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Don't change dosage without doctor's advice


In a couple of days, the holy month of Ramadhan is going to start. It raises questions among those who are under medication for some disease or the other. Experts advise not to stop medication and not to meddle with the dose without doctors’ consultation.

The Ministry of Health, through the campaign ‘I and My Medicine in the month of Ramadhan’, is seeking to know how to use medicines in the month of Ramadhan. The programme aims to educate citizens about the correct use of medicines in the blessed month, in order to overcome the negative aspects of using medicine during fasting and to maintain proper health.

The programme also aims to avoid any complications that may result from fasting for people who suffer from chronic diseases such as diabetes, high blood pressure and heart diseases.

The pharmacist must also be consulted, as they play a key role in providing personalised advice to patients to ensure that they receive the best information about treatment options and adjustments in dose timing.

Some patients are afraid of using certain medications during the daytime, which in turn affects their fasting. Therefore, it is necessary to recognise that all medications that reach the digestive system, through the mouth, nose, or intravenous injection, invalidate the fast in Ramadhan, and they include: oral medications, pills, and tablets. Oral, intravenous feeding tubes, and nasal sprays.


There are also general tips for the patients for the safe use of medicines during the holy month of Ramadhan. Medicines that are taken in a single daily dose do not need to be modified. Single-dose medications can be shifted from morning to evening. These modifications must be discussed with the doctor or pharmacist, through which it is possible to assess any risks that may arise due to shifting the dose to the evening, given the accompanying adjustments in sleeping and eating habits.

Similarly, Dr Hamood Sawafy, Buraimi University, says, “It is clearly important to consult with your medical doctor before making any changes to your medication regimen during the holy month of Ramadhan. Generally, if you are taking prescription medications, it is important to consult with your doctor to discuss whether any adjustments need to be made to the dosing schedule during the fasting holy month. It is also advisable to time your medication doses to coincide with iftar or ٍSuhoor for convenience. Additionally, if you are taking over-the-counter medications or supplements, be sure to check with your healthcare provider about any restrictions during fasting hours.”

For medicines that are taken twice daily, the morning dose can be taken before the pre-dawn meal and the evening dose after Suhoor. For medications that are taken in three or more daily doses, it should be discussed for the possibility of changing the medication with a doctor and using other dosage forms such as extended-release forms, or switching to two doses per day.


According to Dr Rohil Raghavan, Burjeel Hospital, “Medicines ideally should be taken up on a case to case basis. For example, diabetic patients need to meet a physician to consider a change in dosage during the holy month. For those who are taking medicines for pain, need to re-evaluate the timings in which they are taken.”

All must always remember the tolerance and ease of the religion of Islam, as it is permitted to break the fast in the case of a patient whose fasting is a reason for increasing his illness, delaying his recovery, or a reason for bringing him trouble and it is possible for him to fast what missed on other day.

Dr Viresh Chopra, Oman Dental College, says, “Ramadhan is a warm, community celebration that involves a month of fasting and worship with a goal to improve the spiritual and physical state and to fortify the relationship with God. Caring for patients who celebrate the month of Ramadhan represents a unique undertaking for healthcare professionals, including pharmacists.”

“Individuals on chronic medications should adjust medication schedules so they can be taken between the evening meal of Iftar (sunset) and the morning meal of Suhoor (dawn). But this should strictly be done with the advice of their doctor. For medications taken multiple times during the day, recommended strategies include choosing long-acting formulations (e.g., sustained release) or changing dosing regimens to once or twice daily. Pharmacists also have a big role to play when providing over the counter drugs. While serving patients who observe fasting during the holy month of Ramadhan, pharmacists should give special consideration to the safety of fasting and address required changes in pharmacotherapy and lifestyle to avoid potential hazards of fasting,” he says.


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