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Can I Prescribe Medication With Gelatin When a Less Efficacious Alternative is Available?

Shaykh Jamir Meah answers a question related to the permissibility of prescribing medication which contains gelatin.

 

Question:

Salaam,

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?

 

Answer:

Wa’alaykum assalam, thank you for your question.
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

4. The above has been established by a Muslim doctor who is at least outwardly upright or by previous experience.
[Mughni al Muhtaj]
In regards your specific question and field of work, if it is in fact true that the extended release (XR) formulation has numerous benefits over the immediate release (IR) drug, and the side effects are fewer, then it would seem that this would be a valid case for the permissibility of prescribing the slow release version. However, when prescribing to Muslims, you should inform them of the option and give them the choice.
Considerations

The above answer is according to the restrictions of the field you work in and the boundaries of conventional medicine. Another perspective to this is that natural alternatives do exist, are very effective, and carry no side effects. The side effects of conventional medicines such as the ones you have mentioned are disturbing. Furthermore, many patients also complain about the serious come downs associated with the XR formulations you mention compared to the IR formula, and this should be looked into further and taken into account.
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.

Please also refer to the following answers:

Warmest salams,

Jamir
Checked and approved by Shaykh Faraz Rabbani

Can I Treat My Istihada [Abnormal Bleeding] With Medicine Containing Unlawful Ingredients?

Answered by Ustadh Tabraze Azam
Question:Assalam ‘aleykum,
I suffer from persistent abnormal bleeding (istihaada), and would like to begin oral contraceptive pills. However, it is very difficult to find oral contraceptives without beef or pork ingredients. Would it be permissible to take the medication if it contained only beef ingredients?
Answer: Wa alaikum assalam wa rahmatullahi wa barakatuh,
I pray that you are in the best of health and faith, insha’Allah.
It would be permitted to use medicines containing unlawful ingredients if: [a] the medicine is known to be effective, [b] there is no permissible alternative, and [c] this has been established by an expert doctor, through past relevant experience, your own or that of another, or manifest signs such as its being clearly known that it is the only medicine available.
Please see: Is It Permissible to Use Medicine With Haram Ingredients? and: Can I Take Medicine With Unlawful Ingredients? and: Can I Take Non-Halal Medical Supplements?
And Allah alone gives success.
wassalam,
Tabraze Azam
Checked & Approved by Shaykh Faraz Rabbani.

Can I Take Non-Halal Medical Supplements?

Answered by Ustadh Salman Younas
Question: I hope this message reaches you well, inshallah. I am struggling with an array of digestive issues that stem from a decreased production of bile by my liver. There are bile supplements available on the market, however they are derived from a bovine source (e.g. ox bile). Is this permissible to consume?
Answer: assalamu `alaykum
If you have been advised by your doctor to take this medicine due to its effectiveness and there are no alternatives (such as non-animal sourced, or halal/kosher animal sourced), it would be permitted for you to consume this medicine.
You should consult your doctor regarding the presence of any alternatives.
For more details, please also refer to:
Can I Take Medicine With Unlawful Ingredients?
Salman
Checked & Approved by Faraz Rabbani

Can I Take Medicine With Unlawful Ingredients?

Answered by Ustadh Tabraze Azam

Question: I have an under active thyroid that may require hormone replacement. Would it be permissible for me to use a dessicated thyroid supplement from bovine sources (not halal) instead of the synthetic hormone (synthroid) replacement that is commonly prescribed. I have tried the synthetic hormone in the past but didn’t seem to be improving. I have read about people’s success with the dessicated thyroid. I am also concerned about the long term effects of the synthetic hormones (synthroid) on my thyroid. I am trying to optimize and heal my thyroid and I have read negative things about synthroid and it’s long term effect on the thyroid gland.

Answer: Assalamu alaikum wa rahmatullah,

I pray that you are in the best of health and faith, insha’Allah.

It would be permitted to use medicines containing unlawful ingredients if: [a] the medicine is known to be effective, [b] there is no permissible alternative, and [c] this has been established by an expert doctor, through past relevant experience, your own or that of another, or manifest signs such as its being clearly known that it is the only medicine available.

If the doctor is not an outwardly upright Muslim who understands the limits of Islamic Law, you would take their opinion into consideration and make your own judgement.

[see also: Is it Permissible to Take Medicine That Contains Gelatin?  and: Is It Permissible to Use Medicine With Haram Ingredients?]

However, if harm is to be reasonably feared [the same conditions as mentioned in [c] above would apply here] by using the permissible alternative, then the ruling could change. In such a case, you should consult expert doctors regarding your particular condition and then confirm the ruling with reliable scholars.

May Allah give you, your family, and the entire Muslim community, every well-being (`afiya).

Please see related answers in the archives at SeekersGuidance.org

And Allah alone gives success.

wassalam,

Tabraze Azam

Checked & Approved by Faraz Rabbani