Follow up Muslim patients during Ramadan
During Ramadan, Muslim patients often unilaterally change the intake time and dosage of drugs without taking medical advice, a recent review has found (BMJ 2004;329:778).
In general, adult Muslims must not consume food, beverages or oral drugs
between dawn and sunset during Ramadan, the ninth month of the Islamic
lunar calendar. Under Islamic rules, patients with chronic diseases are
allowed not to fast but often do so.
The authors of the review point out that drug regimens need to be carefully
adjusted so that all doses can be safely taken in the shorter period
between sunset and dawn.
However, two surveys, covering over 400 patients, revealed that most
patients change drug regimens during Ramadan, often without taking medical
advice.
The authors recommend, therefore, that Muslim patients with chronic diseases
are followed up during Ramadan, so that optimal dosage regimens that
account for the changes to daily routine can be established.
If therapeutic problems do occur, slow release formulations or chronotherapeutic
formulations should be used, when these are available.
The authors describe several studies demonstrating the importance of
considering circadian changes in the pharmacokinetic and pharmacodynamic
properties of drugs during Ramadan.
However, they suggest that further studies should be carried out to provide
more guidance about the ways in which the administration of drugs should
be modified.
This year Ramadan is expected to start on 15 October. |
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