Ethanol in medicine
This information resource can help you understand how ethanol (also known as ethyl alcohol) is used in medicines, the concerns around its use in medicines for the Muslim community, and whether its use in medicines is halāl (permissible) or harām (prohibited) in Islam. It can be used to support person-centred and informed decision-making around taking medicines that align with an individual’s Islamic values and beliefs.
This resource is for the Muslim community (including patients, carers, parents and members of the public). All healthcare professionals (HCPs), their teams and anyone involved in delivering care and support (across all care settings) to Muslim individuals, may also find it useful.
For information on other types of synthetic alcohols, see our guidance on other synthetic alcohols used in medicines.
- Ethanol
- How ethanol is used in medicines
- Why this is important
- Checking medicine information
- Is ethanol halāl or harām?
- Medicines with more than 1% ethanol: are they khamr?
- 1. Not All Ethanol = Khamr
- 2. Why Some Ethanol-Based Medicines May Still Be Permissible
- 3. When It Becomes Mufsid (Harmful or Toxic Substance)
- Differences of opinion
- Summary table
- Summary
- References and further reading
Ethanol
Ethanol is a type of alcohol and the active substance that causes drunkenness if consumed at high levels. Ethanol is used to make:
- Alcoholic beverages like beer, wine, and spirits
- Perfumes and toiletries
- Disinfectants and hand sanitisers (sprays and gels)
- Medicines. 1
It is a clear, colourless liquid made through a process of either:
- Fermentation (anaerobic respiration) of biomass (e.g. various plant materials such as trees, grass, wood, crop residue, algae, grains, sugarcane, dates, grapes and fruits etc), using yeast as an enzyme2 3 4 or
- Hydration of ethene from crude oil using steam5 (process used to make synthetic ethanol).
Trees, grass and wood
Dates, grapes and fruits
Crude oil
Grains
Note: There are different types of alcohol that have different uses. Not all alcohols are suitable for consumption e.g. methanol (used in antifreeze) and isopropanol (used as rubbing alcohol). Ethanol is the only type of alcohol that is safe for human consumption in moderate amounts.6 For information on other types of alcohol, see our resource on other synthetic alcohols used in medicines.
How ethanol is used in medicines
Ethanol is used in medicines as:
- A processing aid – used in the recrystallisation (i.e. purification) of drug substances. Most of the alcohol is removed during processing but trace amounts may remain in the final product
- A solvent – to improve drug solubility e.g. in cough and cold medicines
- A preservative – it has bacteriostatic, bactericidal, fungicidal and virucidal properties e.g. in topical preparations and mouthwashes. 6 7 8
Why this is important
For many Muslims, it is important to know whether a medicine contains ethanol or involves ethanol in its manufacturing process, and whether its use is permissible (halāl) under Islamic law. The Islamic ruling on ethanol depends on several key factors:
1. Concentration and intoxicating potential
Islamic law prohibits intoxicants (khamr), and the permissibility of ethanol depends on whether it has the capacity to intoxicate:
Low concentration (<1%): If ethanol is present in such small quantities that it cannot intoxicate even if consumed in large amounts, many scholars consider it permissible. Some have indicated >0.5%, however it is well recognised that the same principle holds about the impossibility of drunkenness with concentrations around 1% – so >1% is provided as a realistic and a scientifically validated percentage.
High concentration or poisonous nature: If the ethanol is of such a high concentration that it is toxic (e.g., denatured or used as an industrial solvent), it is considered mufsid (corruptive) rather than khamr (intoxicant), and many scholars allow its external or medicinal use.
Therefore, it is important to check the final concentration of ethanol in the product.
2. Source of ethanol
Islamic rulings also consider the origin of the ethanol:
- Prohibited sources (Ashriba Arbaʿa): Ethanol derived from grapes, dates, raisins, or their juices — known collectively as ashriba arbaʿa — is considered khamr by consensus. If such ethanol is present in more than a trace amount (i.e., >1%), it is generally deemed harām according to the majority of scholars.
