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@ Halal | March-April . 2022
BY FATIHAH MANAF
FASTING during the holy month of Ramadan is one of the five pillars of Islam . Thus , it is an obligation upon every Muslim to fast for this one whole month , except for those exempted from it , such as the sick or travellers .
Since fasting is a very personal act of worship , there may be some exempted people who will still insist on doing it , including high-risk patients . While Muslims need to try their best to fast during Ramadan , taking care of their health will still be the top priority .
Therefore , Muslim patients , or those on medications , must consult their pharmacists and plan their medication intake properly to ensure that the act will not negatively affect their health . They also must be made aware of the types of medications that will invalidate their fast .
According to Dr Ahmad Dahlan Salleh , Senior Lecturer , Faculty of Islamic Studies , Universiti Kebangsaan Malaysia ( UKM ), fasting during Ramadan is obligatory upon all able Muslims , excluding women in menstruation .
However , he stressed that the utmost level was to protect life in a state of darurah ( necessity ). Therefore , there are a few situations where it is permissible for Muslims not to fast during the month .
He elaborated : “ Like having severe diseases that might lead to death , the need for compliance towards medication , or else would lead to resistance like HIV drugs or antibiotics .
“ Next , prevent harm , like pregnant women and breastfeeding mothers , and many more . So , these patients need to consult the doctors and pharmacists for better views , to weigh the risks and benefits to perform fast .”
“ As an alternative towards not fasting in Ramadan , they can always replace their fast ( qadha ), on any day other than Ramadan , soon after they get well . Or pay the penalty ( fidyah ) for those who are unable to fast , like bed-ridden or stroke patients .”
Types of medication that invalidate fast
Ahmad Dahlan shared that every Muslim needed to learn the fundamental concepts and values of fasting . It is because , other than drinking and eating , medication intake can also invalidate someone ’ s fast .
Touching on the invalidation of fasting , firstly , he said consciously putting anything into the nose or oral cavity until it reaches the stomach would invalidate someone ’ s fast , given that the person was fully aware that he was fasting .
“ Secondly , fasting may also become invalid if someone receives something that gives them energy apart from drinking or eating , for example , drips and many more . Thirdly , fasting may be nullified if someone remains unconscious or sleeps the whole day .
“ So , any form of oral medications and supplements such as pills and syrup is not allowed during fasting . Unless we can adjust the time to take them , either before sahur ( pre-dawn meal ) or after iftar ( breaking fast ). So , during Ramadan , Muslims are allowed to consume foods and drinks from iftar until sahur the next day .”
Guidelines for Muslims on medications
He said supplements were not as critical as medications , so Muslims could adjust the time for their intake . However , for medications that could not be adjusted accordingly , they could opt to postpone the treatments .
In his research entitled “ Guidelines Taking Medicines for Out Patients in the Month of Ramadan ”, Ahmad Dahlan came up with a guideline for medication intake during fasting . The approach is as follows : ( See Table )
The guideline serves as a general reference
Dr Ahmad Dahlan Salleh
FREQUENCY to patients and healthcare professionals for medicines usually consumed during the daytime , which may invalidate one ’ s fast . However , medications that are consumed during nighttime can be taken as usual .
DIRECTORY OF MEDICINE INTAKE
Before meals
Patients know what is best
Ahmad Dahlan shared that the central concept in Islam was any act was allowable and permissible unless it was clearly stated
INTAKE TIME After meals
Once a day • Before sahur • After breaking fast
Two times a day • Before sahur
• After breaking the fast , before consuming the main course
Three times a day • Before sahur
• After breaking fast , before consuming the main course
• Before sleep
Four times a day
Islam is simple , keep it that way Muslim patients must consult their pharmacists to manage their medications during Ramadan
• After sahur
• After breaking fast
• After sahur
• After breaking fast
• Before sleep
Depending on the type of disease , seek advice on other alternatives if a patient wants to fast . Please consult with pharmacists . in the Quran . Then , when something changes someone ’ s situation or condition , such as ailments or accidents , the needs and decisions towards medication and supplements might also change .
“ I ’ m sure patients know what is good for them . Hence , they should always consult their doctors for their condition and the pharmacies regarding the timing adjustment and formulation options for better decisions .
“ For example , if they could not take paracetamol during fasting , they might apply balm ( to lessen the pain ). So , Islam is simple , and please keep it simple ,” said Ahmad Dahlan .
Ahmad Dahlan said it was essential for patients with chronic or acute diseases to consult general practitioners or pharmacists to be informed more on their health in preparation for Ramadan . These healthcare professionals could help explain the risks and benefits if they decide to fast and adjust accordingly .
“ Serious complications may develop such as dehydration , hyperglycemia and others . With careful support and advice by general practitioners and pharmacists , along with shared decisions regarding treatment plans , successful health outcomes and safe fasting can be achieved .”
As an alternative towards not fasting in Ramadan , they can always replace their fast ( qadha ), on any day other than Ramadan , soon after they get well .”