Q: SINCE the fasting month is drawing near, I would like some advice on how to manage my medication during Ramadan. I am suffering from a chronic disease that requires long-term medication.
A: THE sick are generally exempted from fasting. But if you think you can manage your medication accordingly without aggravating your health, then you may choose to fast.
It is difficult to give any specific advice through this column. It is better for you to discuss the issue with your doctor or pharmacist. As a guideline, however, you may:
Seek an alternative dosage form that either avoids taking medicine orally on a frequent basis, or, if possible, excludes oral medication altogether.
For example, you can use slow-release preparations which allow patients to take only one or two doses daily. This can be done after the breaking of fast and just before the start of the fast.
Theophylline for asthma, for instance, can be used this way. A study suggests that a longer-acting preparation taken in a single daily dose (preferably at the end of the night) would be a solution during Ramadan for asthmatic patients.
Discuss this possibility with your doctor.
Another example of alternative dosage form is the use of transdermal patches when appropriate.
Seek alternative drugs that are indicated for the same condition. This would be drug groups that have a different dosage regimen. For example, the antibiotic ampicillin could be substituted with bacampicillin, thus reducing the need to take drugs four times daily to twice.
Adjust the use of drugs accordingly. As a guideline, the following could be considered:
Medicine taken twice a day after food could be taken once after the break of fast and another during sahur. It is best in this case to delay sahur so that the interval between the two time-spans is divided almost equally.
Medicine taken three times a day after food. Follow the same instruction as above, but take once more before bedtime. Make sure, however, that you take a light snack at the same time.
Medicine taken twice before food. Take the medicine after breaking fast with water. You can start eating between 30 and 60 minutes later.
Medicine taken three times before food. Follow the above instruction, and take once more before bedtime.
Medicine taken once daily before or after food. Choose the appropriate time suitable to you and follow that timing throughout the fasting month. For medicine to be taken before food, take the medicine with water. Take your food between 30 and 60 minutes later.
Medicine taken every eight hours. Use the suggestion as per three times a day depending on before or after food.
If you are uncertain about these suggestions, you can ask your doctor or pharmacist or call the National Poison Centre. - By the National Poison Centre.
