7 Things You Should Avoid If You Have G6PD Deficiency

Glucose 6 Phosphate Dehydrogenase (G6PD) deficiency is an inherited type of hemolytic anemia, a form of anemia that occurs when the red blood cells are broken down faster than usual (this is called hemolysis). In G6PD deficiency this occurs because you make a reduced amount of G6PD, an enzyme that protects the red blood cell from damage. Fortunately, most people with G6PD deficiency do not have problems on a daily basis. However, there are certain medications or foods that increase the rate of red blood cell breakdown. Let's review some of the common things that can cause problems in this blood disorder.  

1
Antibiotics

Close up of capsule
Close up of capsule. GP Kidd/Blend Images/Getty Images

People with G6PD deficiency can tolerate most antibiotics but should be aware of a selective few that can initiate significant red blood cell breakdown leading to anemia. Antibiotics referred to as "sulfa" drugs should be avoided. These antibiotics are typically used to treat skin or urinary tract (bladder) infections. The most common form of these antibiotics go by the brand names Septra or Bactrim (sulfamethoxazole-trimethoprim). 

The "quinolone" antibiotics should also be avoided. The two most common antibiotics in this group are Cipro (ciprofloxacin) and Levaquin (levofloxacin). These antibiotics are commonly used in adults to treat urinary tract infections and pneumonia. Other antibiotics that should be avoided include nitrofurantoin and dapsone. 

Fortunately, there are many antibiotics that people with G6PD deficiency can take safely. Make sure to discuss this with your physician if you have G6PD deficiency and require antibiotic therapy. 

2
Malaria Medications

Mosquito and pill
Mosquito and pill. Benjamin Van Der Spek/EyeEm/Creative RF/Getty Images

Primaquine, a medication used to treat or prevent malaria, can trigger hemolytic crises in people with G6PD deficiency. Because of this possible complication, it is recommended that people be tested for G6PD deficiency prior to taking primaquine. This includes breastfeeding infants whose mothers take primaquine. Fortunately, other medications used to treat malaria are tolerated by most people with G6PD deficiency.   

3
Medications Used in Cancer Treatment

Nurse preparing intravenous medication
Nurse preparing intravenous medication. Medic Image/Creative RM/Getty Images

Rasburicase is a medication used to treat tumor lysis syndrome, a medical complication of hematologic cancers like leukemia, should not be used in people with G6PD deficiency. Because of this risk, it is recommended that people be tested prior to receiving rasburicase. Similarly, doxorubicin, a type of chemotherapy used to treat multiple types of cancer, can trigger red blood cell breakdown in people with certain types of G6PD deficiency.  

4
Aspirin

Pills
Pills. Lauren Nicole/DigitalVision/Getty Images

Aspirin, commonly used to treat pain or inflammation, should be avoided. Some people take aspirin daily as part of their treatment regimen. When avoiding aspirin, it is important to remember that it is found in many over the counter medications like Anacin, Bufferin, Ecotrin, Excedrin, BC Powders and Goody's Powders.It is also found in Pepto-Bismol. In general other over the counter pain relievers like acetaminophen or ibuprofen are tolerated without issues.  

5
Mothballs

Mothballs
Mothballs. VOISIN/PHANIE/Creative RM/Getty Images

Yes, people still use mothballs. Mothballs can contain a chemical known as naphthalene which can trigger hemolysis in people with G6PD deficiency. Naphthalene can also be found in fumigants, particularly those used to keep snakes away. Naphthalene is a vapor given off by these products so exposure may come from inhaling the vapor or ingesting them.  

6
Henna

Hand with Henna
Hand With Henna. Bill Diodato/Creative RM/Getty Images

There are case reports published indicating henna (used for temporary tattoos or hair dye) has triggered hemolytic crises in people with G6PD deficiency. Newborns under the age of 2 months appear to be more susceptible to this reaction.  

7
Fava Beans

Broad Beans
Broad Beans. Anthony-Masterson/Photo Library/Getty Images

G6PD deficiency is also called favism; particularly the most severe forms of G6PD deficiency. This is because the ingestion of fava beans (also known as broad beans) can trigger hemolytic attacks in patients with G6PD deficiency. Some suggest that all legumes (such as peas, lentils, or peanuts) be avoided, but whether or not this is actually needed is unknown.   

A Word From Verywell

If you have G6PD deficiency, it doesn't mean you cannot take medications. You should be aware of common medications to avoid. This is not a complete list of items that people with G6PD deficiency should avoid. There are other medications that only cause red cell breakdown if taken in high doses. Others only trigger problems in specific types of G6PD deficiency. Make sure you discuss all your new medications with your physician to make sure they are not contraindicated for people with G6PD deficiency. Source: Luzaatto L and Poggi V. Glucose-6-Phosphate Dehydrogenase Deficiency. In: Orkin SH, Fisher DE, Ginsburg D, Look AT, Lux SE and Nathan DG (Eds). Hematology and Oncology of Infancy and Childhood (8th ed). Philadelphia: Elsevier.

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