- Synthetic sources: Ethanol produced through chemical synthesis in laboratories (not from fruit fermentation) is not khamr and is generally considered halāl if it is non-intoxicating according to the majority opinion.
N.B Pleases see the introduction section on our page ‘How we classify medicines based on ingredients and excipients‘ for a detailed explanation of why this has been labelled as the majority opinion, particularly aligned with the Ḥanafī school. In practice, most Muslims, especially those who are unaware of or do not formally adhere to any specific madhhab (school of thought/jurisprudence)—tend to follow the dominant view adopted by the majority of scholars today. Ethanol from such sources is considered halāl if it does not intoxicate in the amount used.) - Other sources (e.g. corn, sugarcane, wheat): Most ethanol used in pharmaceuticals today is derived from these non-khamr sources. According to the majority of scholars ethanol from such sources is considered halāl if it does not intoxicate in the amount used.
3. Purpose of use
The intended use of ethanol is a key factor in determining permissibility:
- Beverage and recreational use: Always harām (prohibited).
- Non-beverage or medicinal use: Permissible according to the majority of scholars if the ethanol is non-intoxicating and the medicine serves a genuine therapeutic purpose. Examples include:
- Hand sanitisers and personal hygiene products
- Industrial solvents in manufacturing processes
- Oral and topical medicines such as cough syrups and mouthwashes.
For healthcare professionals and caregivers, it is important to:
- Be aware that some patients may wish to avoid ethanol due to religious beliefs
- Respect and support patients in making informed decisions about their treatment
- Where possible, discuss concerns and explore alternative formulations that meet the patient’s religious requirements, provided they are clinically appropriate and available
- Assist patients in understanding whether the ethanol in a medicine is present in trace amounts, its source, and whether it is likely to be considered permissible in Islam.
Checking medicine information
You can check if a medicine contains ethanol using the relevant product patient information leaflet (PIL) or summary of product characteristics (SPC) which is available on the electronic medicines compendium (emc) website. You may also find our resource on ‘How to find out if a medicine contains harām ingredients and/or excipients’ useful. If you are still unsure if a medicine contains ethanol, speak to your local pharmacist as they are the experts in medicines.
You may need to contact the manufacturer to find out other information such as the source of alcohol and percentage concentration of ethanol in the final product. Please note that this information is not always readily available from manufacturers.
It is important to remember that even if you find out a medicine contains possible harām ingredients and/or excipients, is derived from harām sources, or that there is cross-contamination with harām sources, this does not always mean it is prohibited to take/use. For further information, see our resource on ‘What to do if a medicine contains harām ingredients and/or excipients’. It includes the conditions of when it is acceptable to take/use a medicine in these circumstances. It can also be used to support person-centred discussions between individuals and HCPs, and help make informed decisions around taking medicines that are both clinically appropriate and align with an individual’s Islamic values and beliefs.
Is ethanol halāl or harām?
The table and explanation below summarise the general rulings, differences of opinion and provides examples of day-to-day use.
