Medications: Difference between revisions

# A beracha is not recited on food which is eaten to heal if one does not have enjoyment from the food. However, if one does have enjoyment from the food, a beracha rishona and achrona (see below) is recited.<ref>Mesechtas Berochos 38a, Tosfas Mesechtas Berochos 36a “k’von,” Meiri Mesechtas Berochos 35b, Tur 204, Shulchan Aruch 204:8, Shulchan Aruch Harav 204:14, Chesed L’alafim 204-205:5, Igros Moshe O.C. 1:82. </ref> Even if one does not want the good tasting food and is only eating it because he is ill, since he has enjoyment from it a beracha is recited.<ref>Mishnah Berurah 43. </ref> Examples of medicines which require a beracha due to their pleasant taste are herbal teas and cough drops.<ref>V’sein Beracha page 200. Refer to Ateres Shlomo 8:page 110. This is the opinion and custom of Harav Pinchus Bodner Shlita (Personal telephone conversation with Harav Bodner Shlita). </ref>

# One who is forced to eat or drink something does not recite a beracha even if it tastes pleasant since he was forced to do so.<ref>Shulchan Aruch ibid, Kaf Ha’chaim 49, see Magen Avraham 20 Taz 12, Aruch Ha’shulchan 19. Refer to Mishnah Berurah 204:44 who maintains if one is forced to eat bread and he is satisfied he should bentch since it is d’oraisa. </ref>

# Some poskim are of the opinion that one does not recite a beracha on a pleasant tasting medicine unless one ate a kezayis or drank a reviis of it. The reason for this is that just as one who tastes food does not recite a beracha unless a kezayis or reviis is consumed; the same applies for medications, since one does not have intent for eating.<ref>Refer to Shevet Ha’kehusi 3:84:3. </ref> Nonetheless, the poskim do not make this comparison and therefore, a beracha on pleasant tasting medicine would be required regardless of the amount being consumed since one's intent is to swallow the medicine as opposed to the "tasting" case where one does not intend to have enjoyment.<ref>Refer to Mikroei Kodesh Pesach 2:page 144, Halacha U’refuah page 278, Pischei Halacha (Berochos page 66:footnote 38), Chazzon Ovadia Berochos page 159:footnote 6.  </ref>

# The Rama<ref>204:11. Refer to Aruch Ha’shulchan 22. </ref> says any food which a healthy person does not eat requires a shehakol if taken as medication, regardless of the food's real beracha.<ref>Aruch Ha’shulchan 22. Refer to Mishnah Berurah 54. The Shar Ha’tzyion 45 says this applies to medicine which was made from the five grains as well. Refer to Halacha U’refuah 3:page 284. </ref> Others say one should recite the appropriate beracha.<ref>Magen Avraham 24, Mishnah Berurah 55, Igros Moshe O.C. 1:82. </ref> The Mishnah Berurah<ref>212:4-5. </ref> maintains that one should avoid this situation when possible.<ref>Some say one should eat the other food before the medicine and then consume the medicine (Halacha U’refuah 3:page 284). </ref>

# One who recited a shehakol on a medication would be required to recite a beracha achrona if the proper shiur was consumed.<ref>Halacha U’refuah page 278. </ref>

# For years people have been erroneously consuming Listerine Pocketpaks® without a hechsher, but obviously this product needs a hechsher,<ref>See www.koltorah.org quoting the opinion of Rabbi Chaim Jachter Shlita. </ref> especially since it is digested in the stomach.<ref>Opinion of Harav Yisroel Belsky as expressed in OU document I-98:page 2. </ref> Recently, this product became available with a hechsher. The question arises if this product requires a beracha prior to placing it in one's mouth. Many people do not recite a beracha. However, even though this product melts in the mouth, it is swallowed and therefore, according to some poskim a beracha of shehakol should be recited before placing it in the mouth.<ref>Harav Yisroel Belsky Shlita, opinion of Harav Forscheimer Shlita (personal telephone conversation), and Harav Doniel Neustadt Shlita.    </ref> Others maintain that a beracha does not need to be recited.<ref>Opinion of Harav Pinchus Bodner Shlita, Harav Ephraim Greenblatt Shlita (Personal telephone conversations). Harav Forst Shlita says if one is taking it for flavor then a beracha is recited, but if it is for fresh breath but not for the flavor in the mouth then no beracha is recited. The opinions of Rabbi Wikler Shlita, Harav Felder Shlita, Harav Fuerst Shlita (personal telephone conversations with the aforementioned rabbonim). This is the opinion of Harav Yisroel Reisman Shlita (as related by Rabbi Shimon Newmark). </ref>

