Quick answer
G6PD deficiency is an inherited condition in which red blood cells can break down when exposed to certain medicines, foods or infections. The Royal Children’s Hospital Melbourne lists triggers including some antibiotics and antimalarials, fava (broad) beans, mothballs and methylene blue, and asks families to make sure everyone who cares for a child with G6PD deficiency — including health professionals — knows about it. A G6PD deficiency medical ID does that job everywhere you go.
Most people with G6PD deficiency feel completely well and never think about it, until something sets it off — a course of antibiotics, a plate of broad beans, a mothball in the wardrobe. Because the condition is invisible and the triggers are everyday things, the most useful protection is making sure anyone about to give a medicine knows first.
What is G6PD deficiency?
According to the Royal Children’s Hospital Melbourne (RCH), G6PD deficiency is a genetic disorder in which the body does not have enough of an enzyme called glucose-6-phosphate dehydrogenase (G6PD). G6PD protects red blood cells. Without enough of it, red blood cells can break down too easily — called haemolysis — when the person is exposed to certain triggers, usually some foods, viruses or medicines.
- It is inherited, more common in males, and usually passed on from the mother, who may have had no symptoms.
- It is more common in people of African, Asian or Mediterranean heritage. RCH notes scientists think about 400 million people worldwide have it.
- There is no cure and it is lifelong, but RCH says most people have a completely normal life as long as they avoid the triggers.
How G6PD deficiency is often found
Many people learn they have it as babies. RCH explains that jaundice is common in the first week of life, but some babies with G6PD deficiency have jaundice for longer than usual, and newborns with persistent jaundice may have a blood test to look for it. Others find out later, after a reaction to a medicine or food. RCH also notes that G6PD deficiency cannot be spread from one person to another.
G6PD symptoms: signs of haemolysis
People with G6PD deficiency only show symptoms when red blood cells are being broken down in excess. RCH lists:
- persistent or severe tiredness
- dark coloured urine
- jaundice (yellow skin or eyes)
- pale skin and lethargy from anaemia
healthdirect also lists G6PD deficiency among the conditions that increase the breakdown of red blood cells and can cause jaundice. RCH advises seeing a GP whenever jaundice or signs of anaemia develop in someone with G6PD deficiency. If someone is seriously unwell or collapses, call Triple Zero (000).
G6PD drugs to avoid, and other triggers
RCH lists the following triggers. The list is written for children; adults should confirm their own list with their doctor or pharmacist, and RCH stresses checking with a doctor or pharmacist before any medicine.
| Group | Triggers listed by RCH |
|---|---|
| Antibiotics | Sulphonamides (check with your doctor), co-trimoxazole, dapsone, chloramphenicol, nitrofurantoin, nalidixic acid |
| Antimalarials | Chloroquine, hydroxychloroquine, primaquine, quinine, mepacrine |
| Chemicals | Mothballs (naphthalene), methylene blue |
| Foods | Fava beans, also called broad beans |
| Other medicines | Sulphasalazine, methyldopa, large doses of vitamin C, hydralazine, procainamide, quinidine, some anti-cancer drugs |
RCH adds that some children with G6PD deficiency must not take aspirin (check with your doctor), that over-the-counter labels should always be checked, and that care is needed with herbal, naturopathic and other complementary therapies. Never give iron or any other tablets without a doctor’s advice.
Paracetamol and G6PD deficiency
A common question is whether everyday pain relief is safe. RCH says paracetamol and NSAIDs (non-steroidal anti-inflammatory drugs) are safe for children with G6PD deficiency. As with everything on this page, check your own situation with your doctor.
G6PD deficiency and favism
RCH explains that some people have a very severe reaction to fava beans, called favism. They are at risk of acute haemolysis, in which red blood cells break down faster than the body can replace them, and this can be life-threatening. Some people with favism are even at risk from the pollen of the fava plant. People with favism always have G6PD deficiency, but not everyone with G6PD deficiency reacts this strongly. If you know you have favism, put it at the top of your record.
Who needs to know
RCH’s advice for parents is to make sure everyone who cares for a child with G6PD deficiency — school, kindergarten, child care, babysitters and health professionals — knows about it, and to give them a printout of the fact sheet. The same logic applies to adults: the people most likely to give you a trigger are a doctor in a hurry, a pharmacist, a travel clinic handing out antimalarials, or a friend with a home remedy.
