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Medications and fasting

Printed From: WhyIslam.org
Category: Learn About Islam
Forum Name: Ramadan Topics
Forum Discription: Anything and everything about and related to Ramadan. This forum only lasts for 60 days. It will close after Ramadan
URL: http://www.whyislam.org/forum/forum_posts.asp?TID=28139
Printed Date: 17 February 2019 at 1:45am
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Topic: Medications and fasting
Posted By: searching
Subject: Medications and fasting
Date Posted: 07 August 2011 at 6:32pm
Asalaamu alaikum,

I am fasting for the first day today.  I had to wake up at 3:20 to take a medicine that has to be taken on an empty stomach.  Then I woke up at 4:20 for suhoor. 

The problem is that I'm supposed to take this medicine every 12 hours.  But I take it at 3:20 am and then when I break my fast at 8:13, I will have to wait another 2 hours because the medicine has to be taken on an empty stomach, one hour before or 2-3 hours after eating.  So I'll take the medicine at 3:20 am, then again 17 hours later at 10:15 (which is 5 hours late) and then again only 5 hours after that at 3:20 am, which is taking the medicine 7 hours early.  This is not AT ALL following doctor's instructions. 

I read on onislam.net that using a nicotine patch is ok and doesn't break fast since the medicine goes through the skin into your body.  I have also read that injections of pure medicine and not water or vitamins don't break the fast.  But why would pills break the fast if you didn't swallow them with water?  All of these medicines eventually get into your bloodstream, whether patch, injection or pill.  And none of them have sustenance or hydration.  So why do they say any pill, simply because it enters your stomach breaks your fast. 

Also, the medicine I take is for chronic pain.  I have been in a special medical program for those with chronic pain and the medicine I take is the one determined to be best to manage my pain.  So the medicine I take is not for a life threatening condition, but uncontrolled chronic pain can lead to a decline in medical health.  It can lead to high blood pressure, which happens to me when my pain is out of control.  It can increase depression and stress can strain your body, including your heart. 

Anyway, I tried to ask the scholar on onislam.net but they aren't taking anymore questions right now.  And I know that there are very knowledgeable people here.



Replies:
Posted By: Aviatrix
Date Posted: 07 August 2011 at 7:30pm
I think you should probably call your doctor asap and ask him about the medication. It could be very dangerous what you're doing.

Taking pills does break the fast, according to what I have heard. And logically, many pills include other substances to bond the pill together besides just the medicine. Injections and patches don't go into the stomach and so they aren't considered to be breaking the fast.

It's great to hear that you want to fast but remember that there is a concession for those who are will or would find hardship in their fast.

And Allah knows best.

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http://ibnatalhidayah.blogspot.com - - Amy's Blog


Posted By: hamayoun
Date Posted: 07 August 2011 at 7:46pm
Salam

Talk to your doctor ASAP like Aviatrix said. Explain to him in detail the times of fasting, and see what he says. I am diebetic, and I always talk to my doctor before Ramadhan to see how I can fit in my medications. Upto now at least, they have always found a way. A lot of this will depend on how flexible the timing is with your medication. Does 12 hours mean twice a day? Or is it strictly 12 hours? Can you adjust the dosage to make it last once a day? Are there any other alternate medications? Only your doctor can answer these questions, so please see him ASAP

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May Allah give me patience, Ameen.

My blog: http://regularbaba.blogspot.com/


Posted By: searching
Date Posted: 07 August 2011 at 8:17pm
I will email my doctor tonight, insha'Allah.  The medicine really is supposed to be taken every 12 hours.  They made a big deal about this in the pain program.  It is supposed to stay at a certain level in the blood and not drop so low and then go to a high level when I take it too soon.  The alternate medication that I was taking might be a little better for fasting because I could take it with food.  This means that I could take it with suhoor instead of an hour before suhoor and I could take it at the time I break the fast, instead of 2-3 hours later.  So it would at least be a little less off schedule (it's also a 12 hour medicine).  I just switched medicines because that one wasn't helping and caused itching at higher doses.  So they changed medicines altogether.  

