• Medicines advice for patients observing a halal diet

    The UK prides itself on its rich and diverse population, within which many religious and personal beliefs are observed. Many of these beliefs may be associated with dietary restrictions, so it is important to consider religious or personal beliefs when prescribing and dispensing medicines for patients.

    Islam: eating and drinking
    Islam is the second most-practised religion in the UK, and makes up 4.4% of the total population1. In Islam, prohibitions are specified either by a verse of the Qur’an (holy scriptures) or authentic and explicit Sunnah (teachings) of the last Prophet Muhammad (peace be upon him), which form the Islamic Law (Shariah).

    “Therefore eat of that on which Allah’s name has been mentioned if you are believers in His verses.” (Qur’an 6:118).

    These laws give Muslims the freedom to eat and drink all food and drinks that are not prohibited (haram)2; however, it should never be assumed that every individual is compliant with all the practices within Islam, so healthcare professionals are advised to consult with each patient as an individual and ascertain their views and beliefs before a treatment plan is put in place.

    The meaning of halal, haram, mushbooh and tayyib
    Halal means lawful or legal. Halal ingredients are vegetables, plants, fish, meat, fat or gelatin from a halal animal (which was slaughtered according to Shariah rules).

    Haram is the opposite of halal. Examples include foods, constituents and pharmaceuticals that contain pork, alcohol, and animals not slaughtered in the Shariah way3.

    In Arabic, mushbooh means ‘doubtful things’. Constituents, food and pharmaceuticals that are mushbooh have been classed as neither halal nor haram, but Muslims are advised to stay away from them. Individuals should seek advice from their religious scholars if there no other options are available; personal situations and circumstances may vary.

    Tayyib refers to a particular good or product that is clean, pure and produced using standard processes and procedures. A pharmaceutical product should not only be Halal, but also deemed clean and quality assured according to Shariah law. This is also expected for pharmaceuticals under the UK licensing law.

    Pharmaceutical constituents that are halal or haram
    Pharmaceutical products that contain ingredients permitted under the Shariah law, and fulfil the following conditions, are considered halal (permissible)4,5:

    The product does not contain any parts or products of animals that are non-halal, or any parts or products of animals that are not slaughtered according to Shariah law;
    The product is safe for consumption, non-poisonous, non-intoxicating and non-hazardous to health according to prescribed dosage.
    Emergency situations
    It is important to note that in life-threatening situations, haram products can become halal. The Shariah is very flexible, and non-halal medication can be given if there is no viable alternative and if the patient’s life depends on it, or if the patient would suffer significant morbidity by not taking the medication.

