Assalamu‘alaikum SS Datuk Mufti. I suffer from asthma. If I use my inhaler during the day while I am fasting, will it invalidate my fasting?
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.
First and foremost, we would like to emphasize that this is a khilafiyyah issue (scholars have acceptable differing opinions) and has been discussed, especially by contemporary (mu’assirin) scholars. It is a current issue due to the advancement of medical technology, thus, it was not specifically discussed by early scholars.
Returning back to the issue, the scholars’ opinions are divided into two:
FIRST: IT DOES NOT INVALIDATE FASTING
- The usage of inhaler during the day in Ramadhan does not invalidate fasting. This is the opinion of the majority of scholars such as al-Syeikh al-‘Allamah Abdul Aziz bin Baz Rahimahullah, al-Syeikh al-‘Allamah al-Faqeh al-Zaman Muhammad bin Soleh al-‘Uthaymeen Rahimahullah, al-Syeikh Abdullah bin Jibrin, al-Syeikh Dr. Muhammad al-Khayyat, al-Syeikh Dr. Muhammad ‘Uqlah Hafizahullah, al-Syeikh Dr. al-Siddiq al-Darir, al-Syeikh Dr. al-Tantawi, al-Syeikh Dr. Yusuf al-Qaradawi Hafizahullah. The same response is issued by other bodies of authorities such as:
- International Islamic Fiqh Academy
- General Presidency of Scholarly Research and Ifta’
- Islamic Organization for Medical Science (IOMS)
- The discussions of this opinion:
- The amount of substance from the inhaler enters the throat and into the stomach is too small, thus, it does not invalidate fasting, using the qiyas (analogical deduction) with gargling and istinsyaq (sniffing water into the nose for ablution).
- The explanation is as the following: “An inhaler contains 10 millimeters of fluid, containing medicines. This quantity is enough to be used for 200 sprays. Each spray releases a very small amount of not less than 1 millimeter, which is not even a droplet. This amount is then further divided into several parts and the largest part enters the respiratory section. One part enters the throat, while the rest travels into the stomach. The quantities that ended up into the stomach are forgiven, using qiyas with the water left in the throat as a result of istinshaq. The amount of residual water is more than the fluid from an inhaler. With this, if a person rinses his water with water enriched with certain substances (such as minerals or vitamins, which can only be seen under x-rays), surely, the substance can be found shortly afterwards in the stomach, which at the same time proves the presence of the substance in the stomach, but since small quantity is forgiven. The quantity of residual water from gargling and istinsyaq, exceeds the quantity of the spray from an inhaler that enters the throat, if it is assumed to enter the throat.” 
- Substance from the inhaler will eventually end up in the stomach is not a certainty for it is not proven. It may or may not end up in the stomach. Thus, returning back to the original ruling, the fasting is not invalid for there is doubt.
- Inhaler spray is unlike food and drink. Furthermore, it is similar with drawing blood for clinical tests and non-nutritive injections. 
- Inhaler spray is in aerosolized form, where it does not travel into the stomach but absorbed inside the lungs. 
- Medical experts confirmed that siwak (teeth cleansing using a twig from the Salvadora persica tree or also known as sugi) contains eight chemicals that helps in the protection of teeth and gum from plaque and infection. These chemicals would surely be absorbed by the tongue and enters the throat when someone is performing siwak. In Sahih al-Bukhari, it is stated from ‘Amir bin Rabi’ah: “I saw the Prophet PBUH performs siwak countless times while he was fasting.” 
- If these chemicals enter the throat (while performing siwak) is forgiven due to its small quantity because it is unavoidable, the same is for the case of using inhaler where the substance from the inhaler enters the throat, it is also forgiven.
SECOND: IT INVALIDATE FASTING
- The usage of inhaler invalidates fasting. Thus, it is impermissible to use inhaler during the day in Ramadhan, unless it is a necessity or a treatment for an illness. Hence, it is permissible for him to break his fast and replace it later. This is the opinion of al-Syeikh Dr. Fadhl Hasan ‘Abbas, al-Syeikh Muhammad al-Mukhtar al-Sulami, Dr. Muhammad Alfai, al-Syeikh Taqiyuddin al-‘Uthmani and al-Syeikh Dr. Wahbah al-Zuhayli.
- The discussions of this opinion:
- The substances from the inhaler will end up in the stomach through tkhe mouth. Thus, it invalidates the fast.
- However, this issue is answered by the opinion that state that it does not invalidate the fast when used during the day in Ramadhan.
- To date, in our knowledge, there is no other evidence that supports this opinion. Wallhua’lam.
After analysing both opinions, we are inclined stating the usage of inhaler during the day in Ramadhan does not invalidate the fast.
Furthermore, we found that asthma attacks do not occur continuously but just happen occasionally while other times the sufferer is healthy. Islam is religion of acceptance and tolerance, thus, there is an exception for the usage of inhaler for asthma sufferer (does not invalidate the fast), while at the same time they are able to gain the rewards of fasting just like everyone else.
This is the appropriate and logical opinion. It is a correct opinion through qiyas with gargling, istinsyaq and siwak. This is in accordance with the opinion of renown contemporary scholars and bodies of authorities of today.
 See Mufattirat al-Siyam al-Mu’asirah by Prof. Madya Dr. Ahmad bin Muhammad al-Khalil, lecturer of College of Sharia and Islamic Studies in the Qassim University, Saudi Arabia. He cited Majalah al-Majma’.
 Fatwa of Syeikh Ibn Baz Rahimahullah (15/265).
 Fatwa of Syeikh Ibn ‘Uthaymeen Rahimahullah (19/211).
 Narrated by al-Bukhari. Also see Fath al-Bari (4/158).