IN conjunction with the holy month of Ramadhan Malaysia’s largest prescription pharmacy Alpro Pharmacy has come up with a set of general guidelines to help Muslims to continue the practice of fasting while practicing proper intake of their medications.  

The guidelines are developed based on recommendations by the Health Ministry (MOH) and the Department of Islamic Development Malaysia (JAKIM) and are aimed at raising awareness on the proper methods to consume chronic medications during the fasting period.  

Does using an inhaler invalidate the fast? 

• There are two categories of inhaled medications: Preventive medications (e.g., Seretide Inhaler, Flixotide Inhaler, etc) and sedatives (e.g., Asthalin inhaler, Ventolin inhaler, etc). 
• Pharmacists advise patients who use preventive inhaled medications to continue using them accordingly. Such medication is normally taken twice a day and can be taken before sahur and bedtime. 
• Pharmacists also caution that preventive medication such as inhalers is vital for optimal disease control. Such medications can reduce the number of asthma attacks when fasting and reduce the need for inhalation-type relievers. 
• Sedative inhalation can be used in the case of an emergency. 

Does fasting carry a risk of dehydration (lack of water) or hypoglycemia (low sugar levels)? 

• For people with diabetes, pharmacists recommend a two-hour sugar level monitoring after sahur and when having symptoms of hypoglycemia, including dizziness, cold sweats, blurred visions, chills, etc. 
• Monitoring sugar levels does not invalidate the fast. Given the health implications, if the sugar level is less than 3.9 mmol/L, the patient should break their fast. 
• For people with diabetes, pharmacists also recommend avoiding delaying the time taken to break the fast. If you are on the go, it is advised to bring one or two dates (buah kurma) during iftar. 

• For optimal sugar level control, dietitians recommend taking foods rich in fibre. Fibre not only satiates but helps stabilise sugar levels in the body as well. 

Are patients suffering from gastric among those at high-risk during the fasting period? 

• If a person has gastric problems, pharmacists advise that they should avoid taking fried foods or fizzy drinks. 
• Drinks with high caffeine content such as coffee are also possible triggers of gastric discomfort. 
• Having smaller meals when breaking the fast is recommended instead of having a large meal immediately upon ‘berbuka’. 

In conclusion, fasting is not a barrier for patients to stop seeking treatments and consuming their medications.  

Adjustment of dosage and consumption timing according to recommendations of doctors and pharmacists can help patients navigate through the month of Ramadhan. 

It is also important to note personal health should always be the utmost priority, and one should not stop taking medication or discontinue treatment during Ramadan. – April 6, 2022