# The company says that there is nothing unsafe with swallowing it since there is no alcohol in the product.<ref>Based on a conversation with Lisa at the Johnson and Johnson Company. </ref> If one uses a breath mist (with a hechsher) then one does not recite a beracha on it, instead one should make a shehakol on a different food.<ref>Harav Yisroel Belsky Shlita.</ref>

# If there is no flavor on the coating on a pill, no beracha is recited because there is no enjoyment from the pill. In addition, swallowing medication without chewing it first is not the normal manner of consumption and is not viewed halachically as eating. Furthermore, it is possible that these pills are not fit to be eaten<ref>Refer to Mesechtas Avodah Zarah 67-68, Mesechtas Pesachim 21b and 45b. In addition see Shulchan Aruch Y.D. 103, and Y.D. 155:3. </ref> and therefore do not require a beracha.<ref>Shulchan Aruch 202:2, see Chazzon Ovadia Berochos page 158, Piskei Teshuvos 204:18:footnote 70. </ref> Some say this even applies to a pill which has a sweet coating; since one swallows it no beracha is recited.<ref>Vezos Ha’beracha page 311, Piskei Teshuvos 204:18, see Nishmas Avraham 4:204:footnote 1. In regard to vitamins, refer to Pischei Halacha (Berochos) page 68:footnote 39 alef, Beracha Achrona (Boreh Nefoshos) page 201. Refer to Nishmas Avraham (English) pages 89-90 quoting the opinion of Harav Shlomo Zalman Aurbach zt”l that a beracha is required. See Ateres Shlomo 8:page 111. The same applies to vitamins (Yalkut Yosef 3:page 436). </ref>

# Some say if one is taking a pill in order for one to lose weight and by taking the pill it makes one feel full, then one should recite a beracha on the pill since it is instead of food. Nonetheless, the poskim suggest one makes a beracha on something else instead.<ref>Piskei Teshuvos 204:footnote 70. </ref>

# A chewable pill which has a pleasant taste requires a beracha according to those who recite a beracha on pleasant tasting medications.<ref>Piskei Teshuvos 204:18:footnote 74. </ref> One should recite a shehakol on a different food before consuming flavored Tums® that have a hechsher.<ref>Harav Yisroel Belsky Shlita. The Diamond – K hechsher on Tums may be relied upon (Harav Yisroel Belsky Shlita). One may not use Tums on Pesach if they are not certified for Pesach (Harav Yisroel Belsky Shlita). </ref>

==Intravenous==

# One who receives food in a liquid form through intravenous does not recite a beracha on the food.<ref>Tzitz Eliezer 13:35:3, Vezos Ha’beracha page 113 quoting the opinion of Harav Elyashiv Shlita.  </ref>

# Food that was in one's pocket while he was sleeping may be eaten.<ref>Salmas Chaim 2:7, Rivevos Ephraim 4:7, Shevet Ha’kehusi 2:242, see Yufei Leleiv Y.D. 3:116:6, Yabea Omer Y.D. 1:9:23.</ref> The same halacha goes for medicine that was in one's pocket.<ref>Tzitz Eliezer 17:35, Rivevos Ephraim 6:4, Shevet Ha’kehusi 2:245, Tosfas Orah page 421:3, see Nezer Ha’chaim page 217:165, Doleh U’mashka page 367.</ref>

# Since there is ruach ra'ah under a bed one should not store food under a bed.<ref>Shulchan Aruch Y.D. 116:5. </ref> However, one is allowed to store medicine under a bed and there is no concern of ruach ra'ah.<ref>Tzitz Eliezer 17:32. Some say if it is a medication which one recites a beracha on because of its pleasant taste then it should not be placed under a bed (Shevet Ha’kehusi 2:245, see 3:229:2). </ref>

# It is permitted for one to walk into the bathroom with a pill etc.<ref>Be’er Moshe 8:41. </ref> In addition it is permitted to keep medicines in a medicine cabinet that is in the bathroom,<ref>Rivevos Ephraim 1:8:2, 2:6, Teshuvos V’hanhugos 1:11, Be’er Moshe 8:41. </ref> but one should not take his medicine with water in a bathroom.

