Medicines for Pesach

medicineQuestion #1: The Ubiquitous Lists

“Why do we have lists of acceptable medicines for Pesach? Aren’t they all inedible?”

Question #2: Leavening Forever!

“Is leavened dough always chometz?”

Question #3: The Spoiler

“Do prohibited foods remain so after they spoil?”


As we all know, the Torah prohibits eating, using or even owning chometz on Pesach. But do these laws apply to something that is no longer edible? May I swallow it as medicine? Understanding properly the source material is our topic for this week’s article.

We should first note that many of these issues are germane not only to chometz, but also in regard to all foods that the Torah prohibits (issurei achilah): Does the Torah ban them even after they have become inedible? Can this be considered eating? And, assuming that the Torah does not prohibit them, are they perhaps forbidden because of a rabbinic injunction? Furthermore, if they were proscribed due to a rabbinic decree, perchance some exemption was provided for a medical reason, even when it is not pikuach nefesh, a life-threatening emergency.

Pikuach nefesh

It is important to point out that most of our discussion is not about instances of medicines necessary because of pikuach nefesh. With very few exceptions, an emergency that might endanger someone’s life, even if the possibility is remote, requires one to take whatever action is necessary, including consuming non-kosher food and benefiting from prohibited substances. We will return to this discussion later in this article, but only after we understand the basic principles.

Unusual benefits

A question similar to what was raised above — whether non-kosher foods that are now inedible remain prohibited — relates to items from which the Torah prohibited benefit (issurei hana’ah), such as the mitzvah of orlah. Does this prohibition apply only if one benefits from orlah fruit the way people typically utilize the forbidden item, such as by selling it or by polishing furniture with orlah lemon juice, or does the prohibition apply even to using the item in an unusual way, such as by taking edible fruit and using it as an ointment?

Unusual eats

Let us begin our search with the original Gemara sources of this discussion, which provides the following statement: One does not get punished for violating any prohibitions of the Torah unless he consumes them the way they are usually eaten (Pesachim 24b). It is not prohibited min hatorah to eat or drink a prohibited substance that is now inedible either because it became spoiled or because a bitter ingredient was introduced (Rambam, Hilchos Yesodei Hatorah 5:8). We will discuss shortly whether there is a rabbinic prohibition involved in eating this food.

The same rule applies regarding eating on Yom Kippur. For example, someone who drank salad dressing on Yom Kippur is not punished for violating the Torah’s law requiring one to fast, because this is not a typical way to eat (Yoma 81a). However, someone who dipped food into salad dressing and ate it violates the Torah laws of Yom Kippur also for the dressing, since this is a normal way of consuming it.

Bad benefits

Similarly, when the Torah prohibits issurei hana’ah, they were usually prohibited min hatorah only when used the way the substance is typically used. However, using the material in an abnormal way, such as by smearing an orlah fruit on his body as an ointment, is not proscribed by the Torah, but only because of an injunction introduced by the Sages, an issur derabbanan. Such an atypical benefit is called: shelo kederech hana’asah.

Rubs me the wrong way

Since the prohibition of benefiting in an unusual way is rabbinic, it is relaxed when there is a medical reason to do so, even when no life-threatening emergency exists. These principles are reflected by the following Talmudic passage:

Mar the son of Rav Ashi found Ravina rubbing undeveloped orlah olives onto his daughter, who was ill. Whereupon Rav Ashi asked Ravina why he did this since the disease was not life threatening? Ravina responded that using the fruit this way is considered unusual because people typically wait until the olives ripen before extracting their oil. Since this is not the normal way to use the olives, the prohibition to use orlah fruit this way is only miderabbanan, and in the case of medical need Chazal were lenient (second version of Pesachim 25b, see Rashi ad locum and Tosafos, Shavuos 22b s.v. aheitera and 23b s.v. demuki).

To sum up: We have established that both issurei achilah and issurei hana’ah are prohibited min hatorah only when they are eaten or used in the way that someone would typically consume them or benefit from them. Benefiting from issurei hana’ah in an atypical way is prohibited miderabbanan; however, the Sages permitted this to be done when a medical need exists. We do not yet know whether this ruling holds true also regarding someone who needs to eat something that is not typically eaten.

Now that we have established some of the basic principles, let us examine some rules specific to the prohibition of chometz that will help us answer our original questions.

When is it no longer chometz?

Can chometz change its stripes so that it is no longer considered chometz? The answer is that it can lose its status as chometz – when it is decomposed or otherwise ruined to a point that it is nifsal mei’achilas kelev, a dog will no longer eat it (see Pesachim 45b). Since it no longer can be used for either food or feed, it loses its status as chometz that one is prohibited from owning and using on Pesach (Tosafos ad locum; Shulchan Aruch, Orach Chayim 442:9; cf. Rashi, Pesachim op cit., whose position is more lenient).