General criteria of ethanol-based products6
| Purpose of use | Source | Concentration and intoxicating potential | Ruling |
|---|---|---|---|
| Non-beverage (e.g. Personal hygiene use, industrial applications, and medicinal use) | Unanimous khamr sources (e.g. dates, grapes) | Less than 1% | ✅ Generally permissible It does not cause drunkenness regardless of the amount used |
| More than 1% | ❌ Harām Classed as khamr, regardless of quantity |
||
| Other sources (e.g. synthetic or industrial materials (e.g. corn, sugarcane etc) | Less than 1% | ✅ Generally permissible It does not cause drunkenness regardless of the amount used |
|
| More than 1% | ⚠️ Differences of opinion (see below) |
Here are some examples of topical and medicinal products (i.e. non-beverage use) that may contain ethanol , their classifications and rulings (list not exhaustive):
| PRODUCT | PERCENTAGE OF ETHANOL | CLASSIFICATION | RULING |
|---|---|---|---|
| Antiseptic solutions and disinfectants | 70-90% | Majority opinion: Permissible (halāl) for medicinal use, as it is derived from non-khamr sources (e.g., corn, sugarcane, synthetic) and is considered ṭāhir (pure) if non-intoxicating in the amount used. Minority opinion: Permissible only if no suitable halāl alternative is available (ḍarūrah or necessity). Alternate view: Some scholars classify it as ⚠️ mufsid (harmful and toxic) if consumed unnecessarily, and permit its use strictly within therapeutic dosage limits and under medical advice. | ✅ Permissible (if used as directed by the manufacturer) |
| Cough syrups | 10-20% | ||
| Hand sanitisers (e.g. gels and sprays) | 50-70% | ||
| Mouthwash and oral applications (e.g. oral sprays, lozenges and gels) | 20-30% |
Medicines with more than 1% ethanol: are they khamr?
Some medicines contain more than 1% ethanol in the final product. Understandably, this raises concerns for many Muslims, since khamr (intoxicants) are strictly prohibited in Islam. However, the Islamic legal ruling on such medicines is not as straightforward, and several key points help clarify the issue:
1. Not All Ethanol = Khamr
According to the majority of scholars, not every substance that contains ethanol is automatically classified as khamr. There are specific conditions that must be met for a substance to be legally defined as khamr in Islam:
- It must be derived from grapes, dates, raisins, or their juices (known as ashriba arbaʿa), and
- It must be typically used as a beverage, and
- It must be capable of causing intoxication when consumed in normal amounts.
- If a substance does not meet all three conditions, then it is not considered khamr even if it contains ethanol.
Example: Ethanol derived from corn or sugarcane, and used in a cough syrup—not as a beverage—is not classified as khamr by most scholars.
2. Why Some Ethanol-Based Medicines May Still Be Permissible
Even if the ethanol content is over 1%, medicines may still be considered halāl based on the following:
- The source of ethanol is not from khamr (i.e. not from grapes/dates/raisins).
- The form and use of the product is non-beverage (e.g., hand sanitiser, topical gel, or medicinal syrup).
- The amount consumed when used correctly is far below the level needed to intoxicate.
Therefore, as long as the medicine is not used recreationally or excessively, and is used as prescribed, it would not fall under the legal category of khamr.
3. When It Becomes Mufsid (Harmful or Toxic Substance)
Some ethanol-containing products may be considered mufsid (harmful or corruptive) rather than khamr. This classification refers to substances that are toxic or dangerous in nature, rather than intoxicating. Such substances are not consumed for pleasure, and their harm comes before any intoxicating effect.
This applies in two main cases:
- External Products Misused Internally
Products like hand sanitisers or ethanol-based topical creams often contain very high concentrations of ethanol and other toxic chemicals. These are meant for external use only.
If someone drinks these products, they will likely be harmed (e.g., poisoning or organ damage) before they could even become intoxicated.
- Medicines Taken in Excess
Some oral medicines (e.g., cough syrups) contain ethanol but are safe in small therapeutic doses.
If someone overdoses or takes much more than the recommended dose, it may cause serious harm before any intoxication occurs. This is a case of misuse and is considered sinful and harmful in Islam and medicine.
Key Point: Medicines with more than 1% ethanol are not necessarily khamr. If the ethanol is not from khamr sources, not used as a beverage, and not consumed in intoxicating amounts, they may be considered permissible by the majority of scholars.
However, misusing such products — either by consuming those meant for external use or taking excessive amounts — may render them mufsid (harmful), and such misuse is prohibited both Islamically and medically.
Differences of opinion
Islamic scholars hold differing opinions on the permissibility (ḥilliyyah) of ethanol in medicines and other non-beverage products. These differences are primarily based on three key factors:
1. Source of Ethanol
Scholars differentiate between:
- Khamr sources: Ethanol derived from dates, grapes, or raisins (ashribat al-arbaʿah) — considered khamr by consensus.