    Table: Examples of searches within SPCs to identify constituents of UK-licensed medications that may be considered haram by Muslims6
    Advanced search term Product listed eMedicines Compendium section Relevant information
    Porcine Creon 40,000 capsules 5.1 Pharmacodynamic properties Contains porcine pancreatin formulated as enteric-coated (acid-resistant) mini-microspheres within gelatin capsules
    Curosurf 2. Qualitative and quantitative composition One 1.5 ml vial contains 120mg of phospholipid fraction from porcine lung (poractant alfa)
    Defitelio 80mg/ml solution for infusion 2. Qualitative and quantitative composition Produced from porcine intestinal mucosa
    Fluenz Tetra nasal spray 6. List of excipients Gelatin (porcine, type A)
    Fragmin 5,000 IU 5.1 Pharmacodynamic properties Produced from porcine-derived heparin sodium
    Hypurin porcine Active ingredients Insulin, porcine insulin, pork insulin
    Pancrease HL 5.1 Pharmacodynamic properties Porcine-derived pancreatic enzymes (lipases, proteases, and amylases)
    Pancrex 5.1 Pharmacodynamic properties Porcine-derived pancreatic enzymes (lipases, proteases, and amylases
    Pork Hypurin Porcine 30/70 mix cartridges Active ingredients Insulin, porcine insulin, pork insulin
    Bovine Hypurin bovine isophane cartridges Active ingredients Beef insulin, bovine insulin, insulin.
    InductOs (dibotermin alfa) 6.1 List of excipients Bovine type I collagen
    NovoSeven 4.4 Special warnings and precautions for use May contain trace amounts of mouse IgG, bovine IgG and other residual culture proteins (hamster and bovine serum proteins)
    Alcohol Codeine phosphate syrup 2. Qualitative and quantitative composition Each 5ml of syrup contains 2.1 vol% of ethanol (alcohol)
    Daktarin oral gel 4.4 Special warnings and precautions for use This medicinal product contains small amounts of ethanol (alcohol), less than 100mg per dose
    Ethanol Diazepam 5mg/ml solution for injection 2. Qualitative and quantitative composition Ethanol 96% 100mg/ml
    Amitriptyline hydrochloride 25mg/5ml and 50mg/5ml oral solution 2. Qualitative and quantitative composition Approximately 10.5mg ethanol in 5mL of solution
    Co-trimoxazole for infusion 16 mg/80mg per ml 2. Qualitative and quantitative composition 13.2 vol% ethanol (alcohol) per 5 ml
    Priadel liquid 2. Qualitative and quantitative composition 211mg of ethanol 96% per 5ml solution
    Further information
    Patients who are unsure whether a particular medicinal product is halal or haram should seek advice from their local imam. Local imams can also offer advice to healthcare professionals.

    Medicines information services can be useful when investigating whether products available in the UK are suitable for Muslim patients, and the services can also suggest alternative options.

    The Muslim Council of Britain can also answer specific enquiries or concerns from patients or healthcare professionals. Find out more at:

    Office for National Statistics. 2011 Census. Available at: (accessed April 2018)
    Sarriff A & Abdul-Razzaq HA. Exploring the halal status of cardiovascular, endocrine, and respiratory group of medications. Malays J Med Sci 2013;20(1):69–75. PMID: 23785257
    Selamat Datang Ke Portal Rasmi MyHEALTH, Kementerian Kesihatan Malaysia. Halal and haram medicines (Islamic perspective). Available at: (accessed April 2018)
    National Pharmaceutical Control Bureau. Ministry of Health, Malaysia. Halal pharmaceuticals: a regulator’s perspective. Available at: (accessed April 2018)
    Halim MAA, Salleh MMM, Kashim MIAM et al. Halal pharmaceuticals: legal, Shari’ah issues and fatwa of drug, gelatine and alcohol. Int J Asian Soc Sci 2014;4(12):1176–1190
    Specialist Pharmacy Service. What factors to consider when advising on medicines suitable for a Halal diet? Available at: (accessed April 2018)
    Nadia Bukhari is senior teaching fellow in pharmacy practice, UCL School of Pharmacy.

  • The Facts on Cannabis Oil to treat Cancer

    The hype: Cannabis oil is often heralded as a treatment to destroy or shrink cancerous tumors, as well as a cure for diabetes, ulcers, arthritis, migraines, insomnia, infections, and many other diseases. Also called marijuana oil or hemp oil, it’s extracted from marijuana plants, often with higher proportion of a compound known as CBD (cannabidiol), which has less of a psychoactive effect than the more-famous THC (tetrahydrocannabinol) compound that gets marijuana users high.

    Cannabis oil is available in several forms with different potencies. It can be infused into cooking oil that users squirt under the tongue or mix into food. Its vapors can also be inhaled. By federal law, cannabis products are illegal, though several states have enacted laws to legalize their medical use.

    The evidence: While commercially available cannabis compounds are FDA-approved to reduce cancer treatment–related side effects such as nausea and vomiting and to improve appetite, no clinical trials have shown that cannabis products can treat cancer.

