7 Things You Should Avoid If You Have G6PD Deficiency

By
Amber Yates, MD
amber yates
Amber Yates, MD
Amber Yates, MD, is a board-certified pediatric hematologist and a practicing physician at Baylor College of Medicine.
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Updated on October 04, 2021
Medically reviewed
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 by
Douglas A. Nelson, MD
Douglas A. Nelson
Medically reviewed by Douglas A. Nelson, MD

Douglas A. Nelson, MD, is a board-certified oncologist and hematologist who previously served for 13 years as a physician in the US Air Force.

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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. This means that oxygen-carrying red blood cells break down too fast (called hemolysis), leading to a lack of red blood cells.

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.

Fortunately, most people with G6PD deficiency don’t have problems most of the time. But certain medications and foods can increase the rate of red blood cell breakdown and trigger anemia.

Let’s review some of the common things you should avoid if you have this blood disorder.

1

Antibiotics

Woman's fingers holding a red and white pill capsule

GP Kidd / Getty Images

People with G6PD deficiency can tolerate most antibiotics. Yet several antibiotics can cause red blood cells to break down.

If you have G6PD deficiency, you shouldn't take antibiotics known as “sulfa” drugs. These antibiotics are typically used to treat skin or urinary tract infections. Septra and Bactrim (sulfamethoxazole-trimethoprim) are some common brand names you might encounter.

You should also avoid “quinolone“ antibiotics. Cipro (ciprofloxacin) and Levaquin (levofloxacin) are two popular medications in this group. They are often used to treat urinary tract infections (UTIs) and pneumonia in adults.

Nitrofurantoin and dapsone are additional antibiotics to avoid. 

The good news? Many other antibiotics are safe for people with G6PD deficiency. Talk to your doctor if you have G6PD deficiency and need to take antibiotics. They can tell you what's safe to take.

Recap

You should avoid these antibiotics if you have G6PD deficiency:

  • Sulfa drugs, including Septra and Bactrim
  • Quinolones, including Cipro and Levaquin.
  • Nitrofurantoin
  • Dapsone

If you need to take antibiotics, make sure your doctor knows you have G6PD deficiency.

2

Malaria Medications

Mosquito landed on a white pill

Benjamin Van Der Spek / Getty Images

Primaquine is a medicine used to treat or prevent malaria. But it can also trigger a hemolytic crisis in people with G6PD deficiency. A hemolytic crisis is when your body destroys red blood cells faster than it can make new ones.

Because of this potential complication, experts recommend extra precautions. They recommend testing people for G6PD deficiency before they take primaquine. This includes testing breastfeeding infants whose mothers take primaquine.

Fortunately, many people with G6PD deficiency can tolerate other malaria medications.

3

Cancer Treatment Medications

Nurse preparing intravenous medication

Medic Image / Getty Images

Rasburicase is a medicine used to treat tumor lysis syndrome. The syndrome is a complication of blood cancers like leukemia. 

However, rasburicase can trigger red blood cell breakdown in people with G6PD deficiency. For this reason, experts recommend screening for the condition before using rasburicase.

4

Aspirin

Aspirin pills scattered on white tabletop

Lauren Nicole / Getty Images

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.

But it's important to know that aspirin is also in many over-the-counter medicines, including:

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

Looking for alternatives for pain relief doesn’t have to be difficult, though. Other over-the-counter pain relievers like acetaminophen or ibuprofen don't cause issues with G6PD.

5

Mothballs

Woman putting moth balls between towels

VOISIN / Getty Images

Yes, people still use mothballs, mainly to get rid of moths and other insects. Mothballs contain a chemical called naphthalene. This chemical can trigger hemolysis in those with G6PD deficiency.

Naphthalene can also be in fumigants (pesticides), especially those used to keep snakes away.

Naphthalene is a vapor (gas) given off by these products. So you could be exposed to the chemical by inhaling the vapor or ingesting products that contain it.

6

Henna

Hand with Henna

Bill Diodato / Getty Images

Henna is a popular dye used for temporary tattoos and hair dye. 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.

7

Fava Beans

Raw shelled beans in a bowl
Laurence Mouton / Getty Images

Did you know that favism is another term for G6PD deficiency, especially in severe cases? Fava beans (also known as broad beans) can trigger a hemolytic attack if you have G6PD deficiency.

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.

Summary

G6PD is an inherited form of hemolytic anemia that can cause damage to your red blood cells. Many people with G6PD deficiency don't experience any symptoms at all on a daily basis.

That said, 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.

A Word From Verywell

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.

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.

Tell your doctor about any new medications you’re taking. They can let you know whether the medications are safe to take with G6PD deficiency.

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5 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.

  1. U.S. National Library of Medicine. MedlinePlus. Glucose-6-phosphate dehydrogenase deficiency.

  2. Nemours KidsHealth. G6PD deficiency.

  3. 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

  4. 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

  5. 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

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