Inhalers During Ramadan:
Planning for Asthma and COPD

Start with a pre-Ramadan review

Asthma and COPD vary in severity. Feeling well today does not necessarily mean that treatment can be stopped. Before fasting, discuss your recent symptoms, night waking, reliever use, flare-ups and other conditions with your clinician.

Bring every inhaler, a medicine list and your current action plan. Ask the clinician to check technique, discuss missed-dose instructions and explain what to do if breathing worsens. A plan should fit your actual diagnosis and prescribed treatment. [1]

Should I stop my inhalers while fasting?

Do not stop prescribed inhalers simply because Ramadan has begun. Preventer treatment helps maintain asthma control; maintenance bronchodilators are important for many people with COPD. Reliever medication treats symptoms according to your individual plan. [2][3]

Inhalers are not interchangeable. A steroid-containing inhaler may be maintenance treatment, and some prescribed asthma regimens use a particular combination inhaler for relief as well. Confirm the name, purpose and instructions for each device.

Using tablets instead of inhalers, doubling a missed dose or borrowing another person’s medicine can create additional risk. Changes should be agreed with the treating clinician. [6]

Can inhaler doses be moved to suhoor and iftar?

Sometimes a clinician can adjust a regimen, but the decision depends on the medicine, dosing interval and disease control. Taking two doses close together is not automatically equivalent to spacing them as prescribed.

Ask about other medicines, including tablets and oxygen, as part of the same review. The plan may differ when fasting days are long or other illnesses affect hydration and medication timing. [1][6]

Does an inhaler invalidate the fast?

Religious opinions differ about inhalers and some other treatments. The answer cannot be settled by saying that an inhaler acts mainly in the lungs. Speak with a trusted, qualified religious scholar about your circumstances and the treatment prescribed by your doctor.

Your clinician can explain the medical risks of delaying treatment. If symptoms require medication or urgent care, do not postpone treatment while seeking a religious ruling. When fasting is medically unsafe, discuss religiously appropriate alternatives with your scholar. [4][6]

When can fasting be medically unsafe?

Risk is individual. Poorly controlled symptoms, frequent need for relief, a recent severe flare-up, significant oxygen requirements or important coexisting illnesses may make fasting unsafe. Your clinician may recommend postponing fasting while treatment and control are reviewed.

Stable asthma does not give everyone the same fasting risk, and COPD should not be treated as a single risk category. Evidence about fasting in respiratory illness is limited; advice considers your medical history and the practical ability to maintain treatment. [1]

Arrange an asthma review or respiratory consultation if you are unsure. Breathing tests are selected when they will help answer a clinical question, rather than being required for every person who plans to fast.

If your breathing worsens during the day

• Follow your personalised action plan and take the prescribed reliever promptly.
• Stop fasting if illness requires urgent treatment or fluids; discuss the religious arrangements afterwards.
• Seek urgent clinical advice for increasing wheeze, breathlessness, repeated reliever use or a worsening COPD symptom pattern.

Do not start antibiotics or steroid tablets unless a clinician or your agreed written action plan directs you to do so. [1][2]

Practical steps for a safer routine

• Keep your action plan and reliever with you.
• Avoid smoking, vaping, incense and other known airway triggers.
• Drink adequate fluids between iftar and suhoor, unless your doctor has given a fluid restriction.
• Protect your sleep and avoid pushing through activity that causes significant symptoms.
• Check inhaler technique and remaining doses before Ramadan begins.

Device technique matters. Read our inhaler and spacer guide, and bring your own device for a demonstration. For background, see our asthma patient guide. [5]

Inhalers during Ramadan FAQs

Related care and patient guides

Meet Dr G Sarwar Chaudhry, MBBS, FRACP (Australia), FCCP (USA), Consultant Pulmonologist and Sleep Physician.