This is true only when the chometz was rendered inedible before Pesach. The Gemara (21b) states that if chometz became burnt before the time on Erev Pesach when one is prohibited from owning it, one may benefit from it even on Pesach. If it was still chometz when Pesach arrived, and it was destroyed or rendered inedible in the course of Yom Tov, it is prohibited from benefit on Pesach (Pesachim 21b).

We will see shortly that there are instances when it is permitted to own and use chometz on Pesach even though it is still edible. But first, we need to explain an important principle.

What is sourdough?

The Torah explicitly prohibits possessing on Pesach not only chometz, but also sourdough (Shemos 12:15, 19; 13:7; Devarim 16:4). What is sourdough? It is dough left to rise until it has become inedible. However, it can be used as a leavening agent added to other dough to cause or hasten fermentation. Since sourdough originates as chometz and can produce more chometz it shares the same fate as chometz – one may not consume, use, or even own it on Pesach. (By the way, although yeast has replaced sourdough as the commonly used fermentation agent, sourdough is often used today in rye breads and other products to impart a certain desired flavor.) This halachah implies that something may no longer be edible and yet still be prohibited as chometz.

Can sourdough go sour?

I mentioned above that once chometz is no longer edible for a dog, it loses its status as a prohibited substance. Does this law apply also to sourdough? Although a Jew may not own or use inedible sourdough on Pesach, does this prohibition apply only to what a dog would eat? May one own and use sourdough on Pesach that decomposed to the point that a dog would not eat it?

These questions are the subject of a disagreement among the rishonim. Many authorities permit owning sourdough that would no longer be eaten by a dog, whereas others, such as the Raavad (Hilchos Chometz Umatzoh 1:2), proscribe owning over-soured dough on Pesach. Those who forbid it do so because sourdough is never considered an edible product, yet the Torah banned it because of its facility as a leavening agent, which is not harmed by its becoming inedible. Edibility, whether for man or beast, is only a factor when we are defining prohibited foods, but not when the Torah forbade an item that was never a food to begin with.

The later authorities dispute which way we should rule in this last matter. See the Biur Halachah 442:9 s.v. Chometz who quotes much of the dispute.

When is edible chometz permitted?

We have so far established that although chometz that a dog would not eat is no longer forbidden as chometz, sourdough that a dog would not eat might still be prohibited. However, there is a major exception to this rule – that is, there are instances when chometz may not have reached the level of nifsal mei’achilas kelev, and yet one may own it and even use it on Pesach. This exception is when the chometz is no longer considered to have any food use, notwithstanding that it is technically still edible. Here is the germane passage of Gemara:

Rabbi Shimon ben Elazar says one must destroy chometz only as long as the bread or the sourdough still exists as a food. However, a block of sourdough that was designated to use for sitting is no longer considered chometz,  even when it is still edible (Pesachim 45b and Tosafos ad loc.).

How can one possibly own this sourdough on Pesach if a dog would still eat it?

When presenting this case as a halachic rule, the Rambam (Hilchos Chometz Umatzoh 4:10, 11) introduces us to a new term: nifsad tzuras hachametz, literally, its appearance as chometz is lost. The Chazon Ish (Orach Chayim 116:8) explains this to mean that since people are now repulsed to eat it or to use it in a food product, it is no longer halachically chometz since people no longer regard it as food. The same ruling applies to similar items whose use is not for food, such as chometz used in ointments or to starch clothes (Rambam, Hilchos Chometz Umatzoh 4:10; Rosh, Pesachim 3:5).

A sourdough cover-up

Although the Gemara concludes that we are not quite as lenient as is Rabbi Shimon ben Elazar, this is a question of degree, but not of basic principle. Whereas Rabbi Shimon ben Elazar permitted sourdough that one intends to use as a seat, the Gemara permits it only when the surface of the block is coated with a layer of dried mud. This demonstrates that it is now viewed as a piece of furniture (Rashi). The halachic authorities dispute to what extent one must coat the sourdough block, some ruling that it must be covered on all sides whereas others rule that it is sufficient if the top, the part that will be sat upon, is coated with mud (see discussion in Mishnah Berurah 442:42 and Shaar Hatziyun ad loc.).

Notwithstanding this dispute concerning how much of the block needs to be coated, all agree that the sourdough beneath the dried mud surface is still theoretically edible, yet one may own and use it on Pesach (Shaar Hatziyun 442:69). Since people no longer view this sourdough as food, it loses its status. As the Mishnah Berurah (442:41) emphasizes, our conclusion is that two steps must have occurred to this block before Pesach to permit owning and using it on Pesach:

  • The owner must have designated the sourdough as a seat.
  • Its surface was overlaid with mud.

The dispute among tanna’im regards only whether we require the second step, which Rabbi Shimon ben Elazar did not require.

At this point we can answer one of our opening questions:

“Is leavened dough always chometz?”

The answer is that there are two instances when it is not considered chometz anymore:

  • When it was rendered before Pesach so inedible that a dog would not eat it.
  • When it is being used for a non-food purpose and something has been done to it that makes people repulsed by the idea of eating it.