    Claims that cannabis oil cures cancer are anecdotal and largely unsupportable, based on scant research done in mice and in labs. Side effects can include memory and attention loss. Perhaps most important, there is evidence that cannabis compounds may inhibit enzymes that patients need to metabolize other anticancer drugs, thereby increasing their toxicity or reducing their effectiveness.

    The verdict: “So far, there are no human studies that show cannabis oil can be used as cancer treatment,” Dr. Yeung says. “Patients who are using it — or any form of marijuana — should let their doctors know so they can advise you properly.”

  • I am asked about how can something be allowed in Islam where the natural way someone looks is being altered, ie altering Allah’s given features.

    I’d like to state at the outset, the sources of the opinion below are listed at the end.
    It is often said that an act is not permitted in Islam because it changes the natural features that Allah gave you or that you were born with etc.  This is not necessarily the basis given in the framework of the Quran and sunnah for forbidding an act, or I should say, we need to understand what is meant in Shariah by this.
    On this point tattoos are quoted by people that: tattoos are forbidden because they change your natural appearance, interfere or tarnish the features Allah created etc.
    The Hadith often quoted in this respect is the narration of sayyedena ibn Masud who said May Allah’s curse be upon the one who has tattoos, removes facial hair, or files her teeth (a practice at that time).
    So a person with no knowledge will take this Hadith at face value. However we now must consider an apparently conflicting Hadith where a lady came to the mother of the Ummah Sayyeda Ayesha Radiallahu anh, asking about removing facial hair for her husband.  Ummul mu’mineen replied: remove the unsightly hair and leave the rest in seeking to adorn yourself for the pleasure of your husband.
    What do we do now when we have apparently contradicting ahadith? The scholars reconcile them. So in this situation the hanafi akaabireen, when extracting law have used the jawaz for permissibility in the second narration to define the prohibition in the first.
    So now they, through their knowledge and expertise, rule that the removal of facial hair or other acts in the first Hadith are prohibited if they ‘change Allah’s creation’ and to change Allah’s creation means if a woman changes her features through hair removal or cosmetic procedures to the point where she:
    1) mutilates and disrespects her body,
    2) changes the way she looks so she no longer looks like a human and
    3) changes the way she looks so that she resembles men/looks masculine.
    Then in these situations she has in fact ‘changed Allah’s creation’ and this is prohibited.
    If a woman on the other hand changes her looks to enhance her beauty where her femininity is further evoked for her husband, that does not class as ‘changing Allah’s creation’.
    Likewise if she has any cosmetic procedure done, the same rule will apply. So Botox, dermal fillers, teeth whitening, make up, contouring etc!
    One proviso here in modern times would also be that you are not totally misleading your husband in the way you look!
    Therefore having cosmetic procedures done is permissible within the framework of Islamic law. The classical scholars have used the second Hadith to define the first and reconcile them.
    The question simply remains how you will define ‘changing Allah’s creation’ and who’s definition you will follow.
    On this note, piercing of nose and ears and wearing nose studs/rings and ear rings falls in the same category. This is actually physically changing a feature Allah has given you by making a hole in it and then using that hole to adorn yourself with jewellery. This was began by  Sayyeda Sara, the wife of Prophet Sayyedena Ibrahim Alayhisalaam. It has been done for thousands of years by Muslim women without concern and was continued through the time of the sihaba, tabi’een and taba tabi’een up until now, and is still considered as permissible within shariah. Surely if we apply the argument of ‘changing Allah’s creation’ then this act must be prohibited?
    Then why is it not? Why is it permissible in Islam to pierce ears and nose for women? Because this change in yourself causes you to facilitate enhancing your beauty as a woman and adorning yourself for your husband. This therefore does not fall in the three categories of actual change stated above, ie piercing does not make you look masculine, does not make you look ‘inhuman’ and is not classed as disrespect or multilation of the body. For this reason it is permitted.
    There are many other acts which fall in this category.
    Now modern procedures were not present hundreds of years ago and in the future there will be procedures that are not around today. You have to apply the rationale and understanding of the examples of the past on to the situations of the present and future. This is the job of the fuqaha, not your next door neighbour, your doctor or your school teacher.
    If such adornment, removal of facial hair, dying, etc do not cause ‘change in Allah’s creation’ and are therefore permissible, then apply this ruling to Botox, dermal fillers, teeth whitening, laser hair removal, laser dermal treatments and even make up which was not around at the time of the Prophet ﷺ. (And any other procuedure).
    Remember the rule of Islam is anything is permissible unless proven otherwise. Evidence is required to make something haram, not to consider it halal!
    Therefore Changing your natural features to beautify yourself for your husband is not haram. This does not fall under the actual definition of ‘changing Allah’s creation’. This is key.
    Undergoing cosmetic procedures is permitted on three conditions.
    Firstly, that there are no adverse consequences of the action which would affect health long term.
    Second, that the change does not make you look masculine, does not mutilate or disrespect your body and does not take you away from looking human.
    Third, that it is done to beautify and adorn, to enhance beauty not to tarnish oneself, for your husband.
    Rasoolallah ﷺ forbid the cutting of hair for women. The reason for forbidding hair cut for women was to ensure they don’t look like men, ie get their hair cuts so short as to resemble men (which we see today). If a woman has her hair cut and it does not interfere with her femininity but in fact enhances it and enhances her beauty, then that is perfectly permissible. The reason for this prohibition is clear and the rule is when the reason is not found, the prohibition or order does not apply. Women can have their hair styled and cut as long as it does not make them look masculine, and in fact enhances their femininity.
    The prohibition on plucking or shaping of eye brows, again this is not permissible if it makes a woman look masculine but if it enhances her beauty and femininity for her husband, then there is nothing forbidding this act which is permissible. It is not classed as ‘changing Allah’s creation’ (as above).

