How do I take my medication safely during Ramadan?

February 20, 2025

Special consideration must be given to medication compliance and appropriate diet during the holy month of Ramadan. The pharmacist plays a key role in providing personalized, counseling to ensure that patients are fully informed about treatment options and dose timing changes.

Disclaimer: This information is designed to provide practical advice about safe medication use during the holy month of Ramadan. Any lifestyle or medication changes must be discussed with and approved by a clinician.

General tips for safe medication use during the holy month of Ramadan

Drugs with a single daily dose in the evening do not need modification.
For drugs with a single daily dose in the morning, the dose can be switched to the evening. However, you should discuss these changes with your clinician and pharmacist as they will assess any risks that might occur from shifting the dose to the evening given the change in your eating and sleeping habits.
For medications that are taken twice daily, you can take the usual morning dose at the predawn meal (Suhoor) and the second dose at the sunset meal (Iftar).
For medications that are taken three times a day or more, you may discuss with your clinician the potential to switch to different medications, such as sustained-release formulas that are taken once or twice a day. The clinician may also consider the use of non-oral formulations such as patches or topical preparations.

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Essential questions that patients may need to ask a healthcare professional

Do I need to make any changes to my medication or treatment regimen? What are the risks based on my specific health history?
Can I maintain my usual level of physical activity during Ramadan?
Are there any situations where I should break my fast?
After I finish my fast, will I need to book a follow-up appointment?
Whom should I contact in case of an emergency?

Long gaps between food intake and certain diabetes medications (such as insulin or oral diabetic medications) are well-known risk factors for hypoglycemia (low blood sugar). Some Diabetic patients might require adjustments to their insulin or oral diabetic medications doses.
You may also want to schedule a follow-up consultation after Ramadan to discuss any necessary readjustments of your medication(s).
Seek Help: You should break your fast and seek emergency assistance if you experience symptoms of hypoglycemia or any of the following:
- Low blood sugar – Blood glucose less than 70 mg/dl.
- High blood sugar – Blood glucose higher than 300 mg/dl.
It is essential to monitor your blood sugar level closely during Ramadan and consult your healthcare professional immediately if you have problems managing your condition.

Safety tips for patients using

Antibiotics

For antibiotics with a single daily dose, the dose can be taken after the sunset meal (Iftar). Follow the label instructions as some antibiotics may need to be taken with food while others need to be taken on an empty stomach.
For antibiotics that are taken twice daily, you can take the usual morning dose at the predawn meal (Suhoor) and the second dose at the sunset meal (Iftar).
For antibiotics that are taken thrice a day or more, you may discuss with your clinician the potential to switch to different therapies that can be used twice daily.
Ensure you take the full course. Do NOT stop therapy once you feel better.

Anticoagulant medications

Discuss your condition with your health care provider and religious advisor to ensure the best regimen for you. They can determine if you are eligible to fast.
Warfarin : Instructions to avoid INR fluctuation:
- Take your Warfarin at the usual time.
- Warfarin should be taken at the same time.
- Do not change the amount of green vegetables you consume.
- Rivaroxaban should be taken after the sunset meal (Iftar).

Blood pressure medications

Avoid salt-rich foods, such as pickles to ensure blood pressure control.
Most blood pressure medications are used once or twice daily, and therefore, the timing can be adjusted accordingly. Periodic blood pressure monitoring using home devices is advised.
Periodic blood pressure monitoring using home devices is advised.
Diuretics should be taken with the sunset meal (Iftar).

Levothyroxine

Discuss your condition with your health care provider and religious advisor to ensure the best regimen for you. They can determine if you are eligible to fast.
Levothyroxine absorption is impacted by food, therefore it is advisable to take Levothyroxine as follows:
Take the dose, wait for 30-60 minutes, then start the Iftar meal; OR
Take the Iftar meal, then do not eat any food for three hours. Take the Levothyroxine dose, then wait another 60 minutes before taking any additional food.

Epilepsy medications

Discuss your condition with your health care provider and religious advisor to ensure the best regimen for you. They can determine if you are eligible to fast.

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