Drugs to avoid in G6PD deficiency
Patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency have diminished levels of a key enzyme, G6PD, which protects red blood cells against oxidative stress. Therefore they should not be prescribed oxidative drugs, which can result in rapid hemolysis of their red blood cells.
Most patients with G6PD deficiency are asymptomatic, but they may have a history of neonatal jaundice, often requiring exchange transfusion, or a history of drug-induced hemolysis.
The following drugs should be avoided. I have highlighted ones commonly prescribed from an ED setting.
1. Nitrofurantoin
2. Pyridium
3. Sulfamethoxazole (i.e. component of TMP/SMX or Bactrim)
4. Primaquine
5. Dapsone
6. Flutamide
7. Methylene blue
8. Sulfacetamide
9. Nalidixic acid
[Frank JE. Diagnosis and Management of G6PD Deficiency. Am Fam Physician 2005:72(7):1277-1282.]
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