    The great authority in the Hanafi School Imam Ibn Abideen (Alayhi rahma) states concerning the prohibition of plucking facial hair, “It is possible that the prohibition mentioned [in the hadith] is when it is done for the sake of beautifying herself for strangers; otherwise, if she has facial hair which causes her husband to dislike her appearance, then the prohibition of removing such hair seems far-fetched. This is because [self-] beautification for women is recommended in order to look good [for the husband], unless the hadith is interpreted to mean when it is done without a need, since there is harm in ‘plucking’ hair…

    It is related in Al-Tatarkhaniyya from Al-Mudmarat that there is no objection in removing hairs from the eyebrows and face provided it does not cause one to resemble an effeminate (mukhannas). (Radd al-Muhtar ala ‘l-Durr al-Mukhtar 5:239)

    Extrapolating this ruling to Botox, face lifts, dermal fillers etc, there is nothing which forbids these being disallowed in Islam except unfortunate cultural misconceptions and where people have been going ‘direct’ to Hadith to understand without any knowledge of how to understand the meaning.
     A woman should beautify herself for her husband. This is actually an Islamic concept much to people’s surprise!
    It was a concept promoted by the beloved mothers of the Ummah, the wives of Rasoolallah ﷺ  and by the prophet ﷺ himself.
    There may be instances where men do not feel that piercings and the wearing of ear rings or nose studs/rings is enhancing beauty and in such cases women should refrain from doing these things since their husbands dislike it.
    Henna was advocated by the prophet ﷺ for women since it enhances the beauty of a woman. We could argue this changes the way you look. You might respond, it’s temporary? Then so is make up and many cosmetic procedures. Again if a man dislikes this, his wife should refrain! It is however in actual fact sunnah (henna that is!).
    The same principle applies to make-up. It’s shocking to actually see how much make up and contouring (so I’m educated!!) can change the appearance of someone totally. Are these things haram? Is wearing make up haram? The answer is no.
    As long as the intention is to beautify yourself for your husband, these acts are permissible.
    Whether something is permanent or temporary is not the measure of whether the act is permissible. Whether temporary or permanent, enhancing your beauty as a woman, for your husband through the use of external substances, chemicals, procedures etc is permissible as long as the substance itself is halal and as long as the three conditions above are met.
    The trouble we have is that there can be allergic reactions to many of the substances and chemicals. A woman may even react to make up. In fact this can apply to anything, you can have an allergic reaction to body spray or even washing up powder. Does this now mean these things are forbidden?
    No… What it means is that these procedures should be done professionally and responsibly where the relevant testing and safety procedures and precautions have been followed. If an unfortunate reaction occurs after that then you have followed due process and are not liable in Islamic law. This can happen anytime to anyone.
    Giving my personal example, I’ve always eaten kiwi fruit, one day I ate and my oesophagus and trachea constricted and I stopped breathing.. It was a long few minutes and I sincerely thought my time was up… Alhamdulillah after taking some antihistamines the matter resolved itself. Does this mean it’s haram for the Ummah to eat kiwi fruit now?!
