.
Some individuals stop taking their medicines out of concern for invalidating the fast, which may jeopardise their health and treatment outcomes.
This guide provides a clear, practical overview to help patients use medications safely during Ramadan, while remembering that Islam places strong emphasis on protecting health and wellbeing.
“Whoever among you is ill or on a journey, then they may make up the days later.” (Quran 2:184)
Pharmacists play a key role in collaborating with healthcare professionals to support patients during Ramadan.
As accessible and trusted health professionals, they can:
- review medications prior to Ramadan,
- assist with safely adjusting dosing schedules to non‑fasting hours (iftar and suhoor) or formulation change,
- advise on therapeutic drug monitoring and answer common questions such as “Does this medication break my fast?” or “Can I take my medicine at night instead?”.
Anyone taking regular medication—especially for chronic conditions such as diabetes, asthma, cardiovascular disease, thyroid disorders, or other long‑term illnesses—should speak with their prescriber or healthcare provider before Ramadan.
Islam offers flexibility for people who are unwell. The Qur’an states that those who are sick are permitted not to fast and may make up the days later, depending on their circumstances.
Exemptions are a form of mercy, not a failure. Islam encourages people to preserve their health and avoid harm.
“Whoever among you is ill or on a journey, then they may make up the days later.” (Quran 2:184)
Which medication forms break the fast?
Medications that enter the digestive system break the fast. These include:
- Oral medicines (tablets, capsules, syrups)
- Nasal sprays
- Rectal suppositories
- Nutritive routes such as PEG, NGT, or jejunostomy feeds
The distinction lies in whether the route provides nutrition or calories (nutritive/enteral) or delivers medication without feeding the body (non‑nutritive/parenteral).
Nutritive methods typically use the gastrointestinal tract, while non‑nutritive methods such as many injections bypass it entirely.
Opinions differ regarding inhalers. Some scholars permit them, while others—such as Mufti Mohammed Zubair Butt (Shariah Advisor to the Muslims Spiritual Care Provision in the NHS)—advise avoiding them during fasting. Patients are encouraged to seek individual religious guidance if unsure.
Emergency medical care must always be prioritised, even during fasting hours.
Which medication forms do not break the fast?
Most scholars generally agree that the following do not break the fast:
- Non‑nutritive injections (IM, IV, subcutaneous)
- Topical products (creams, ointments, patches)
- Eye and ear drops
- Vaginal pessaries
“If somebody eats or drinks forgetfully, then they should complete their fast, for what they have eaten or drunk has been given to them by Allah.” (Hadith, Sahih al‑Bukhari 6669)
Many medications can be safely taken during non‑fasting hours with proper guidance. Examples include:
- Once‑daily medicines – usually taken at iftar or suhoor
- Twice‑daily medicines – commonly taken at both meals, even if not exactly 12 hours apart
- Long‑acting or extended‑release formulations – may reduce daily dosing needs
Never adjust medication timing or dosage without consulting a healthcare professional.
People with chronic illnesses require special consideration:
- Diabetes: Risks include low blood sugar, dehydration, or diabetic ketoacidosis. Medication adjustments and regular monitoring may be necessary.
- Hypertension: Monitoring is important; some medications, such as diuretics, may increase dehydration risk.
- Asthma: Preventer inhalers should be continued (use during non-fasting hours), ensure asthma action plan is updated; opinions vary about using reliever inhalers while fasting.
- Gastrointestinal conditions: Some medicines can be taken at iftar; large meals may worsen symptoms.
- Mental health conditions: Stable, consistent medication schedules are essential.
“Allah intends ease for you, not hardship.” (Quran 2:185)
Safe fasting is possible for many people, but not for everyone. Medication regimes should be individualised, and open conversations with healthcare providers and scholars are essential.
Ramadan is a time of mercy and ease—protecting one’s health is an important part of faith.
This article was written as part of the Australian Islamic Medical Association’s Healthy Fast, Healthy Ramadan initiative. Learn more at aima.org.au/ramadan.
