Blood Disorders Anemia 7 Things You Should Avoid If You Have G6PD Deficiency By Amber Yates, MD twitter linkedin Amber Yates, MD, is a board-certified pediatric hematologist and a practicing physician at Baylor College of Medicine. Learn about our editorial process Amber Yates, MD Medically reviewed by Medically reviewed by Douglas A. Nelson, MD on July 26, 2020 linkedin Douglas A. Nelson, MD, is double board-certified in medical oncology and hematology. He was a physician in the US Air Force and now practices at MD Anderson Cancer Center, where he is an associate professor. Learn about our Medical Review Board Douglas A. Nelson, MD Updated on July 26, 2020 Print Glucose 6 phosphate dehydrogenase (G6PD) deficiency is an inherited type of hemolytic anemia, a form of anemia that occurs when the red blood cells are broken down faster than usual (this is called hemolysis). In G6PD deficiency this occurs because you make a reduced amount of G6PD, an enzyme that protects the red blood cell from damage. Fortunately, most people with G6PD deficiency do not have problems on a daily basis. However, there are certain medications or foods that increase the rate of red blood cell breakdown. Let's review some of the common things that can cause problems in this blood disorder. G6PD Deficiency Overview and More 1 Antibiotics GP Kidd / Getty Images People with G6PD deficiency can tolerate most antibiotics but should be aware of a select few that can initiate significant red blood cell breakdown leading to anemia. Antibiotics referred to as "sulfa" drugs should be avoided. These antibiotics are typically used to treat skin or urinary tract (bladder) infections. The most common form of these antibiotics goes by the brand names Septra or Bactrim (sulfamethoxazole-trimethoprim). The "quinolone" antibiotics should also be avoided. The two most common antibiotics in this group are Cipro (ciprofloxacin) and Levaquin (levofloxacin). These antibiotics are commonly used in adults to treat urinary tract infections and pneumonia. Other antibiotics that should be avoided include nitrofurantoin and dapsone. Fortunately, there are many antibiotics that people with G6PD deficiency can take safely. Make sure to discuss your condition with your physician if you have G6PD deficiency and require antibiotic therapy. 2 Malaria Medications Benjamin Van Der Spek / Getty Images Primaquine, a medication used to treat or prevent malaria, can trigger hemolytic crises in people with G6PD deficiency. Because of this possible complication, it is recommended that people be tested for G6PD deficiency prior to taking primaquine. This includes breastfeeding infants whose mothers take primaquine. Fortunately, other medications used to treat malaria are tolerated by most people with G6PD deficiency. 3 Cancer Treatment Medications Medic Image / Getty Images Rasburicase is a medication used to treat tumor lysis syndrome, a medical complication of hematologic cancers like leukemia. It should not be used in people with G6PD deficiency. Because of this risk, it is recommended that people be tested prior to receiving rasburicase. 4 Aspirin Lauren Nicole / Getty Images Aspirin, commonly used to treat pain or inflammation, should be avoided. Some people take aspirin daily as part of their treatment regimen. When avoiding aspirin, it is important to remember that it is found in many over-the-counter medications like Anacin, Bufferin, Ecotrin, Excedrin, BC Powders and Goody's Powders. It is also found in Pepto-Bismol. In general, other over-the-counter pain relievers like acetaminophen or ibuprofen are tolerated without issues. 5 Mothballs VOISIN / Getty Images Yes, people still use mothballs. Mothballs can contain a chemical known as naphthalene which can trigger hemolysis in people with G6PD deficiency. Naphthalene can also be found in fumigants, particularly those used to keep snakes away. Naphthalene is a vapor given off by these products, so exposure may come from inhaling the vapor or ingesting them. 6 Henna Bill Diodato / Getty Images There are case reports published indicating henna (used for temporary tattoos or hair dye) has triggered hemolytic crises in people with G6PD deficiency. Newborns under the age of 2 months appear to be more susceptible to this reaction. 7 Fava Beans Laurence Mouton / Getty Images G6PD deficiency, and particularly the most severe forms, is also called favism. This is because the ingestion of fava beans (also known as broad beans) can trigger hemolytic attacks in patients with G6PD deficiency. Some suggest that all legumes (such as peas, lentils, or peanuts) be avoided, but whether or not this is actually needed is unknown. A Word From Verywell If you have G6PD deficiency, it doesn't mean you cannot take medications. You should be aware of common medications to avoid. This is not a complete list of items that people with G6PD deficiency should avoid. 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. Make sure you discuss all your new medications with your physician to make sure they are not contraindicated for people with G6PD deficiency. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. NIH U.S. National Library of Medicine. Glucose-6-phosphate dehydrogenase deficiency. Updated May 2017. KidsHealth. G6PD deficiency. Updated July 2018. Akande M, Audino AN, Tobias JD. Rasburicase-induced hemolytic anemia in an adolescent with unknown glucose-6-phosphate dehydrogenase deficiency. J Pediatr Pharmacol Ther. 2017;22(6):471–475. doi:10.5863/1551-6776-22.6.471 Feghaly J, Al Hout AR, Mercieca Balbi M. Aspirin safety in glucose-6-phosphate dehydrogenase deficiency patients with acute coronary syndrome undergoing percutaneous coronary intervention. BMJ Case Rep. 2017;2017:bcr2017220483. doi:10.1136/bcr-2017-220483 Raupp P, Hassan JA, Varughese M, Kristiansson B. Henna causes life threatening haemolysis in glucose-6-phosphate dehydrogenase deficiency. Arch Dis Child. 2001;85(5):411–412. doi:10.1136/adc.85.5.411