Eating spoiled chometz

We mentioned above the Gemara’s statement that chometz burnt before Pesach may be used on Pesach (Pesachim 21b). The wording of the Gemara causes the rishonim to raise the following question: Why does the Gemara say that one may benefit from the burnt chometz, rather than permit even eating it, since it is no longer considered food and therefore not included under the prohibition of chometz?

There are two major approaches to answer this question, which result in a dispute in practical halachah. According to the Ran, since the burning rendered the chometz inedible even by an animal, one may even eat it, but the Gemara does not mention this. This approach seems to have the support of the Rambam (Yesodei Hatorah 5:8), who permits consuming a prohibited beverage after a bitter ingredient was added to it.

However, the Rosh contends that the rabbis prohibited one from eating the inedible chometz because of a principle called achshevei, which means that by eating it one is treating it as food. Most later authorities (e.g., Terumas Hadeshen #129; Taz, Orach Chayim 442:8; Magen Avraham 442:15; Shaagas Aryeh #75) follow the Rosh’s approach, prohibiting someone from ingesting inedible chometz because of this rabbinic prohibition.

Is chometz medicine prohibited?

With this lengthy introduction, we are now able to discuss the original question posed above: “Why do we have lists of acceptable medicines for Pesach? Aren’t they all inedible?”

I will now rephrase the question: Does oral intake of a chometz-based medicine qualify as achshevei? If it does, then it is prohibited to ingest inedible chometz, even as medicine, unless the situation is life-threatening.

We find a dispute among later authorities whether ingesting medicine is prohibited because of achshevei. We can categorize the positions into three basic approaches:

  1. Taking medicine is considered achshevei.

The Shaagas Aryeh (#75) rules that ingesting medicine is prohibited miderabbanan because of the rule of achshevei.

  1. Taking medicine is not considered achshevei.

Rav Moshe Feinstein (Shu”t Igros Moshe, Orach Chayim 2:92) maintains that medicine never qualifies as achshevei. His reason is that people take even very bitter items for their medicinal value; thus taking something as a medicine does not demonstrate that one views it as food. (See also Shu”t Yechaveh Daas 2:60.)

  1. It depends on why the chometz is an ingredient.

The Chazon Ish advocates a compromise position. Although he agrees with the Shaagas Aryeh that consuming something as a medicine qualifies as achshevei, he contends that achshevei applies only to the active ingredient – the item for which one is taking the medicine. However, he maintains that achshevei does not apply to the excipient ingredients, those added so that the medicine can be made into a tablet.

According to Rav Moshe, as long as the medicine is foul-tasting, there is no need to check if it contains chometz. The chometz is nifsal mei’achilas kelev, and the consumption of medicine does not qualify as achshevei. The only need for a medicine list is when the medicine is pleasant tasting.

On the other hand, according to the Shaagas Aryeh, barring a situation of pikuach nefesh, one may not ingest a medicine containing chometz on Pesach, and it is important to research whether it contains chometz. There are also some authorities who contend that when a prohibited substance has a bitter ingredient added, it remains prohibited. I leave it for each individual to ask his or her own halachic authority to decide which approach they should follow. A lay person should not decide on his or her own not to take a necessary medicine without consulting with a rav or posek.

Even according to the Shaagas Aryeh, there is nothing wrong with owning or even benefiting from these medicines on Pesach – the only prohibition would be to ingest them. Thus, a Jewish owned pharmacy is not required to remove from its shelves foul-tasting medicines that are on the prohibited chometz lists.

Regardless as to which approach one follows, one must be absolutely careful not to look down on someone who follows the other approach. In any situation such as this, this attitude will unfortunately cause great harm, since it can lead to feelings of conceit.

Pikuach nefesh medicine lists

There can be another situation in which it is important for a rav or posek to know whether a product contains chometz, but, personally, I would discourage making such a list available to lay people. The case is: Someone who is taking a pleasant-tasting food supplement containing chometz for a pikuach nefashos condition in which the chometz is not a necessary ingredient. Halachically, we should try to find for this person a non-chometz substitute. For example, many years ago, someone I knew used a medicine where the active ingredient required being dissolved in alcohol, which could be chometz. We arranged to have a knowledgeable pharmacist make a special preparation for Pesach using alcohol that was kosher lepesach. (It is humorous to note that the pharmacist used his home supply of kosher lepesach Slivovitz since it was the easiest available Pesach-dik alcohol, and the preparation did not require pure alcohol.)

Is it a good idea to make a medicine list available to the general public? We know of situations when lay people thought that a product may contain chometz and therefore refused to use it, which led to a safek or definite pikuach nefashos situation, itself a serious violation of halachah. Many rabbonim feel that these lists should be restricted to the people who understand what to do with the information – the rabbonim and the poskim.


According to Kabbalah, chometz is symbolic of our own arrogant selves. We should spend at least as much time working on these midos as we do making sure that we observe a kosher Pesach!