# Some have a custom before taking medication to recite a yehi ratzon that all should be well.<ref>Refer to Shulchan Aruch 230:4, Magen Avraham 6, Mishnah Berurah 6. Some say saying the yihiy ratzon exempts one from the beracha that one would recite on a sweet medication (Refer to Ateres Shlomo 8:page 111, Nishmas Avraham 204:page 91). </ref> This tefilla may be recited on Shabbos and is not a concern of asking for personal needs on Shabbos.<ref>Refer to Shar Ha’tzyion 230:8, Bakashas B’Shabbos page 27:footnote 15. See Betzel Hachuchma 5:41.</ref>

# One is permitted to drink water while taking a pill on Shabbos after candle lighting before kiddush.<ref>Refer to Minchas Yitzchok 8:18, Shevet Ha’kehusi 1:109, Nishmas Shabbos 2:9. </ref>

# One who needs to carry a pill on Shabbos in a place which does not have an eiruv should ask his Rav before doing so.<ref>Refer to Shemiras Shabbos K’hilchoso 40:7, Tzitz Eliezer 13:34. </ref>

# One is permitted to cut a tablet in half on Shabbos, and there is no concern of "mechatech" (cutting) on Shabbos.<ref>Shemiras Shabbos K’hilchoso 33:4, Shulchan Shlomo 314:13:3, Avnei Yushfei 4:58 quoting the opinion of Harav Elyashiv Shlita. Refer to ibid:footnote 30 for the reason. </ref>

==Taking Medicine on Shabbos <ref> The same halacha applies to the first day of Yom Tov (Refer to Magen Avraham 532:2, Chai Adom 23:1, Kitzur Shulchan Aruch 98:33, Mishnah Berurah 532:5, Yom Tov Shenei K’hilchoso 1:22, Nishmas Avraham 1:pages 275-276) and both days of Rosh Hashanah (Nishmas Avraham 1:600:1, see Shemiras Shabbos K’hilchoso 31:28, Yom Tov Shenei K’hilchoso 1:22:footnote 76, Shevet Ha’kehusi 1:156 ) </ref> ==

# There are different categories of people who may not feel well on Shabbos. We will only deal with the category of people who do not feel well on Shabbos, but are not in danger (sakana). One who may have a headache or a runny nose (slight discomfort) is not permitted to take medication.<ref>Shulchan Aruch O.C. 328:1, see Nishmas Avraham 1:328:page 163. </ref>

# Chazal made a gezeirah that one is not allowed to take medications on Shabbos because one may come to grind it which is forbidden because of tochain.<ref>Refer to Mesechtas Shabbos 52b, Tur O.C. 328, Shulchan Aruch 328:1. In regard to taking mouthwash on Shabbos see Be’er Moshe 1:page 78, Rivevos Ephraim 2:page 192:23, 3:536:6, 4:97:5, 6:195,  Nishmas Shabbos 5:318, Cheshev Ha’efod 2:59. Refer to Shevet Ha’kehusi 2:151 if one recited a beracha on medicine on Shabbos and then realized he is not allowed to take it. In regard to the idea that today may be different because we do not crush medicine in our homes but only in a pharmacy etc see Ketzos Ha’shulchan 134:badi 7:2, Tzitz Eliezer 8:15:15:1,4. </ref>

# Many times one is prescribed medication for more than a week's time for a slight ailment in which case he would have to take the medicine on Shabbos as well. The question is if one is permitted to take his medication even on Shabbos? The opinion of many poskim is that when one is prescribed medication for more than a week's time one is permitted to continue taking it on Shabbos as well, even if he would otherwise not be permitted to take medicine on Shabbos.<ref>Refer to Shemiras Shabbos K’hilchoso 34:footnote 76, chelek 3:34:footnote 76, Da’as Chazzon Ish 7:19, Dinim V’hanhugos Chazzon Ish 15:1, Shulchan Shlomo 328:59, Be’er Moshe 1:33:8, 4:31, Avnei Yushfei 1:90:3, Rivevos Ephraim 3:227, 4:97:54, 5:202, Oz Nedberu 1:31:5, 4:24, Tzitz Eliezer 8:15:15:17:pages 147-148. Refer to Rivevos Ephraim 1:222:10 in regard to taking a suppository on Shabbos. </ref>  Others are more lenient and permit one to take the medication on Shabbos even if he started taking the medication a day or two prior to Shabbos.<ref>Refer to Kovetz Teshuvos (Harav Elyashiv Shlita) 1:40:2, Chut Shuni 4:page 153. </ref> The opinion of Harav Moshe Feinstein zt"l<ref>Igros Moshe O.C. 3:53.  Refer to Da’as Torah 328:37 who is stringent. </ref> is to be stringent with this and he does not permit the taking of any medications in the aforementioned situation (unless one is in danger).

