How to Take Medicine While Fasting

Ramadan is nearby. Ramadan is coming, so how to take your medicine. During Ramadan, Muslims will fast from dawn fajar (before sunrise) until dusk (iftar/Maghreb/sunset). In Indonesia, Muslims will fast about 13-14 hours. Not all places fasting for those hours, maybe some of them are shorter or longer than that.

During Ramadan, our eating habits are changing, yet if you or live with someone who has a certain chronic condition, Ramadan must challenge because it may change the dosage because of fasting. A certain chronic condition such as diabetes, hypertension, thyroid.

It’s not recommended for you to stop your regular medication just because you want to fast, for sure. What should you do if you can take medicine and fast safely?

Talk to Your Doctor or Pharmacist

Before you decide to fast, you better talk to your doctor or pharmacist first before the fasting month begins. Tell your doctor about your plan during Ramadan, he will examine your condition, you may or may not fast. If you may, maybe he will adjust the dosage of your medicine. A pharmacist also helps to recommend changing your medicine into a long-acting formulation namely sustained release.

How to Take Medicine While Fasting

Take medicine on a regular day (not fasting) depends on your prescription. If 3 times a day, so 3 times a day over 24 hours, take your medicine every 8 hours.

Read more about the time gap between taking medicine on Time Hour Apart Between Taking Medicine (2/3/4 Times a Day).

So, if you are fasting, these are some advice for you. The rule of taking medicine while fasting below based on condition in Indonesia (13-14 hours of fasting) and explanation from social media of the Ministry of Health of Indonesia.

Adjust Medication

Medicines that have to be taken several times a day choose long-acting formulation, for instance, sustained release. For example, captopril is taken 2-3 times a day, if possible, change it into lisinopril once a day. Otherwise, you still need to discuss with your doctor and pharmacist first.​1​

Take Medicine Once a Day

Take your medicine around the same time every day to keep a constant level of your medicine. You can take it at suhoor/dawn or iftar/sunset.

Take Medicine 2 Times a Day

The same advice as above, take your medicine around the same time every day. Take medicine at suhoor and iftar.

Take Medicine 3 Times a Day

For medication that you should take multiple times, if your medication cannot be changed into long-acting medicine, take medicine at the same time gap, around 5 hours gap. 3 times a day, thus take it at iftar, before sleep (or near to midnight), and suhoor.

To illustrate, if you take your first medicine at 06.00 p.m., next schedule at 11.00 p.m., and last at 04.00 a.m.

Take Medicine 4 Times a Day

Take medicine 4 times a day is not recommended while fasting, especially antibiotics. If you still have to take it, no other choice. Take it at the same around time hour apart, around 4 hours.

For example, take your medicine at 06.00 p.m., 10.00 p.m., 01.00 a.m., and 04.00 a.m. Make sure you already knew how to take your medicine, on an empty stomach or with food. If your medicine should be taken with food, for suhoor, better you do not eat early, enjoy your meal around 04.00 a.m. If you’re not sure how to take your medications, check with your pharmacist.

Get to Know Some Medicines While Fasting

Diabetes Medications

The best time to take diabetes medications is 04.00-05.00 in the morning. At that time, our body is overly sensitive to insulin, hence give the best effect. Thus, you are advised to take it in the morning. How about while fasting? If you take at suhoor, there is concern that it will increase the possibility of hypoglycemia. So, it will be better if you take it at iftar, to avoid the occurrence of hypoglycemia. For specific explanations and tips to take diabetic medications, read more on the 2020 recommendation for management of diabetes during Ramadan.​2​

Diuretic Medications

The best time to take this medication is in the morning at 07.00. It associates with the function of the kidney and hemodynamic. Also, take this medication increases the urinary frequency, so better it happens when you still awake, and no disturb your good night’s sleep. Thus, take diuretic medication at suhoor.

Hypertension Medications

Some studies showed the peak of blood pressure happens around 09.00-11.00 in the morning, and the lowest at night while sleeping. Hence, better if you take it in the morning as well. During Ramadan, take it at suhoor.

Cholesterol Medications

Those who take cholesterol medications want the best result, so take your medications around 07.00-09.00 p.m. This is because the highest metabolism of cholesterol happens at night. Therefore, take your medicine at iftar.

Anaemia Medications

The best time to take this medication at 08.00 p.m. because it gives 3-4 times better than taking it in the morning. You should take it after iftar because of fasting.​3​

Medicines that Do Not Break the Fast

One cause that breaks the fast is drink or take something orally. Explanations above for medicines orally, indeed. Nevertheless, there is limited to put something into the body including the eyes, nose, mouth, ears, vagina, anus. Here are some medicines that may not break your fast.​4​

  • Sublingual tablet, this tablet is placed beneath the tongue and not swallowed.
  • Eye/ear drops.
  • Injection (intramuscular, intravenous, intra-articular)
  • Applying ointment, cream, patch on the surface of the skin
  • Mouthwash gargle, mouth spray (for therapeutic use), if it is not swallowed
  • Inhalation
  • Half of local anesthesia
  • Inserting catheter through blood vessels
  • Laparoscopy
  • Suppositories

Do you have additional medicine to be written on the list? Lemme know.

Conclusion

Ramadan is the month that Muslims have waited. Muslims will fast from dawn until dusk. During Ramadan, eating habits are changing, so are taking medication rules. If you want to fast while you must take your medicine too, make sure to talk to your doctor or pharmacist first. If your condition allows you to fast and take multiple times of medicine a day. You may change your medicine into long-acting formulations or if this option is not available, take your medicines at the same time hour apart.

Happy Ramadan! Ramadan Mubarak! May this Ramadan be filled with joy, health, and wealth.

References

  1. 1.
    Grindrod K, Alsabbagh W. Managing medications during Ramadan fasting. Can Pharm J. Published online April 3, 2017:146-149. doi:10.1177/1715163517700840
  2. 2.
    Ibrahim M, Davies MJ, Ahmad E, et al. Recommendations for management of diabetes during Ramadan: update 2020, applying the principles of the ADA/EASD consensus. BMJ Open Diab Res Care. Published online May 2020:e001248. doi:10.1136/bmjdrc-2020-001248
  3. 3.
    Ikawati Z. Cerdas Mengenali Obat. Kanisius; 2010.
  4. 4.
    Fasting and Medicines. My Health Kementrian Kesihatan Malaysia. Accessed April 3, 2021. http://www.myhealth.gov.my/en/fasting-and-medicines/

Selvi Megawati

Pharmacist. Part of wethinkweshare team. I enjoy writing and sharing about pharmacy and health. I hope you have much information from this website. 

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6 Responses

  1. amirria says:

    thankyou for the tips 🙂

  2. Indah says:

    Thanks for share info kak

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