Every Pesah some people get very sick because they do not take their medications due to a concern that they might contain hametz. However, according to the halacha, this practice is incorrect.
There are three different biblical prohibitions regarding hametz: we are not allowed to eat, to derive benefit from, or to own hametz over Passover. Even a small amount of hametz is prohibited. We must either get rid of hametz before Passover or sell it to a non-Jew.
But does this also apply to medications that may contain hametz?
Taking Medication for Acute or Chronic Conditions
Today’s column will focus on incapacitated people taking medicines for acute or chronic conditions. Generally speaking, halacha recognizes three categories of illness:
- A person who is so sick that his life may be in danger.
- A person whose illness does not endanger his life, but he is bedridden or incapacitated (for example, due to the flu, a migraine, or arthritis).
- A person experiencing some discomfort, but who can generally function normally (for example, one suffering from common colds, mild headaches, or heartburn).
A person who has a life-threatening illness and the only cure involves some violation of hametz, must avail himself of this option. Saving a life takes priority over the prohibition of hametz. A person with a serious, even if not immediately life-threatening, health condition – such as cardiac, lung, or kidney disease, diabetes, mental health illness, or any serious chronic condition must continue taking their medication as usual during Passover. They most certainly should not stop taking their meds and should not even substitute them for something else without explicit authorization from their doctor. Even if there is a non-hametz alternative but the doctor feels there is some risk involved in changing from the regular medication, the regular medicine should be taken. On the other hand, a person experiencing only some discomfort must find a non-hametz alternative.
Non-Life-Threatening Conditions
When it comes to non-life-threatening conditions, it becomes a bit more complicated.
The prohibition of eating hametz applies to foods, and hametz loses its technical status as food when it becomes so inedible that even a dog would not eat it. But even though one may own or derive benefit from such hametz, there is still a Rabbinic prohibition against eating it. This is because at some level, it is still considered to be food, considering we are talking about items that we are interested in consuming. This principle is known as “Achshevei,” which means that our interest in eating this item upgrades its status as food. However, Hacham Ovadia, zt”l, (Yehave Daat 2:60) explains that Achshevei does not apply to items consumed solely for medical reasons, even if there may be hametz ingredients mixed in, so long as the medication is swallowed and is tasteless. Under these circumstances, the item no longer qualifies as a food at all. Similarly, Hacham Ben Zion Abba Shaul (Ohr Lezion 3:8:2) maintains that since this is only Rabbinically prohibited, a bedridden person may ingest bitter-tasting medications that may contain hametz.
The problem arises with sweet-tasting medications, liquid medications, or vitamins, that may contain hametz (such as glucose or alcohol derived from a hametz source [even products that are described as gluten free may still be problematic]). For these, a non-hametz alternative should be found unless there is a life-threatening situation. Regarding children under bar/bat Mitzva, an authoritative rabbi should be consulted, as there are many factors to consider in each case.
All of this only applies to oral medications. Artificial nutrition or medications provided through an IV or PEG and are not ingested orally, are not considered food that is being eaten. Therefore, they pose no general kashrut concerns and no bracha is recited prior to using them. However, aside from eating, we may not benefit from or even own hametz even if it is not eaten. Therefore, these types of products should be sold to a non-Jew before Passover. If, however, no alternative can be found, and since the products are no longer owned by a Jew, they may still be used on Passover for medical reasons even if they might contain glucose or other hametz-derived products.
Topical medications such as creams, ointments, and lotions are usually inedible and may be applied on Passover. The same is true of injectable medications, inhalers, nasal sprays, eye drops, suppositories, and alcohol-based sanitizers, as they are all inedible and are never consumed orally.
Rabbi Yehuda Finchas is a worldwide expert, lecturer, and author on Medical Halacha. He heads the Torat Habayit Medical Halacha Institute. His latest book is “Brain Death in Halacha and the Tower of Babel Syndrome.” To contact Rabbi Finchas, email rabbi@torathabayit.com.