I wish this was a cut and dry answer.  I'm think of just staying on the medicine I'm on now and just taking it an hour before suhoor and then again in 12 hours and just keep fasting from food and water.  I know pills are supposed to break the fast , but this is a small pill and I really think that any substances in it would not even equal 1 calorie, so it really wouldn't provide any sustenance at all.  But just not fasting because of this medicine wouldn't be that good, either.  Why throw away the whole fast just to take a single small pill? 

I better email my doctor.


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Posted By: searching
Date Posted: 07 August 2011 at 8:29pm
I just emailed my doctor.  She usually gets back to me pretty quickly.  I hope to have an answer by tomorrow, insha'Allah.  It would be good to hear sister well wisher's thoughts here since she is a doctor and a Muslim.  I think that my doctor may be a Hindu.  And sometimes people don't understand our fast.  But I explained it and I guess what matters is that she thinks of my health first.  I'll post when I hear something for those who are curious.

And thank you both for your help.  You both help so many people here with kind and well thought out, well researched answers.  May Allah reward you. Ameen. 


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Posted By: hamayoun
Date Posted: 07 August 2011 at 11:49pm
Salam

Inshallah things will work out. My doctor worked with me this year to put me on an alternate medicine from my usual one. Doctors usually understand fasting.

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May Allah give me patience, Ameen.

My blog: http://regularbaba.blogspot.com/


Posted By: a well wisher
Date Posted: 08 August 2011 at 10:59am
Assalaamualekum sister searching
 
If you can write down the generic name(chemical name) of your med here , it would help me with the answer.


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La ilaha ill-Allah, Muhammadur Rasulullah


Posted By: a well wisher
Date Posted: 08 August 2011 at 12:56pm
The name of the medication that you have to take on an empty stomach 12 hourly...
 
 


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La ilaha ill-Allah, Muhammadur Rasulullah


Posted By: searching
Date Posted: 08 August 2011 at 1:39pm
It is called Opana (oxymorphone).

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Posted By: a well wisher
Date Posted: 08 August 2011 at 1:49pm

the milligrams?



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La ilaha ill-Allah, Muhammadur Rasulullah


Posted By: a well wisher
Date Posted: 08 August 2011 at 1:49pm

Extended release?



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La ilaha ill-Allah, Muhammadur Rasulullah


Posted By: searching
Date Posted: 08 August 2011 at 2:04pm

Sorry.  I take 5 mg twice a day and in a week I'm supposed to increase to 10 twice a day.  It is extended release.



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Posted By: a well wisher
Date Posted: 08 August 2011 at 2:05pm
Sister searching
 
Actually Opana is recommended to be taken on an empty stomach because it interacts adversely with alcohol so the general guidelines are there.There is not much food interaction (Dosing an extended release narcotic with food might create a longer more stable form of pain relief but might hinder the medication from kicking in at it's designated time or as if it had been taken on an empty stomach).So you can take it on an empty stomach, two hours after meal and for Ramadan you can even try taking it with food and see.Insha allah it won't be a problem.
 
If you are taking ER you can divide the milligrams...what is the total mg you take in a day to maintain the levels in the blood.
 


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La ilaha ill-Allah, Muhammadur Rasulullah


Posted By: searching
Date Posted: 08 August 2011 at 2:15pm
I take 5 mg twice a day, so 10 total.  I'm supposed to increase that to 10 mg twice a day so 20 mg total in about a week.  The problem with taking it on an empty stomach is that I have to take it extra early in the morning, before suhoor and then again after iftar but 2 hours after so that makes a long wait between medicine times and then a short time between night dose and morning dose.

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Posted By: a well wisher
Date Posted: 08 August 2011 at 3:36pm

You can take a 5 mg dose at suhoor about half an hour after eating at the onset of time of fast.You might have to wake up a little early for Suhoor...I hope thats ok.

And when iftar time comes just take your other 5 mg with water and some dates or light snacks and then eat after one hour.When the time comes to increase the dose to 20 mg BD then just divide it to 10/10.
 
Insha Allah I hope this would solve the problem and correct your dosing schedule.Don't worry, even with some food in your stomach, the absorption of the drug would be fine Insha Allah.
 
Take the opinion of your doctor as well.There are transdermal patches that can be worn  in emergency situations to manage chronic pain which you can use in Ramadan but Insha Allah I pray that this dosing schedule works.
 
May Allah give you Shifa and enable you to continue fasting without any hindrances Aameen.


