ROCHESTER, Minn. — Fasting during Ramadan involves abstaining from food and drink from dawn to sunset. Depending on geography and the time of year when Ramadan occurs, daily fasting can range from as little as 10 hours in the winter months to more than 17 hours during the summer. This daily fast should not have a negative effect on health for most individuals. However, even if you have a chronic condition, including coronary artery disease, kidney disease, high blood pressure or diabetes, you can fast safely if your condition is well managed and uncomplicated.  

Anyone with a chronic health condition who chooses to fast — especially if you have complications or take medications to manage it — should take time to plan and prepare in order to avoid experiencing problems or worsening your condition. Because fasting is not intended to cause harm, it's important to consider consulting your health care clinician before Ramadan — or any time you plan to fast — to plan how best to maintain good health or determine whether fasting is safe for you.  

Some questions to ask include: 

• Is fasting safe based on my health conditions? 
• How is it best to take my medications? 
• Could medications that are taken multiple times a day be changed to once-a-day dosing? 
• Should I check blood glucose (sugar) levels more frequently, or change my insulin or other medication dosing?  

Taking medications 

Medications taken by mouth or intravenous feeding are considered to break your fast. As a result, if it is safe to do so, these types of medications should be given or administered before dawn or after sunset if you choose to fast and if it's safe to do so after consulting with your health care clinician.  

However, Islamic scholars generally recognize that other types of medications do not break the fast and may be taken during hours of fasting. These include medicated skin patches or creams, eye and ear drops, injections given in the skin or muscle (including insulin), supplemental oxygen, mouthwash or gargles that are not swallowed. In addition, many scholars also hold that nasal sprays and inhalers do not break your fast.  

For those planning to fast, it's recommended you drink plenty of liquids when you're not fasting, and limit caffeinated or highly sugared beverages. It's also recommended that you avoid or limit highly processed foods or foods high in fat, and eat healthy, balanced meals with moderate portion sizes.  

Vaccinations 

The consensus among Islamic scholars is that getting a vaccine does not break a fast. As such, it is completely acceptable to receive any recommended vaccination, even during the day while fasting.  

Helpful resources 

If you have a health condition or a concern, you are encouraged to consult with your health care clinician or a pharmacist to ensure you remain in the best possible health during Ramadan.  

Other helpful resources: 

• Caring for Muslim patients who fast during Ramadan (American Academy of Family Physicians). 
• Fasting in Ramadan and Muslim patients (IMANA).  

Muhamad Elrashidi, M.D., Community Internal Medicine, Mayo Clinic, Rochester, Minnesota 

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