# The halacha is that a food which is not necessarily meant for refuah, but is taken by healthy people may be consumed on Shabbos by a person who has a slight ailment.<ref>Shulchan Aruch O.C. 328:37, Aruch Ha’shulchan 48. Refer to Mishnah Berurah 117-118. See Ketzos Ha’shulchan 134:16:pages 31-32 in depth on what constitutes a health persons food. </ref> Many poskim are of the opinion that Tylenol® and other aspirin should not be taken even though healthy people may take them as well.<ref>Minchas Yitzchok 3:35:2, Be’er Moshe 1:33:5, 2:32, 6:39, Shraga Hameir 2:40, Refuas Yisroel page 16:footnote 42. Refer to Divrei Chachumim pages 137-138:389 who quotes a lenient opinion. </ref> However, if one is in great pain then taking them is permitted.<ref>Minchas Yitzchok ibid, Be’er Moshe ibid, Refuas Yisroel page 16:footnote 42. </ref>

# Some say that a multi-vitamin that one takes everyday is permitted since it is a food and not a refuah.<ref>Opinion of Harav Yaakov Kamenetsky zt”l quoted in Divrei Chachumim page 137:footnote 389, Shemiras Shabbos K’hilchoso 34:footnote 85. In regard to regular vitamins see Divrei Chachumim pages 137-138, Igros Moshe O.C. 3:54, Nishmas Avraham 1:328:pages 212-213, Shulchan Shlomo 328:58, Tzitz Eliezer 14:50, Oz Nedberu 6:72, Be’er Moshe 1:33, Shalmei Yehuda 10:footnote 51. In regard to the muktzah status of pills and other medications see Minchas Shabbos 88:footnote 77, Har Tzvi tal harim tochain 2, Shalmei Yehuda 10:15:footnote 46, Zera Yaakov 13:page 153, Nachlas Yisroel pages 633-650 in depth, Shulchan Shlomo 318:7:2:page 298, Ohr Yisroel 6:pages 17-20, Aruch Ha’shulchan 308:59, Bais Avi 3:52, Avnei Yushfei 5:62. </ref>

# According to the opinion of some poskim, on Shabbos one should rip the wrapping around a medication by destroying it and making it useless.<ref>Nishmas Avraham 1:340:5:page 245. </ref>

# On a fast day one that is not feeling well and wants to take a pill is permitted to do so. Some say one should wrap the pill in a tissue before swallowing it.<ref>Halichos Shlomo Moadim 2:13:footnote 8. </ref> Some poskim say that one may not use water to swallow a pill.<ref>Nishmas Avraham 550:4.</ref> (However, if one's doctor instructs him to take a pill on a fast day then even according to this opinion using a little water is permitted).<ref> Harav Yisroel Belsky Shlita, Halichos Shlomo Moadim (Pesach etc) 16:3, Nishmas Avraham 5:page 46. </ref> Others say if one cannot take a pill without water then one may use a little water.<ref>Harav Yisroel Belsky Shlita, see Teshuvos V’hanhugos 3:156. </ref> One should avoid this if possible on Tisha B'av, and on Yom Kippur since using water in order to swallow a pill is forbidden.<ref>Harav Yisroel Belsky Shlita, see Teshuvos V’hanhugos 3:156.</ref> One is permitted to take a medication before a fast if it will enable him to have an easier fast.<ref>Nechamas Yisroel 27:22. </ref>

# There is a discussion in the poskim if one is allowed to use mouthwash on the morning of a fast day. Some poskim are stringent,<ref>Harav Yisroel Belsky Shlita, see Kinyan Torah 2:49:2, Modanei Yeshurin page 108, Chai Ha’Levi 5:48, Divrei Chachumim page 166:471 quoting the opinion of Harav Sheinberg Shlita. Some say if there is a need, brushing ones teeth is permitted (Divrei Chachumim Ibid). </ref> while others say if one will have bad breath then it is permitted.<ref>Be’er Moshe 8:94. Refer to Minchas Yitzchok 4:109. </ref>

# Taking Listerine Pocketpaks® (that have a hechsher) is not permitted on a fast day since one swallows the liquid which melts in the mouth.

# When one walks down the aisles in a pharmacy he may see many pills which contain a gelatin coating. This issue involves the discussion of gelatin. Below we will discuss what gelatin is and what its kosher status is, and how it applies to ingesting gel-caps.