- Non-khamr sources: Ethanol from corn, sugarcane, wheat, or synthetic chemical processes — not considered khamr by the majority.
The ruling changes based on whether the ethanol is derived from a najāsa (ritually impure source) or a ṭāhir (pure) substance, and whether it falls under the category of intoxicants or industrial solvents.
2. Concentration in the
Final Product
Scholars also differ on whether ethanol above 1% is permissible in non-beverage products such as medicines and hygiene products.
This 1% threshold is often used as a guideline for determining whether a product is potentially intoxicating or not.
3. Application of ʿUmūm al-Balwa (Widespread hardship)
ʿUmūm al-Balwā is a legal principle in Islamic jurisprudence that refers to a situation of widespread public hardship or difficulty that is common, unavoidable, and affects a large number of people. When such hardship becomes pervasive and fulfilling a ruling becomes excessively burdensome or practically impossible for the general public, scholars may allow dispensations (rukhṣah) or adopt less strict rulings to ease the difficulty. This principle is rooted in the Qurānic objective of removing hardship from the Ummah and is used cautiously by scholars to strike a balance between upholding the law and addressing real-world necessity. In the context of medicines, ʿumūm al-balwā is often invoked when ethanol-based or otherwise doubtful ingredients are commonly used and suitable alternatives are not readily available, allowing for conditional permissibility in therapeutic contexts.
In cases where ethanol-containing products are widespread and unavoidable, some scholars apply the legal principle of ʿumūm al-balwā to permit their use, especially in medical contexts.
Majority Opinion (including the contemporary Ḥanafī position):
Minority Opinion (more cautionary/strict view):
Summary table
| Issue | Majority opinion | Minority opinion |
|---|---|---|
| Ethanol from khamr sources | Harām if >1% (unless dire need) | Harām regardless of need or use |
| Ethanol from non-khamr | Halāl if non-intoxicating and used medicinally | Harām if >1%, even for medicinal or topical use |
| Personal care/industrial | Permissible (as non-consumable and/or mufsid) | Harām if ethanol >1%, unless medicinal need or necessity |
| ʿUmūm al-Balwa | Used to justify permissibility in widespread cases | May allow temporary dispensations in case of need and necessity. |
Summary
- Summary: ethanol in medicines – Islamic perspective
- Ethanol is a type of alcohol used in medicines as an excipient — commonly functioning as a solvent, preservative, or processing aid.
- For members of the Muslim community, it is important to know whether a medicine contains ethanol and whether its use is permissible (halāl) under Islamic law.
- For healthcare professionals (HCPs) and those involved in care provision, it is essential to have open and respectful discussions about patients’ religious values and beliefs when relevant to their treatment.
- Guidance for Muslim patients
- If you are unsure about the halāl status of a medicine or are seeking alternatives, do not stop, delay, or change how you take your medicine without first consulting the healthcare professional who prescribed or supplied it.
- Always seek medical advice first before making any decisions regarding your treatment.
- Islamic rulings on ethanol: summary of scholarly opinions
- Ethanol is generally considered permissible (halāl) by the majority of scholars if it is not derived from grapes, dates, or raisins (known as ashribat al-arbaʿah, or khamr sources).
- There are differences of opinion based on two main factors:
- Source:
- Ethanol from khamr sources (grapes, dates, raisins) is generally harām if present in amounts that can intoxicate.
- Ethanol from non-khamr sources (e.g., corn, sugarcane, synthetic) is generally halāl if it does not cause intoxication, especially in medicinal use.
- Concentration:
- Some scholars consider ethanol above 1% to be problematic, especially in oral medicines, though others allow it based on source and usage context.
- Source:
- High-concentration ethanol products (>1%)
- According to the majority opinion, even products with ethanol concentrations above 1% are not classified as khamr if:
- The source is non-khamr,
- The product is not a beverage,
- It is used within prescribed medicinal limits.
