G6PD Deficiency Drugs to Avoid and Other Contraindicated Substances (Extracted from: http://g6pddeficiency.org/index)
Low Risk drugs, medicine, foods and other substances below MAY be safe at normal theraputic doses. People with Class 1 G6PD Deficiency (ie: Mediterranean variant among others) may still react to low risk substances. Consult with your physician before using any of these substances.
We try our best to keep this list up to date, but the constant influx of new drugs, medicines and research makes this task quite difficult. To be safe the following classes of drugs, medicines and other substances should be avoided if at all possible.
1. NSAIDS (Aspirin, Ibuprofen)
2. Tylenol
3. Quinolones
4. Drugs metabolized through the liver or known to cause blood or liver related problems or hemolysis
5. Sulfa drugs
6. Petrochemically derived substances (This is a long list and gets longer every year. Many artificial foods, dyes and vitamins are included in this list.)
7. Moth balls and anything containing naphthalene.
8. Artificial food coloring (Methylene and Toluidine blue
When in doubt, the safest course of action is to avoid the substance. If you react to something not on this list, avoid that substance in the future. Watch carefully for hemolysis signs at all times.
Contraindicated Substances for G6PD Deficient Patients
Avoid moth balls, artificial blue food color, legumes (fava beans, beans, peas, peanuts, soy, lentils, etc.), sulfites, tonic water. Please read all labels on processed foods before feeding to patient.
Substances labeled Low Risk MAY be given safely at normal therapeutic doses UNLESS the patient is severely G6PD Deficient or has chronic non-spherocytic hemolytic anemia. There is no guarantee that low risk drugs will not cause hemolysis. Please see g6pddeficiency.org for more information.
A diet rich in antioxidant foods is recommended to help minimize the effects of oxidative stress and the resultant hemolysis. Vitamins B6, B12, folic acid and NAC are also important.
Acetaminophen - Low Risk
Acetanilid - High Risk
Acetylphenylhydrazine -
High Risk
Aminophenazone - High Risk
Antazoline - Low Risk
Antipyrine - Low Risk
Ascorbic Acid - Low Risk
Aspirin - High Risk
Astemizole – Risk
Beta-Naphthol - High Risk
Celebrex - High Risk
Chloramphenicol - High Risk
Chloroquine - High Risk
Ciprofloxacin - High Risk
Colchicine - Low Risk
Dapsone - High Risk
Dimercaprol - High Risk
Diphenhydramine - Low Risk
Dopamine - Low Risk
Doxorubicin - High Risk
Ethanol - High Risk
Furazolidone - High Risk
Furosemide - High Risk
Gadopentetate dimeglumine – High Risk
Glucosulfone - High Risk
Glyburide - High Risk
Henna - High Risk
Ibuprofen - Low Risk
Isobutyl Nitrite - High Risk
Isoniazid - Low Risk
Lamotrigine - High Risk
Levofloxacin - High Risk
Lisinopril - high Risk
Magnevist – Risk
Mefloquine - High Risk
Menadiol Sodium Sulfate
(Vitamin K4 sodium sulfate) - High Risk
Menadione - High Risk
Menadione sodium Bisulfite (Vitamin K3 sodium bisulfite) - High Risk
Menthol - High Risk
Mesalazine - High Risk
Metformin - High Risk
Methylene Blue - High Risk
Mirtazapine - Low Risk
Moxifloxacin - High Risk
Nalidixic Acid - High Risk
Naphthalene - High Risk
Nimesulide - High Risk
Niridazole - High Risk
Nitrofurantoin - High Risk
Nitrofurazone - High Risk
Norfloxacin - Low Risk
Oxidase, Urate - High Risk
Pamaquine - High Risk
Para-Aminobenzoic Acid -
Low Risk
Pefloxacin - High Risk
Pentaquine - High Risk
Phenacetin - High Risk
Phenazopyridine - High Risk
Phenylbutazone - Low Risk
Phenylhydrazine - High Risk
Phenytoin - Low Risk
Primaquine - High Risk
Probenecid - High Risk
Procainamide - Low Risk
Proguanil - Low Risk
Pyrimethamine - Low Risk
Quinacrine - High Risk
Quinidine - Low Risk
Quinine - Low Risk
Stibophen - High Risk
Streptomycin - Low Risk
Sulfacetamide - High Risk
Sulfacytine - Low Risk
Sulfadiazine - Low Risk
Sulfadimidine - High Risk
Sulfafurazole - High Risk
Sulfaguanidine - Low Risk
Sulfamerazine - Low Risk
Sulfamethoxazole - High Risk
Sulfamethoxypyridazine -
Low Risk
Sulfanilamide - High Risk
Sulfapyridine - High Risk
Sulfasalazine - High Risk
Sulfathiazole - High Risk
Sulfonylurea - Low Risk
Sulfoxone - High Risk
Tamsulosin - High Risk
Tiaprofenic Acid - Low Risk
Toluidine Blue - High Risk
Trihexyphenidyl - Low Risk
Trimethoprim - Low Risk
Trinitrotoluene - High Risk
Tripelennamine - Low Risk
Vitamin K1 - Low Risk