#Gelatin is a protein which is derived from a naturally occurring protein known as collagen. Collagen is the component of animal connective tissue, bones, sinews and skin. Gelatin does not have any taste to it. Gelatin is widely used in the pharmaceutical industry to coat capsules as well as hold tablets together. In addition, gelatin is used in marshmallows, yogurt, ice cream, jello,<ref>Refer to Gelatin in Jewish Law pages 10-14. </ref> to remove cloudiness or haze in apple juice,<ref>www.oukosher.org. </ref> in gummy bears, throat lozenges, frostings, protein supplements, and sugar glazes.<ref>Star-K in Kashrus Kurrents in an article by Rabbi Mushell. This article can be seen at http://www.star-k.org/kashrus/kk-palate-gelatin.htm.</ref>

# The source of gelatin is almost always the bones or hides of non-kosher animals. To improve the quality of the process, the raw material is pretreated by soaking the hard bones in a mixture of lime and water between 70-120 days.  Soft bone and hides are treated with a five percent concentration of mineral acids for ten to thirty hours. Gelatin is then extracted from the pretreated material in a process which is like cooking. The bones are warmed in a series of runs at increasing temperatures. Eventually gelatin liquor is formed, which is then filtered and evaporated to remove the water and concentrate the liquor. The liquor is then cooled to form a gel. The gel is dried and cut into desired shapes.<ref>Refer to Medicines and Kashrus page 16, Gelatin in Jewish Law pages 15-22 in great depth, Yabea Omer Y.D. 8:11.  See Journal of Halacha and Contemporary Society 30:page 67:footnote 2 who maintains that most gelatin today is from pig skins. </ref>

# The poskim discuss many reasons why consuming gelatin may be permitted. Each one will be dealt with below.

# The Toras Kohanim<ref>Parshas Sheminei 2:4. </ref> says the posuk "from non-pure animals one should not eat their flesh"<ref>Vayikra 11:8. </ref> excludes bones, sinews, and hooves. There is a discussion if there is no issur at all, or if there is an issur d'rabanan to consume the above items. The Rambam<ref>Hilchos Machalas Asuros 4:18. Refer to Rashi Vayikra 11:8 “mivsaram.” See Kashrus pages 245-249.</ref> is of the opinion that "one who eats from a non-kosher animal, it's skin, bones, sinews, horns, hooves, or nails, even though they are forbidden, is excused from punishment." It seems from the opinion of the Rambam that bones are forbidden d'rabanan, while others maintain that he does not seem to imply even an issur d'rabanan.<ref>Refer to Igros Moshe Y.D. 2:27 (end) page 44 who says gelatin is a sofuk issur.  </ref> The opinion of Tosfas<ref>Mesechtas Avodah Zarah 69a “ha’hu.” Refer to Rosh Avodah Zarah 5:11. </ref> who talks about permitting bee legs implies that bones are indeed permitted.The opinion of some poskim is that the Rambam when implying that an issur d'rabbanan exists for bones was referring to soft bones which have some moisture to it, but hard and dry bones are permitted even according to the Rambam.<ref>Refer to Achiezer 3:33:5, Introduction of the Tzitz Eliezer volume 4 where he brings the opinion of Harav Yecheskel Abramsky zt”l. Some say there are no commercially made gelatin that come from hard bones today (Journal of Halacha and Contemporary Society 30:page 69). </ref>

The Mishnah Berurah<ref>O.C. 216:7, see Magen Avraham 3. See OU document P-86 who says that fermentations are not considered kitniyos sh’nishtana. </ref> and others<ref>Shiurei Knesses Hagedolah 216:7, Rosh (Teshuvos) klal 24:6, Buei Chai Y.D. 103. </ref> say regarding "musk," which is a byproduct of blood that is found in the neck of a deer, we can consider it "changed," since the blood is turned into a new entity. Many poskim follow this opinion.<ref>Refer to Rosh Mesechtas Berochos 6:38, Mishnah Berurah ibid. Refer to Magen Avraham O.C. 216:3, Taz 2. </ref> Using the same line of reasoning, some poskim permit the use of gelatin since it is totally changed from it original state.<ref>Refer to Yabea Omer Y.D. 8:11:15, Tzitz Eliezer’s opinion expressed in the introduction to volume 4, see Melamed L’hoyel 2:35. </ref> Others are not convinced that one can draw a parallel between musk and gelatin.<ref>Refer to Achi Ezer 3:33:5, Tzitz Eliezer ibid quoting the opinion of Harav Yecheskel Abramsky zt”l, opinion of Harav Elyashiv Shlita quoted in Yeishiv Moshe page 165. </ref>