Guidance and instructions regarding the use of medication over Pesach, brought to you by the Federation Beis Din.

1. Which ingredients present in medication might be problematic?

The following ingredients can be present in solid or liquid preparations and may have the possibility of being chometz-derived: Wheat Starch, Ethanol, Glucose, Sorbitol, Xylitol, Maltitol, Maltodextrin.

Not all of these are definitely chometz; however, where present the source must be verified. Wheat starch was once quite widely used in tablets, but now it is very rarely used. Maize and potato starch are now much more common.

The other substances mentioned are mainly used in liquid preparations. Here again, these ingredients do not present an inherent problem, but their source must be researched and verified.

2. Medication comes in a variety of forms: tablets, capsules, soluble tablets, chewable tablets and liquids. CAN THE FORM AFFECT THE SUITABILITY FOR USE ON PESACH?
  • Most non-chewable tablets and capsules are permitted to be used.
  • Even in rare instances where the tablet is formulated using wheat starch, tablets are permitted for use if they contain inedible ingredients.
  • Some tablets are coated with ingredients of chometz origin. Examples are some brands of Ferrous Sulphate tablets which contain glucose in the coating; these must be avoided and put away with the chometz over Pesach.
  • Chewable tablets or liquid preparations such as syrups with a pleasant taste often contain ingredients which could be chometz. These ingredients are used as sweeteners. Such tablets are forbidden unless they have been listed as permitted.
  • Soluble tablets also contain ingredients which can be problematic.
  • Where liquid antibiotics are being supplied, the ones flavoured with sucrose (non-sugar free) are less likely to contain chometz than the sugar-free ones.

 

3. Under which circumstances can one be lenient for a choleh (sick patient)?

Obviously, in a case where not taking a particular medication could endanger life, then that drug would be permitted even if it contained chometz. In all such circumstances, one should initially try to find a suitable chometz-free alternative. Where there is a choice between solid dose products and soluble liquid or chewable preparations, one should try to use the solid dose tablets or capsules. Many medications do not contain chometz but instead kitniyos derivatives; these are permitted in any case where medication is required.

 

4. Can one be lenient for children under the age of Bar or Bas Mitzvah?

Liquid preparations are most often required for younger children who cannot swallow tablets; where a Pesach version of the medication is unavailable, administering necessary medications can present a significant obstacle. In some circumstances, Poskim allow the administration of chometz to a child under Bar/Bas Mitzvah who requires it even if the child is not seriously ill. It is worth discussing any personal circumstances with a Rov in advance of Pesach.

Usually, when administering chometz medication to a child, one should avoid doing so oneself. Instead, one should ask a non-Jew or at least a child under Bar/Bas Mitzvah to dispense the medication, or the child himself can take it. Where this is not possible, it may be administered by the parent.

As chometz must not be owned by a Jew on Pesach, all edible chometz medications should be sold. This includes medications such as antibiotics and paracetamol suspensions. In these cases, one should make an arrangement with the non-Jew who purchases the chometz that it can be used if needed. Many Rabbonim include this as a standard clause in their mechiras chometz.

 

5. There is no Kosher le’Pesach approved paracetamol for children on sale in the UK this year. What should we do if our child has a temperature?

In previous years, Rabbi Adler of Gateshead was able to approve the paracetamol suspension manufactured by Rosemont. This year, he has unfortunately been unable to confirm the source of some of the ingredients used. As such, there is no known Kosher LePesach paracetamol suspension available here in the UK.

The lines below are instructions for how to make use of medications which are not approved for Pesach:

  1. Since one may not own Chometz on Pesach,  non approved medications should be sold and locked away with the Chometz
  2. When selling the Chometz, Rabbonim stipulate with the non-Jew that in cases of need we may administer Chometz medications. On this basis if a child under Bar/Bas Mitzva needs medication it may be given to them when necessary. If possible a non-Jew or child should administer the medication
  3. The medicines remain out of Jewish possession throughout and should be returned each time to the sold cupboard
  4. Wash up any utensils used away from Pesach food

Note: If you are concerned that your child may need a Chometz medication, ensure to have sufficient supply in the house before Pesach and stored the medicines in a place which is easily accessible.

 

6. my 14 year old daughter can not swallow pills. we normally use a soluble paracetamol for her, what are the options over pesach?

As your child is over Bas Mitzva, she is not allowed to take chometz medications unless the situation is one of pikuach nefesh. Where medically appropriate (please check with your doctor or pharmacist), one would be advised to grind up the correct dosage of the pills and disperse them in apple sauce or some other food.

Note: pills may be ground up on Shabbos and Yom Tov and are not subject to the prohibitions of grinding as they are compressed powder and not a naturally whole item. They should not be ground with a dedicated tool such as a pestle and mortar but with a knife or using another unusual method.

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