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Dear Colleagues: 

Please see this important note relevant to the medical care of patients observing Ramadan, which begins the evening of March 22 and ends at sundown on April 21. One of the fundamental principles in observing this holy month for followers of Islam is fasting.

Fasting takes place during daylight and this includes not taking oral medications during this time. As a result, medications are taken after sunset and prior to dawn. Please be aware of this fact and ask patients if they will be observing Ramadan. If so, it would be prudent to discuss a medication plan with them to insure optimal medical care while they observe this holy month. Patients using insulin for management of diabetes can have particular challenges during the fasting periods. Similarly challenging are when multiple doses of a medication are required throughout the day. 

Please note that intra-muscular injections are permitted, including the COVID vaccine. 

Those who cannot safely fast, including people who are intellectually or developmentally disabled, or are acutely or chronically ill, are excused from fasting. Women who are pregnant or breastfeeding may opt in or out of fasting and are encouraged to excuse themselves if they have concerns over their health or their child’s. Some may choose to fast, and a conversation about care in this circumstance is warranted. Children generally begin participating in fasting around the age of 10 and this can vary by family.

I hope you find this useful in the care of patients observing Ramadan. For additional context, here is a resource written by one of our medical student graduates.

 The Islamic Society of Central Virginia also provides information; here is their website. An appropriate greeting for Ramadan is Ramadan Kareem or Ramadan Mubarak. 

Fern R. Hauck, MD, MS, FAAFP (she/her)
Spencer P. Bass, MD, Twenty-First Century Professor of Family Medicine 
Professor of Public Health Sciences
Director of Research and Faculty Development
Director, International Family Medicine Clinic
University of Virginia Department of Family Medicine