- Minority opinions may still consider such products harām, but allow permissibility based on:
- ʿUmūm al-Balwa (widespread hardship),
- Ḍarūrah (necessity), or
- Classification as mufsid (toxic or harmful substances), where use is permitted only if safe and within therapeutic dosage.
- If such products are misused (e.g., consumed in overdose or used orally when meant for external use like hand sanitisers), they may be prohibited (harām) due to the harm caused.
- According to the majority opinion, even products with ethanol concentrations above 1% are not classified as khamr if:
- Key principles for decision-making
- You should follow the guidance of your school of thought (madhhab) or consult a qualified local Imam or Islamic scholar, ideally someone knowledgeable in Fiqh of Medicine.
- All scholars agree on one foundational principle:
- If there is no equally effective halāl alternative and the medicine is medically necessary, its use is permissible — regardless of ethanol’s source or concentration.
- In Islamic law, medical need and necessity (ḥājah and ḍarūrah) override the general prohibition of ethanol if no lawful substitute is available and the medicine is essential for health.
- How to check ethanol content in medicines
- Patients can check for ethanol by reviewing the:
- Patient Information Leaflet (PIL)
- Summary of Product Characteristics (SmPC)
- Alternatively, ask your pharmacist to assist you.
- If further detail is needed, you may request the following from the manufacturer (note: some details may be limited):
- Patients can check for ethanol by reviewing the:
References and further reading
- UK Health Security Agency. Ethanol: general information. [online]. Available at: https://www.gov.uk/government/publications/ethanol-properties-uses-and-incident-management/ethanol-general-information [Accessed 30th April 2025] ↩︎
- Alternative Fuels Data Center. Alternative Fuels Data Center: Ethanol Feedstocks. [online] Available at: https://afdc.energy.gov/fuels/ethanol-feedstocks [Accessed 30th April 2025] ↩︎
- Ahmad A, Naqvi SA, Jaskani MJ, Waseem M, Ali E, Khan IA, Faisal Manzoor M, Siddeeg A, Aadil RM. Efficient utilization of date palm waste for the bioethanol production through Saccharomyces cerevisiae strain. Food Sci Nutr. 2021 Feb 21;9(4):2066-2074. doi: 10.1002/fsn3.2175. ↩︎
- Chitranshi R, Kapoor R. Utilization of over-ripened fruit (waste fruit) for the eco-friendly production of ethanol. Vegetos. 2021 Feb;34(1):270-276. doi: 10.1007/s42535-020-00185-8. ↩︎
- BBC Bitesize Making chemicals on an industrial. [online]. Available at: https://www.bbc.co.uk/bitesize/guides/zwjsk2p/revision/6 [Accessed 30th April 2025] ↩︎
- Shaykh Rafāqat Rashid. Revising The Fiqh of Khamr and Alcohol: Ethical Use from an Islamic Perspective. Al Balagh Academy. 2024 May. Available at: https://www.albalaghacademy.org/blog/revising-the-fiqh-of-khamr-and-alcohol/ ↩︎
- European medicines agency. Questions and Answers on Ethanol in the context of the revision of the guideline on ‘Excipients in the label and package leaflet of medicinal products for human use’ (CPMP/463/00) [online]. Available at: https://www.gmp-compliance.org/guidelines/gmp-guideline/eudralex-volume-3-questions-and-answers-on-ethanol-in-the-context-of-the-revision-of-the-guideline-on-excipients-in-the-label-an [Accessed 30th April 2025] ↩︎
- Ref Chung E, Reinaker K, Meyers R. Ethanol Content of Medications and Its Effect on Blood Alcohol Concentration in Pediatric Patients. J Pediatr Pharmacol Ther. 2024 Apr;29(2):188-194. doi: 10.5863/1551-6776-29.2.188. https://pmc.ncbi.nlm.nih.gov/articles/PMC11001219/ ↩︎
