What to Avoid With a G6PD Deficiency

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a genetic condition that can be passed down from parents to their children. It's a type of hemolytic anemia, meaning oxygen-carrying red blood cells break down too fast (called hemolysis), leading to a lack of red blood cells.

Most people with G6PD deficiency don’t have problems most of the time, but there are certain medications, foods, and substances that increase the rate of red blood cell breakdown and trigger anemia.

This article lists common things you should avoid if you have this blood disorder.

What Is a G6PD Deficiency?

G6PD is an important enzyme (protein) in your body that protects your red blood cells from damage. However, if you have G6PD deficiency, your body makes a smaller amount of G6PD, which can lead to anemia.

What to Avoid

Those with G6PD Deficiency need to avoid certain medications, foods, dyes, and other substances.

G6PD Deficiency Drugs to Avoid

Having G6PD deficiency doesn't mean you can't take any medications. Still, you should know common medications to avoid to prevent damage to your red blood cells.

Certain types of antibiotics can cause red blood cells to break down and need to be avoided:

• “Sulfa” antibiotics, such as Septra and Bactrim (sulfamethoxazole-trimethoprim), that are typically used to treat skin or urinary tract infections
• Quinolone antibiotics, such as Cipro (ciprofloxacin) and Levaquin (levofloxacin), used to treat urinary tract infections (UTIs) and pneumonia in adults
• Nitrofurantoin used for urinary tract infections
• Dapsone used to treat skin infections

These medications can also carry risks and need to be avoided:

• Primaquine, used to treat or prevent malaria, can also trigger a hemolytic crisis in which your body destroys red blood cells faster than it can make new ones. Many people with G6PD deficiency can tolerate other malaria medications.
• Rasburicase is used to treat tumor lysis syndrome, a complication of blood cancers like leukemia. However, it can trigger red blood cell breakdown in people with G6PD deficiency.
• Aspirin is often used to treat pain or inflammation. Some people even take aspirin daily to prevent heart disease. But if you have G6PD deficiency, you shouldn't take it due to a risk of hemolysis.

Screening for G6PD is recommended before taking these medications. This includes testing breastfeeding infants whose mothers take primaquine.

Aspirin is also in many over-the-counter medicines, including:

• Anacin
• Bufferin
• Ecotrin
• Excedrin
• BC Powders
• Goody’s Powders
• Pepto-Bismol

This is not a complete list of items you should avoid if you have G6PD deficiency. 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.

G6PD Deficiency Foods to Avoid

Foods to avoid may include:

• Fava beans: Also known as broad beans, fava beans can trigger a hemolytic attack if you have G6PD deficiency. Favism is another term for G6PD deficiency, especially in severe cases.
• Legumes: Some people recommend removing all legumes (such as beans, peas, lentils, or peanuts) from your diet. But it’s not clear if completely avoiding all legumes is actually necessary, so talk to your healthcare provider.

Other Substances to Avoid

There are some other substances that carry risks for those with G6PD deficiency:

• Mothballs used to get rid of moths and other insects contain a chemical called naphthalene that can trigger hemolysis in those with G6PD deficiency.
• Fumigants (pesticides), especially those used to keep snakes away, can release naphthalene as a vapor (gas). You could be exposed to the chemical by inhaling the vapor or ingesting products that contain it.
• Henna is a popular dye used for temporary tattoos and hair dye, but there are reported cases of henna triggering hemolytic crises in people with G6PD deficiency. Newborns under the age of 2 months are especially sensitive to this reaction.

What to Choose

If you have G6PD deficiency, you can usually follow a standard diet so long as they avoid fava beans and other trigger foods.

Over-the-counter pain relievers like acetaminophen or ibuprofen don't cause issues with G6PD and are alternatives to aspirin.

Talk to your healthcare provider if you have G6PD deficiency and need to take antibiotics or malaria medications, as they can tell you what's safe.

Summary

G6PD is an inherited form of hemolytic anemia that can cause damage to your red blood cells. There are some medications and foods you should avoid if you have this condition.

Certain antibiotic, anti-inflammatory, and anti-malarial medications can trigger red blood cell breakdown. Likewise, fava beans have a similar reaction and are best to avoid as well.