Which medicines raise Passover questions

OU Kosher's Passover medication guidelines sort medicines by form, not by ingredient alone. The form determines whether a medicine is considered palatable (likely to contain chametz) or not, and that sorting shapes what questions to ask your rav and clinician. The guidelines open with a caution: exercise extreme care and consult your doctor and rabbi before deciding not to take a medicine [1]. No medicine question belongs to you alone.

How the OU guidelines sort medicine forms

OU Kosher states that known and tested medications in the form of creams, non-chewable pills and injections may be owned, used and consumed on Passover, even if they contain chametz or kitniyot [1]. These forms are not considered palatable, meaning they are not designed to taste good and are not eaten for pleasure. The reasoning is that a medicine you swallow whole without tasting it does not raise the same Passover concern as food you chew and taste.

Liquid medicines, chewable pills and pills coated with a flavored glaze are treated differently [1]. These forms are considered palatable because they are designed to be tasted or because they dissolve in the mouth. A flavored coating exists to make the medicine more pleasant to take. Palatable forms may contain chametz, and the guidelines recommend replacing them when possible.

Gelcaps present a separate problem [1]. They may contain non-kosher edible gelatin, which is why the guidelines single them out. The label lists inactive ingredients, so you can check whether gelatin appears on your specific product. If it does, or if the label does not disclose what the capsule is made from, that is a question for your clinician and your rav.

The sorting is practical: it tells you which medicine forms raise a Passover question and which do not, so you know what to bring to your rav and what to ask your clinician.

What the medicine label actually says

The label lists inactive ingredients and describes how the medicine is manufactured. It does not state any religious status [3]. For semaglutide, an injectable GLP-1 receptor agonist, the label states that the peptide backbone is produced by yeast fermentation and lists the inactive ingredients in the solution [3]. It does not say whether the medicine is kosher, halal, or permitted for Passover. That determination is not the label's job.

Your job is to read the label for two things: the form of the medicine and the inactive ingredients. The form tells you whether the OU guidelines place it in the non-palatable category (cream, non-chewable pill, injection) or the palatable category (liquid, chewable, flavor-glazed) or the problem category (gelcap). The inactive ingredients tell you whether gelatin or other flagged materials appear.

Then you cross-check against the OU Kosher Passover medicine guidelines and the annual Star-K list. Star-K publishes a Quick-Pick Medicine List each year that samples chometz-free and kosher medicines for the USA only, listed by category under brand names [2]. It is not exhaustive, but it covers many common medicines. If your medicine appears on the list, you have a starting point for your rav. If it does not, you use the label and the OU sorting to frame the question. For help reading the label itself, see the guide to reading a medication label.

When to ask your clinician about a different form

OU Kosher's guidelines state that where possible, liquid medicines, chewable pills and gelcaps should be replaced, under the direction of a doctor, with a non-chewable, uncoated pill [1]. That conversation belongs with your prescribing clinician only. Your clinician knows your medical history, your condition, and whether a different form will work as well as the one you are taking.

The question to ask is straightforward: Is there a non-chewable, uncoated pill form of this medicine? If yes, can I switch to it for the week of Passover? Your clinician may say yes, no, or maybe with conditions. Once you have the answer, you bring the new form's label to your rav, who applies the same sorting process.

Do not stop taking a medicine, do not delay taking it, and do not change it on your own. The decision to switch forms belongs to your clinician. The decision whether the new form is permitted belongs to your rav. Neither decision is yours to make alone.

How to read the annual lists

Star-K's 2026 Quick-Pick Medicine List describes itself as a sample of chometz-free and kosher medicines for the USA only, listed by category under brand names [2]. It notes that products may contain kitniyos unless otherwise indicated. The list is organized by condition and medicine type, so you can search for your medicine by name or category.

If your medicine appears on the list, that is a strong signal that it qualifies under the OU guidelines. But the list is a sample, not exhaustive. If your medicine does not appear, that does not mean it is not permitted. It means you need to check the label yourself and bring the question to your rav.

OU Kosher's guidelines also state that in many cases medicinal items which contain kitniyot are permitted for people who are ill, and that questions on this issue should be directed to your rabbi [1]. Kitniyot is a category of legumes and seeds that some communities avoid on Passover. Whether a medicine containing kitniyot is permitted for you depends on your rav's ruling and your community's custom.

The Passover medicine lists explained guide walks through the annual lists in detail. For a broader look at how Refuah approaches medicine and observance, see the guides hub.

Here is how the OU guidelines sort the medicine forms you are most likely to encounter.

What to do next

1. Find your medicine on the label and identify its form: pill, liquid, injection, cream, chewable, gelcap, or flavor-glazed.
2. Read the inactive ingredients section on the label and note any gelatin, alcohol, or other materials that concern you.
3. Check the Star-K 2026 Quick-Pick Medicine List to see whether your medicine appears.
4. If your medicine is a liquid, chewable, flavor-glazed pill or gelcap, call your prescribing clinician and ask whether a non-chewable, uncoated pill form is available for you.
5. If a different form is available, get the label for that form and note its inactive ingredients.
6. Print the label or take a photo of the inactive ingredients section for each medicine you take.
7. Bring the labels and the list of your medicines to your rav, along with the OU Kosher Passover medicine guidelines, and ask which medicines qualify for Passover in your community.
8. If your rav rules that a medicine does not qualify and you cannot replace it, discuss with your clinician and your rav together whether you should take it during Passover. That decision belongs to both of them, not to you alone.

Sources

1. OU Kosher, Passover medicine lists and guidelines, medicine form sorting and replacement guidance, accessed 2026-08-09, https://oukosher.org/passover/medicine-guidelines/
2. Star-K, 2026 Quick-Pick Medicine List, sample of chometz-free and kosher medicines for the USA, accessed 2026-08-09, https://www.star-k.org/articles/wp-content/uploads/qp-med-list.pdf
3. DailyMed, Ozempic (semaglutide) prescribing information, inactive ingredients and manufacturing, accessed 2026-08-09, https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=adec4fd2-6858-4c99-91d4-531f5f2a2d79