Management of G6PD-Deficient Patients

Classification of Sulfonamides in G6PD Deficiency

• Sulfonamides are classified among the drugs most commonly used that can lead to hemolysis in G6PD deficiency, alongside dapsone and primaquine, according to the Clinical Infectious Diseases journal 1

Pathophysiology of Risk

• The Mediterranean variant (Gdmed) can cause life-threatening hemolysis, while the African variant (GdA-) typically produces milder, self-limited hemolysis, as reported in Clinical Infectious Diseases and Praxis Medical Insights: Practical Summaries of Clinical Guidelines 1, 2

Clinical Management Recommendations

• Qualitative screening for G6PD deficiency is recommended before starting therapy with oxidant drugs (including sulfonamides) in patients with predisposing racial or ethnic backgrounds (Mediterranean, African, Indian, or Southeast Asian descent), as suggested by Clinical Infectious Diseases and Praxis Medical Insights: Practical Summaries of Clinical Guidelines 1, 2
• Clinicians should monitor for signs of hemolysis including jaundice, dark urine, fatigue, and pallor when any new medication is started in G6PD-deficient patients, according to Praxis Medical Insights: Practical Summaries of Clinical Guidelines 3