Navigating Ramadan with Rheumatoid Arthritis: Part 1

Blog by Dr Shirish Dubey & Hifsa Mahmood

As we look forward to the holy month of Ramadan, some of you will be wondering whether you should fast or not. There are, of course, exemptions from fasting – one of those being people who are ill or have medical conditions. 

Instead of fasting, you could choose to honour Ramadan through charity, such as by feeding a less privileged person. I know that a lot of you will want to fast, in keeping with good religious practice whilst also ensuring you can maintain good health. It is imperative that you ensure medications are taken regularly, and the dosing schedule is maintained. There may be a need to adjust daily schedules so medicines can be taken between the evening meal of Iftar (sunset) and the morning meal of Suhoor (dawn). Fortunately, we are in winter with approximately 11 hours between sunrise and sunset but the days will gradually get longer. 

Medications that are taken twice a day such as Sulfasalazine or Mycophenolate can be taken with Suhoor or after Iftar. Medications that are taken once a day or less can be taken at a convenient time. Injections such as biologics are less of an issue since these are usually once a week or sometimes even less frequently. Painkillers such as Paracetamol are a bigger problem since the dosing schedule is usually 4 times daily. Anti-inflammatory agents can be adjusted around the fasting times and longer acting versions that last for 12 hours or 24 hours can be chosen. Where possible, longer acting versions of painkillers should be preferred and it is worth having a discussion with your health practitioner to get the prescriptions sorted well in advance to avoid any last-minute stress. 

The purpose of Ramadan is to improve the spiritual and physical state and to fortify your relationship with God (Allah). It’s important that we ensure that we are not ignoring our physical health whilst looking after the spiritual.

Further information from the British Islamic Medical Association can be found here. Keep an eye out on Part 2 during Ramadan.

Dr Shirish Dubey (Consultant Rheumatologist) and Hifsa Mahmood (Specialist Clinical Pharmacist, Oxford University Hospitals NHS FT).

We hope this advice helps you! Share your tips and experience with us on Facebook, Twitter or Instagram– we’d love to hear them!