Question:
Assalamu‘alaikum SS Datuk Mufti. A patient needs to take the sublingual medication, does the patient’s fast still valid?
Answer:
Waalaikumussalam wbt,
Alhamdulillah, praise and thanks to Allah for the countless blessings He has blessed us all with. Blessings and salutations to the Prophet Muhammad PBUH, his family, companions and all those that follow his teachings to the day of judgement.
The advancement and development of the science and medicine especially in the field of pharmacy through research and experiments lead to the findings of new and improved medicine and treatments. First, we will explain briefly regarding sublingual medication to ease the understanding of society and the relationships of it with the rulings of fasting.
Sublingual Medication
Sublingual in Latin means under the tongue. It refers to the process of taking medicine in the forms of pills or tablets under the tongue where it will be absorbed under the tongue quicker through the capillaries into human bloodstream.
It is different from the normal medication taken orally, which will then go through several processes before it is digested and absorbed in the stomach. As for sublingual medication, the medicine will be put under the tongue and through a reaction with mucous membrane under the tongue, it will be absorbed straight into the bloodstream and the effects of the medication is much quicker than medicine taken orally. This is important during emergencies such as medicine for heart attack.
There are numerous sublingual medications prescribed now, some of them are:
- Heart medicine (nitroglycerin, verapamil)
- Steroids
- Some barbiturate
- Enzyme
- Vitamin
- Some medicine for mental illness
Does Taking Sublingual Medicine Invalidate Fasting?
Reviewing the method of sublingual administration of medicine, in our opinion it does not invalidate fasting. According to mazhab al-Syafi’e, inserting anything in any open cavity will invalidate someone’s fast. Al-Jauf according to our mazhab means brain and anything that passes the throat and eventually leads to the stomach. Medicine administered through other channels (other than open cavity), such as medicine administered directly into the brain or medicine or ointment applied on wounds (not an open cavity), even if it is absorbed into the body it does not invalidate someone’s fast. [1]
As for sublingual medication, it is placed under the tongue and does not pass through the throat and is directly absorbed into the bloodstream quickly.
International Islamic Fiqh Academy (مجمع الفقه الإسلامي الدولي) has decided after research and explanation from medical experts and Islamic scholars, that sublingual medication for heart attack and other illness does not invalidate someone’s fast, as long as it is not swallowed through the throat. [2]
It is also in line with the fatwa issued by Jordan’s Dar al-Ifta: “Taking medicine pill/tablet that is placed under the tongue does not invalidate fasting because it does not pass through any open cavity. However, if it is swallowed, then the fast is invalid.” [3]
The same answer is given by Egypt’s Dar al-Ifta which states that it does not invalidate the fast. This answer is given by the Brand Mufti of Egypt Prof Dr Shauqi Ibrahim ‘Allam Hafizullah since 2013. [4]
Wallahua’lam.
End Notes:
[1] See al-Mu’tamad fi al-Fiqh al-Syafi’e (2/181)
[2] See the decision made by International Islamic Fiqh Academy (مجمع الفقه الإسلامي الدولي) number 93 (1/10) on the 10th General Meeting in Jeddah on 28th June until 3 July 1997 where previously the research paper on ‘Medical Processes That Invalidate Fasting’ was presented in Morocco on 14-17 June 1997.
[3] http://aliftaa.jo/ShowContent.aspx?Id=103
[4] http://dar-alifta.org/AR/Default.aspx. Please click on the banner written with the following phrase: بعض الأمور الطبية التي قد تفسد الصيام