Fasting and Medication

There are many cases where individuals who regularly take prescribed medications are deemed healthy enough to fast during the holy month of Ramadan, and fasting would not aggravate or prolong their health condition, nor would it deter their health condition from getting better. However, such individuals are unable to benefit from the practice of fasting, because their medication is administered during fasting hours.

Muslim scholars generally claim that since an individual is prohibited from consuming food and drink whilst fasting, they are also prohibited from consuming medication whilst fasting. As such, a healthy individual on routine medication is generally required to pay a penalty known as kafāra for each missed fast.

Any individual taking prescribed medication must ensure that all efforts are exhausted to receive medical consultation and proper medical advice regarding how to safely modify their medication regimen so that it falls outside of fasting hours. However, in those cases where this modification is not possible, and medical advice deems it suitable for an individual to fast, then it is permissible for them to take medication during fasting hours. The medication can be administered by any route (e.g. orally, inhaled, sublingual, rectal, intravenous etc.), and where medication is administered orally, it is acceptable to consume only the minimum amount of water needed to swallow the medication.

It is not permissible for an individual to fast if they are prescribed medication that cannot be taken without a meal, or if medication is administered as a supplement to a meal (e.g. nutrition drinks or intravenous fluids).

1. If a person is taking routine prescribed medication and wishes to observe fasting, then it is necessary for them to seek consultation from their medical practitioner prior to the commencement of the holy month of Ramadan. The justification for this position is provided in the following ICCI discussion: Can a person who suffers from illness fast during the holy month of Ramadan?

2. From the verse of the Quran that states, “Eat and drink until the whiteness of dawn becomes clear from the darkness of night then fast until night”^[1] , we understand that it is impermissible to eat or drink during fasting hours. However, the Quran does not stipulate what exactly is meant by ‘eating’ and ‘drinking’.

We cannot read this verse to unrestrictedly indicate all types of eating or drinking. The reason for this is because by interpreting ‘eating’ and ‘drinking’ unrestrictedly, swallowing saliva would be considered as drinking or eating. However, we know that ever since the time of the Prophet, this was never considered as an instance of eating or drinking during fasting.

This demonstrates that the impermissibility of eating or drinking does not unrestrictedly include all cases of eating or drinking, rather it only includes those cases that are conventionally defined as ‘eating’ and ‘drinking’. In light of this, modern day convention does not consider taking medication as an example of eating.

3. This understanding is further supported by the tradition of Imam al-Sadiq, which states:

“It is permissible to sip water whilst fasting and carry on fasting”^[2] 

This tradition clarifies that in extreme situations, it is permissible to consume a minimum amount of water and continue fasting. Accordingly, if a person’s medical regimen cannot be modified then this would be considered as an extreme situation. As such, it is acceptable for such a person to take the medications they require and continue fasting, even in cases where he/she may need to consume a minimum amount of water to swallow their medication.

^[1] Quran 2:187

^[2] Al-Kāfī, vol. 4, p. 117