    Of course not, what it means is that I need to be careful as an individual and if this is the reaction I have then Islam forbids me as an individual to eat it.
    If a procedure or substance has proven risks, side effects then it’s important for you to consult the appropriate professionals and healthcare personnel to ascertain the medical risks and if it is documented by a professional that a procedure or substance is harmful and should not be used by anyone then using that procedure or substance would be haram.
    Now some people say that cosmetic procedures are only permissible to cover defects or if you have had an unfortunate accident etc or for medical reasons. But the same argument could apply there, that well Allah willed it that way, why are you interfering?
    We can apply the argument to people who are naturally obese.. Why go I a diet and exercise program? Your interfering with your natural features. We must therefore conclude that ‘changing Allah’s creation’ does not mean improving and beautifying yourself for your husband and self esteem.
    To beautify yourself for your husband and pleasing him for the sake of Allah ﷻ & His Rasool ﷺ is in itself rewarding in the domain of the Almighty.
    To conduct cosmetic procedures to beautify yourself as a woman or to enhance your beauty for the pleasure of your husband is perfectly acceptable in Islam.
    The conditions are three fold :
    1) No proven medical issues
    2) Does not make you look masculine/nonhuman
    3) Done for your husband’s sake.
    Hadith literature is littered with ahadith promoting the adorning and beautifying of women for their husbands. Likewise there are ahadith cursing certain cosmetic procedures at the time. How do we reconcile these apparent contradictions? In the way the ulema have done for centuries, as discussed above.
    Remember this is a reliable opinion in the hanafi madhab, shafi, Maliki and hanbali (I can speak with certainty only for the ahnaaf) but followers if the other Madhabs should seek clarification from their scholars and fuqaha.  This opinion is endorsed by the  modern fuqaha of the Hanafi school such as Allama Mufti Azam Rafiq Al Hasni.
    For the record, if a procedure requires operating the the permissibility would depend on the particular process involved and medical implications. This discussion has assumed non operative procedures.
    There are of course other opinions and remember whichever opinion you follow, you will be rightly guided انشآء الله تعالى as long as your niyya is sincere and the opinion is evidence based, and of those qualified to give opinion.
    These days everyone has an opinion. There is a distinct difference between the opinion of a lay person and one who has spent his/her entire life studying a subject.
    IMPORTANT: please take care that this beautification is for husbands only and not for non mahram men. Attracting the attention of non-mahram men is tabarruj and is haram. 
    Allah ﷻ & His Rasool ﷺ know best.
    By Shaykh Abu Yusha Yasin
    Sahih Bukhari: fath Al Bari (ibn Hajar Asqalani), Ummda tul Qari
    Sahih Muslim: Al minhaj sharh sahih Muslim
    Sunan Abu Dawood
    Al Musanaf Abdal Razzaq
    Durr al Mukhtar
    Hashiyat at Tahtawi ala Durr Al mukhtar. 
    Radd al Muhtar (ibn Abideen)
    Mufti Rafiq Al Hasni.
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