Shaykh Jamir Meah answers a question related to the permissibility of prescribing medication which contains gelatin.
I know it is haram to take medicine that has haram elements in it (like gelatin capsules) if there is a reasonable alternative (such as tablets). So as a muslim psychiatrist, many of our medicines have extended release formulations that have many advantages over the immediate release formulations. The immediate release formulations do not have gelatin capsules, and right now, that’s really their advantage. For example, effexor XR has a decreased risk of side effects including nausea and people only have to take it once a day, and this is why the immediate release tablets have fallen out of favor (though the IR tablets have no gelatin). The other thing is that compliance with psychiatric medications is found to be low, and once daily medications are more likely to have increased compliance as well. The other consideration is that extended release formulations have less risk of withdrawal syndromes (which are non-fatal but really really uncomfortable and can make you sick) compared to immediate release formulations.
Is it haram to prescribe XR on the basis of the issue of gelatin and I can only recommend IR to my patients (even if they are non-Muslim) as to avoid direct assistance in sin?
Most scholars hold the position that gelatine from animals not Islamically slaughtered remains impure and is therefore unlawful. The exception for when it would permissible to take or prescribe impure gelatine is when:
1. It is known that the medicine will be effective
2. The medicine is needed
3. There is no permissible alternative reasonably available
Nevertheless, if what you have stated is indeed true in regards the two formulas, then you are only required to work within your own capacity and area of expertise, and based on that, it would be permissible for you to prescribe the XR version if the patient also chooses such a course of treatment. And Allah knows best.
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