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La ilaha ill-Allah, Muhammadur Rasulullah


Posted By: searching
Date Posted: 09 August 2011 at 2:46am
Jazak Allah khair sister,

I have spoken to a Muslim pharmacist at work and I'm waiting for my doctor's response. I will decide what to do. I just took the medicine today after about 13 hours with sips of water, just enough to swallow it. My pain was really bad since I worked today. I didn't eat though and was still so thirsty and hungry by maghreb time. I guess Allah will have to judge me as He sees fit but I think I have to do it this way due to the pain. And the pharmacist said I really need to take it on an empty stomach. She said this is one that really should be taken without any food. She said some drugs say that but you can take them 30 minutes before eating. She said this one needs to really be on an empty stomach. But that aside, I just have too much pain.

I will insha'Allah talk to my doctor and see what she says maybe about the patch. I just have to do my best under the circumstances and hope Allah is merciful.

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Posted By: a well wisher
Date Posted: 09 August 2011 at 8:44am
Assalaamualekum sister Searching
 
Well generally the food restrictions are for fatty meals but I can understand your pharmacist's concern.Its not about just being dangerous with food which at low doses, its not but about not yet finding your individual dose for the drug and food may hinder ascertaining that.
 
 
You are technically still in the titration phase with Opana and have started with the lowest dose ie 5 (it comes in 5 - 40 mg strength), meaning you need to find a dose that works...Opana is lipid soluble and so is absorbed and metabolized more quickly when a fatty meal is taken.The ingestion of food with or prior to administration of the drug can result in a 50% increase in the maximum concentration achieved after a single dose. Because of this food effect, the pharmacists recommend administration of Opana and Opana ER at least 1 hour before or at least 2 hours after eating but these restrictions are a safety concern for those who  are successfully titrated to oxymorphone ER as excessive blood levels may be experienced with higher dosages beyond 20 mg.Some people who have been taking Opana for longer periods or at low doses actually prefer to take it with food  and it has been safe in their case so as to acheive better pain control but you should do as your doctor prescribes because you have just started to use this drug and your body still needs to respond to it.Don't worry if your pain is still not controlled on the current schedule because the doctor needs to find the dosage just right for you so that it is effective and well tolerated.
 
Just consult with your doctor on what to do.Maybe he can give you the Opana trial after Ramadan and switch you back on drugs that comply with the Ramadan schedule or maybe they can give you an asymmetric (different dose given in AM than in PM) dosing, tailored to the pain pattern which helps some patients although symmetric (same dose AM and PM), around-the-clock, every 12 hours dosing is appropriate for the majority of patients.Explain the Ramadan eating schedule to him.He can Insha Allah come up with alternatives and maybe switch you to other drugs for now.Insha Allah whatever is best for you.
 
May Allah make it easy on you and give you Shifa Aameen.
 


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La ilaha ill-Allah, Muhammadur Rasulullah


Posted By: searching
Date Posted: 09 August 2011 at 6:24pm
Well I made the mistake of taking it with food this morning. I hadn't read your post yet. I didn't wake up at 3:25 to take it one hour before suhoor. So I just decided to take it with suhoor. I thought it wouldn't work as well with food.

The result was that I could hardly keep my eyes open. I was walking across my room to get some socks and I was stumbling. I felt drunk. Luckily, I got cancelled at work because there was no way I could drive in that condition. I literally felt drunk (I used to drink occasionally before converting). So I won't do that again. It was stupid on my part since the pharmacist just told me to take it on an empty stomach.

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Posted By: a well wisher
Date Posted: 11 August 2011 at 4:33pm
I am sorry to hear that sister Searching.Thank God  that you managed to take the day off.
 
Hope you are feeling better now and that you sort this out with your doctor soon Insha Allah
 
Take care and I am sorry that my advice was not helpful.


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La ilaha ill-Allah, Muhammadur Rasulullah


Posted By: searching
Date Posted: 12 August 2011 at 8:06pm
Whatever happens with my medication and fasting, you don't need to apologize.  You are always so helpful and you're one of the people I trust the most here.

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Posted By: a well wisher
Date Posted: 13 August 2011 at 11:25am
Thats very gracious of you sister Searching
 
Thank you...
 
Please don't worry....Insha Allah you will be able to resolve this issue with the help of a scholar...there is ease in religion , not hardship.
 
