Medication Safety in G6PD Deficiency

Contraindicated Medications

• The American Society of Hematology recommends that Primaquine and Rasburicase be avoided in G6PD-deficient patients due to the risk of severe hemolytic anemia 1
• Methylene blue (methylthioninium chloride) is contraindicated in G6PD-deficient patients as it may cause severe hemolytic anemia and worsen methemoglobinemia 2, 3
• Dapsone requires monitoring in G6PD-deficient patients due to the risk of hemolysis 4, 5

Safe Medication Use

• The American College of Clinical Pharmacology suggests that screening patients of Mediterranean, African, Indian, or Southeast Asian descent for G6PD deficiency is crucial before starting oxidant drugs 6, 1
• Educating patients about signs of hemolysis, such as jaundice, dark urine, fatigue, and pallor, is essential for early detection 1

Variant Severity and Management

• The severity of G6PD deficiency varies by genetic variant, with the Mediterranean variant (Gdmed) causing life-threatening hemolysis and the African variant (GdA-) producing milder, self-limited hemolysis 1, 6, 5