Médicaments à risque en cas de déficit en glucose-6-phosphate deshydrogénase

The best known morbid effect of glucosephosphate dehydrogenase (G-6PD) deficiency is hemolysis induced by oxidative drugs. When prescribing drugs for G-6PD deficient subjects, two points should be kept in mind: different genetic variants of G-6PD deficiency entail different susceptibility to the hemolytic risk from drugs; thus a drug found to be safe in some G-6PD deficient subjects may not be equally safe in others; the risk and severity of hemolysis is almost always dose-related. The purpose of this paper is to underline the main drugs that cannot be safely administrated to G-6PD deficient subjects. They can be separated in drugs that must be avoided by G-6PD deficient subjects (such as sulphonamides, quinolones, nitrofurantoin), and drugs that do not systematically precipitate hemolysis but must nevertheless be prescribed with caution.