May Allah reward you  for your struggle Aameen
 
 
 


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La ilaha ill-Allah, Muhammadur Rasulullah


Posted By: searching
Date Posted: 18 August 2011 at 12:16am
Well I did get an answer from a scholar, alhamdulilah. He said I would be exempt from fasting based on my medication problems. He said if I could make up the days in the winter that would be good but if that still messes up the medicine, I could feed a poor person for each day I missed. I think I should be able to fast in the winter when the days are shorter and it won't mess up my medication schedule so much. But I also donated to Islamic Relief. I just still feel very guilty about this whole thing and kind of not like a real Muslim.

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Posted By: Al-Cordoby
Date Posted: 18 August 2011 at 12:29am
There is no room for feeling guilty sister

This is God's command: a person who is taking medication which can't be fit in the fasting schedule is exempt from fasting

In-Shaa-Allah you can make up for these days in the winter

God wants ease for us, He does not want hardship




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Think Win-Win for a better world for all...

http://cortoby.blogspot.com/ - My Blog
http://www.muslimheritage.com/ - Muslim Heritage



Posted By: searching
Date Posted: 18 August 2011 at 1:34am
Thank you for posting that. I do appreciate your kindness.

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Posted By: a well wisher
Date Posted: 18 August 2011 at 4:28pm
Its great that you were able to consult a scholar.
 
Our body is a trust from God sister searching and you are being rewarded for taking care of it.Plus you have the intention of fasting in the winter months and Insha Allah you will be able to manage it then...infact you are being rewarded for that intention as well as for feeding the poor in the meantime...so  even if you are not able to fast due to medical reasons,you are being blessed for all these good deeds Insha Allah... just imagine the ease your donation would bring to others....Allah has made you the source of relieving someone's hardship.Alhumdulillah
 
 


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La ilaha ill-Allah, Muhammadur Rasulullah


Posted By: Nura
Date Posted: 18 August 2011 at 6:27pm
Sister Searching,
 
when I was pregnant I insisted on fasting despite the fact I was feeling so weak. Then a Muslim teacher told me that I wasn't doing something good: just think God has given you a present (to break the fasting if you are ill or pregnant or travelling) and you refuse it by fasting anyway. It's just like you are telling God "I don't need your present, I am strong enough ", which could be a sign of arrogance.
 
You have a really valid excuse not to fast, and if you aren't able to make up for the lost days, than you'll do something wonderful by helping poor Muslim with your money, so just be happy for this blessing.
 
What does your son say about the fasting? Does he asks questions, maybe he wants to try himself?


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Spare me the political events and power struggles, as the whole earth is my homeland and all men are my fellow countrymen. K.Gibran


Posted By: searching
Date Posted: 18 August 2011 at 8:33pm
My son doesn't want to fast himself. But he really respects me fasting. He actually prayed to Allah to forgive me for not fasting at the time I wasn't sure if I had a valid medical reason. He is so sweet, alhamdulilah. How old is your oldest? My son turned 9 in June.

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Posted By: Nura
Date Posted: 20 August 2011 at 9:54am
My oldest daughter is going to turn 6  in 10 days inshaAllah. it wil be the day before Eid, so she wishes a bicycle for her birthday and skates for Eid ...
Your son is very sweet alhamdulillah!

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Spare me the political events and power struggles, as the whole earth is my homeland and all men are my fellow countrymen. K.Gibran


Posted By: a well wisher
Date Posted: 21 August 2011 at 2:22am
Yeah that is incredibly sweet of him ...he is a very perceptive boy...Masha Allah
 
Originally posted by Nura

so she wishes a bicycle for her birthday and skates for Eid ...
 
 
Awww...What a deal on wheels Masha Allah!:)
 


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La ilaha ill-Allah, Muhammadur Rasulullah


Posted By: searching
Date Posted: 21 August 2011 at 2:39am
That's nice that she wants a bicycle and skates. She must be a very active little girl.

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Posted By: Nura
Date Posted: 24 August 2011 at 3:01pm
Alhamdulillah she got the skates. Now we have to go out every day because she cannot learn to use them inside the flat!...SO it was a present for me as well. Now I WANT the bicycle!!!

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Spare me the political events and power struggles, as the whole earth is my homeland and all men are my fellow countrymen. K.Gibran



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