Ramadan fasting with a chronic condition: who to talk to before the month, what to ask, and what to record

You or someone in your family wants to keep the fast and takes regular medication. How the two fit together is settled before the month, with your doctor and your pharmacist. For that conversation you record your symptoms and intake, on paper or in Sam. Its medication list keeps an intake log and reminders for planned daily doses. This guide says who to talk to, what to ask, and what to record.

It is general information, not medical advice. It does not tell you whether to fast, and it gives no dosing times. Whether you fast is your choice. What that means for your condition and your medicines is decided with your doctor and pharmacist beforehand. Islamic guidance exempts some people with health conditions from fasting; that is general, not religious advice. Ramadan moves about 10 to 11 days earlier each year in the solar calendar. Your community or a reliable calendar tells you the exact dates.

Who do you talk to before Ramadan?

Your doctor and your pharmacist. NHS North East London ICB advises checking with your GP or pharmacist whether doses or times need to change. Diabetes UK, working with the British Islamic Medical Association, says fasting can be dangerous with diabetes and that you should only fast after discussing it with your healthcare team. A UK Ramadan health guide from 2008, hosted by an NHS trust, adds that for high blood pressure and asthma a consultation is a chance to discuss how to complete a fast safely while keeping the disease under control.

Some people need the booked appointment more than others. For people with diabetes, Diabetes UK names insulin, other medicines that can cause low blood sugar, and complications such as heart or kidney disease as raising the risk of fasting. Anti-seizure medication belongs in the same early conversation. Plan the appointment well ahead, because Ramadan moves each year. A list of what to bring to any appointment is in the doctor visit checklist for a chronic condition.

Who decides when you take your tablets?

You decide that with your doctor and pharmacist, not alone. Many people move doses to the night. The 2008 guide notes that a GP may need to change some people's tablets so they can take them outside fasting hours. Not every medicine can simply be shifted: some have fixed intervals, and some are meant to be taken with food.

This is why the guide gives no times here. Which of your medicines have fixed gaps or need food is something to confirm in the practice. Never stop or change a long-term medicine on your own.

What about inhalers and asthma?

Medically, daily preventive inhalers for asthma are meant to continue as prescribed so the condition stays controlled. Whether an inhaler breaks the fast is a matter on which Islamic scholars differ. That part is for your faith community to weigh. What applies to your own inhalers is for your care team to say. The asthma diary in Sam is one of the program diaries, which have a doctor report and a monthly questionnaire. How asthma is otherwise recorded is covered there.

What do studies say about epilepsy and fasting?

A systematic review in the journal Cureus (2025) looked at 12 studies on Ramadan fasting and epilepsy. It found the effect on seizures is very individual. Some people had fewer, others had more. It cites one Moroccan case series of 120 people. There, 51.7 percent said their epilepsy worsened in Ramadan, most often with lack of sleep and broken sleep. People who had changed their anti-seizure drug plan reported a worsening more often (80 percent) than those who did not.

The review lists changed medication habits, shorter or broken sleep, emotional stress and fatigue as influences. It concludes that care should be personalised, with a consultation before Ramadan and a tailored medication schedule. The authors also list limits: small samples, often no control group, self-reported data and short follow-up. A seizure record you bring to the talk gives the practice your own picture.

What do studies say about migraine and fasting?

The International Headache Society describes, in the ICHD-3 classification, a headache caused by fasting. It is usually diffuse, non-pulsating and mild to moderate, and it is relieved after eating. The definition uses a fast of at least eight hours. The Society notes this headache is commoner in people who already have a headache condition. A fasting-triggered migraine attack is coded as a migraine.

Studies on Ramadan and migraine are small, regional and observational, so the guide keeps to what the classification itself states. How triggers like fasting, sleep and stress show up in your daily record is covered in the post on migraine triggers.

What about blood pressure and tablets?

A small Lebanese study followed 58 people whose high blood pressure was well controlled. They kept taking their tablets in the usual dose during Ramadan. Blood pressure did not differ between fasting days at the end of Ramadan and days a month later. The authors apply this only to people who were well controlled and stayed on their medication.

That is not a green light. Dose and timing remain a topic for your practice. If you record readings at home, write the time of your last tablet next to the value. Which readings matter while fasting, and when one is high, is for your care team to judge.

What do you record before and during Ramadan?

Start two to four weeks before the month, so you have a comparison with your normal routine. One line per day is enough:

• Date
• Sleep: hours and how often you woke
• Medication: planned and actual time you took it
• Symptoms: a seizure, a headache day, breathlessness and spacer or inhaler use, a blood pressure value with the time
• Fast broken: yes or no, and the reason
• Anything notable: little to drink, travel, an infection

Count later in blocks of ten days. That shows whether the first days differ from the rest. In Sam you mark when you took a medicine in the intake log. Symptoms go in the symptom diary. For asthma, high blood pressure, epilepsy and migraine, Sam has a program, meaning a diary with a doctor report and a monthly questionnaire. It starts after you confirm a doctor's diagnosis.

Which questions do you bring to the practice?

Take your record and your medication list. These questions help the talk:

• Which of my medicines have fixed gaps or must be taken with food?
• Is there a form or a rhythm that fits my hours, and who decides it?
• Does it matter for any of my medicines that I drink nothing during the day?
• What do I do if I miss a dose?
• What is a reason to call the practice?
• What do we do if I break the fast?

For an emergency, such as a seizure that does not stop, severe breathlessness, chest pain or pressure, or sudden weakness or trouble speaking, call your local emergency number (112 in the EU, 999 in the UK, 911 in the US). For non-urgent medical questions, use your country's usual service, such as NHS 111 in the UK.

Log medication and symptoms before and during Ramadan in Sam

You arrive at the practice with a course of weeks, not with what you remember in the room. That starts a month before Ramadan.

• Instead of paper: the intake log shows when you took each medicine. Entries in a program for epilepsy or migraine that you make the same day bring in the night's sleep from Apple Health when data exists.
• Instead of a notes app: symptoms outside a program go in the symptom diary, with dates and the course.
• Instead of remembering in the appointment: the doctor report sums up the period you choose as a PDF, inside a program for asthma, high blood pressure, epilepsy or migraine.

Sam gives no hints on dosing times and does not replace the talk with your doctor or pharmacist.

Try Sam Health

Sam is a wellness companion, not a medical device. The app does not diagnose, treat, cure or prevent any condition or health state. Always consult qualified professionals for medical decisions.

Related reading

• Doctor visit checklist for a chronic condition
• Alcohol and migraine: is it a real trigger?
• Migraine triggers: sleep, stress and tracking
• Holter Monitor Diary: What to Write for Palpitations
• Bring medication to Germany from the US: what applies

Sources

Updated: October 2026

• Diabetes UK: Diabetes and Ramadan (developed with the British Islamic Medical Association)
• Communities in Action, supported by the Department of Health, hosted by Norfolk and Norwich University Hospitals: A Guide to Healthy Fasting (Ramadan Health Guide) (2008)
• NHS North East London ICB: Make sure you plan ahead for a healthy Ramadan 2026
• Mahdaoui et al.: Impact of Ramadan fasting on patients with epilepsy: a systematic review, Cureus 2025 (full text)
• International Headache Society: ICHD-3, 10.5 Headache attributed to fasting
• Hammoud et al.: Impact of Ramadan intermittent fasting on the heart rate variability and cardiovascular parameters of patients with controlled hypertension, Journal of Nutrition and Metabolism 2021 (full text)