In an emergency, ANZCOR Guideline 2 includes checking for “physical (eg. alert jewellery) or electronic alert devices (eg. smartphone application) that may be relevant to assessment or management”. A medical ID means the warning reaches the right person even when you cannot speak, or when your child is with someone else.
What a G6PD deficiency medical ID should say
On the band
- G6PD DEFICIENCY
- FAVISM, if you have it
- CHECK ALL MEDICINES
- Your membership number, so the full record can be read
In the profile
- Your diagnosis, and any past episodes of haemolysis and what caused them.
- The medicines and substances to avoid, as confirmed by your own doctor.
- The pain relief and antibiotics your doctor has said are safe for you.
- Your other medicines and conditions.
- Your GP or haematologist and emergency contacts.
The triggers are everyday medicines and foods. Make sure the person giving them knows.
A MedibandPlus profile holds your G6PD deficiency diagnosis, the medicines and foods to avoid, and your doctor’s details behind a membership number on a band you wear. No app, no login, from $19 a year.
Set up your profilePart of the Mediband family. Designed in Australia since 2004.
Travel, school and new prescriptions
- Travel: several antimalarials are on the RCH list. healthdirect advises visiting your doctor or a travel clinic 4 to 6 weeks before travelling to a malaria area, for advice based on your itinerary and medical history — so tell them about your G6PD deficiency before any prescription. Our travel health guide covers what else to pack.
- School and child care: give staff the RCH fact sheet and add the school as a contact in your child’s profile.
- Pharmacies: ask your pharmacist to note G6PD deficiency on your file, and read labels on anything bought over the counter.
For keeping a reliable list of what you take, see tips to manage your medication. If food allergies are also part of your picture, our anaphylaxis first aid guide explains a different kind of reaction and what to do.
FAQs
What is G6PD deficiency?
The Royal Children’s Hospital Melbourne describes it as a genetic disorder in which the body lacks enough of the enzyme G6PD, which protects red blood cells. Certain foods, infections or medicines can then cause red blood cells to break down.
What are the symptoms of G6PD deficiency?
Symptoms only appear when red blood cells are breaking down. RCH lists persistent or severe tiredness, dark coloured urine, jaundice (yellow skin or eyes) and the pale skin and lethargy of anaemia.
What drugs should people with G6PD deficiency avoid?
RCH lists some antibiotics (such as co-trimoxazole, dapsone and nitrofurantoin), antimalarials (such as primaquine and quinine), and other medicines including sulphasalazine and large doses of vitamin C. Always check any medicine with your doctor or pharmacist first.
What foods should be avoided with G6PD deficiency?
RCH lists fava beans, also called broad beans. Some people react very severely to fava beans, a condition called favism, which can be life-threatening.
Is paracetamol safe with G6PD deficiency?
RCH says paracetamol and NSAIDs are safe for children with G6PD deficiency. Check your own situation with your doctor.
Who is more likely to have G6PD deficiency?
RCH says it is more common in males, is usually passed on from the mother, and is more common in people with African, Asian or Mediterranean heritage.
What should a G6PD deficiency medical ID say?
On the band: “G6PD deficiency”, “favism” if relevant, “check all medicines” and a number that opens your record. In the record: diagnosis, past episodes, medicines and foods to avoid, medicines your doctor says are safe, and your doctor and emergency contacts.
Sources
- The Royal Children’s Hospital Melbourne — G6PD deficiency — triggers, symptoms, favism and who needs to know.
- healthdirect — Jaundice — (last reviewed July 2024) G6PD deficiency as a cause of haemolysis.
- healthdirect — Malaria — seeing a doctor or travel clinic 4 to 6 weeks before travel.
- ANZCOR Guideline 2 — Managing an Emergency — checking for alert jewellery and devices.
Disclaimer: This article is general information about recording G6PD deficiency for emergencies, not medical advice. The trigger list quoted is from a children’s fact sheet; which medicines are safe for you is a decision for your own doctor or pharmacist. In an emergency, always call Triple Zero (000). For non-urgent health advice, call healthdirect on 1800 022 222 (NURSE-ON-CALL 1300 60 60 24 in Victoria, 13 HEALTH 13 43 25 84 in Queensland).
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