Short answer
Yes. Swallowing a tablet, capsule or syrup breaks the fast in all four schools, even without water. If you are ill and need the medicine during the day, you are excused: take it and make up the day later. Many daily medicines can be moved to suhoor and iftar with your doctor's advice.
Swallowing medicine breaks the fast. A sick person who needs it takes it and makes up the day, with no kaffarah. Someone with no excuse who deliberately swallows medicine during a Ramadan fast owes qada and kaffarah, since medicine counts with food and drink in the Hanafi school. Injections, creams, patches and eye drops do not break the fast.
Other madhhabs
- Shafi'i, Hanbali
- Swallowing medicine breaks the fast, but only a make-up day is due, never kaffarah, which is only for intercourse.
- Maliki
- As in the Hanafi school, kaffarah can be due if it was swallowed deliberately without an excuse in Ramadan.
Explanation
Anything that goes through the mouth down to the stomach breaks the fast, whether it is food, drink or medicine, and a pill swallowed dry is no different. This includes painkillers such as ibuprofen or paracetamol, vitamins, ADHD medication, antidepressants, antacids and supplements.
If you are ill, you are excused. Allah says that whoever among you is ill or on a journey makes up the days later. If your condition means you need a dose during the day, take it and make up that day after Ramadan. The Prophet ﷺ told people to seek treatment, because Allah has not sent down a disease without sending a cure. See skipping the fast when ill.
Ask your doctor about timing. Many medicines taken once or twice a day can be moved to suhoor and iftar, and some come in long-acting forms. Never change a dose or timing on your own, especially for epilepsy, diabetes, heart conditions or mental health medication.
What does not break the fast:
- Injections and vaccines. See injections.
- Creams, ointments and skin patches.
- Eye drops. See eye drops and nasal sprays.
If your illness is lifelong and you will never be able to fast, you pay fidya instead: see what is fidya. Because each case is different, ask a mufti about your own medication.
Ask a mufti about your own case. This answer explains the general ruling. When the details of your situation matter, as they do here, ask a qualified mufti and give them the full facts. Where to ask a scholar.
The evidence
Quran, Surah Al-Baqara 2:184
أَيَّامًۭا مَّعْدُودَٰتٍۢ ۚ فَمَن كَانَ مِنكُم مَّرِيضًا أَوْ عَلَىٰ سَفَرٍۢ فَعِدَّةٌۭ مِّنْ أَيَّامٍ أُخَرَ ۚ وَعَلَى ٱلَّذِينَ يُطِيقُونَهُۥ فِدْيَةٌۭ طَعَامُ مِسْكِينٍۢ ۖ فَمَن تَطَوَّعَ خَيْرًۭا فَهُوَ خَيْرٌۭ لَّهُۥ ۚ وَأَن تَصُومُوا۟ خَيْرٌۭ لَّكُمْ ۖ إِن كُنتُمْ تَعْلَمُونَ ﴿١٨٤﴾
[Fasting for] a limited number of days. So whoever among you is ill or on a journey [during them] - then an equal number of days [are to be made up]. And upon those who are able [to fast, but with hardship] - a ransom [as substitute] of feeding a poor person [each day]. And whoever volunteers excess - it is better for him. But to fast is best for you, if you only knew.
A sick person may leave the fast and make up the days later.
Sunan Abi Dawud 3855
Graded sahih... تداووا فإن الله عز وجل لم يضع داء إلا وضع له دواء ...
"Seek treatment, for Allah has not placed a disease without placing a cure for it."
Taking needed medicine is encouraged, and illness is an excuse from fasting.
Where the ruling is recorded
- al-Hidaya, Kitab al-Sawm, chapter on what requires qada and kaffarah. Whoever deliberately eats or drinks something taken as food or as medicine owes qada and kaffarah.
- Radd al-Muhtar (Ibn Abidin), Kitab al-Sawm, chapter on excuses that allow breaking the fast. A sick person who fears harm may break the fast and makes up the days.
- al-Majmu' (Nawawi), Kitab al-Siyam. The Shafi'i view that kaffarah is only for intercourse.
Checked by our team. For a more accurate answer to your own situation, consult a scholar. Quran translation by Sahih International. Hadith Arabic from the standard editions of the six books and the Muwatta, with gradings as recorded there; the English is our own rendering. Spotted a mistake? Tell us.