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Drugs that should be avoided - Official List

Bergwolf G6PD浩宇

这个列表有每种药的化学式.

Name Molecular Formula Risk Leve(Note[1]) For Whom Notes
Streptomycin C21 H39 N7 O12 Low All
Colchicine C22 H25 N O6 Low All
Mepacrine (Quinacrine) C23 H3O Cl N3 O High Medit., Asian
Glucosulfone (glucosulfone sodium) C24 H34 N2 Na2 O18 S3 High All
Doxorubicin C27 H29 N O11 High Medit., Asian
Dimercaprol C3 H8 O S2 High All
Phytomenadione (Vitamin K1) C31 H46 O2 Low All
Glibenclamide C32 H28 Cl N3 O5 S High Medit., Asian Note[2]
Isobutyl Nitrite C4 H9 N O2 High Medit., Asian
Pamaquine C42 H45 N3 O7 High All
Niridazole C6 H6 N4 O3 S High All
Nitrofural (nitrofurazone) C6 H6 N4 O4 High All
Isoniazid C6 H7 N3 O Low All
Phynylhydrazine C6 H8 N2 High All
Sulfanilamide (Sulphanilamide) C6 H8 N2 O2 S High All
Ascorbic Acid C6 H8 O6 Low All
Sulfaguanidine C7 H10 N4 O2 S Low All
Trinitrotoluene (2,4,6-Trinitrotoluene) C7 H5 N3 O6 High Medit., Asian
Para-Aminobenzoic Acid (4-Aminobenzoic Acid) C7 H7 N O2 Low All
Mesalazine - 5-Aminosalicylic Acid (paraminosalicylic acid) C7 H7 N O3 High Medit., Asian
Acetylphenylhydrazine (2-Phynylacetohydrazide) C8 H10 N2 O High All Note[3]
Sulfacetamide C8 H10 N2 O3 S High All
Dopamine (L-dopa) C8 H11 N O2 Low All
Nitrofurantoin C8 H6 N4 O5 High All
Furazolidone C8 H7 N3 O5 High All
Acetanilide (acetanilid) C8 H9 N O High Medit., Asian
Paracetamol (acetaminophen) C8 H9 N O2 Low All
O-Acetylsalicylic Acid (acetylsalicylic acid) C9 H8 O4 High Medit., Asian Note[4]
Thiazosulfone (thiazolesulfone) C9 H9 N3 O2 S2 High Medit., Asian
metamizole C13H16N3NaO4S High Medit., Asian
Arginine (acido 2(S)-ammino-5-guanidilpentanoico) C6H14N4O2 Low
Brinzolamide High All Note[5]
Dorzolamide High All Note[6]
Oxidase, Urate (urate oxidase) High Medit., Asian
Arsine As-H3 High All Note[7]
Sulfadiazine C10 H10 N4 O2 S Low All
Sulfamethoxazole C10 H11 N3 O3 S High All Note[8]
Phenacetin (acetophenetidin) C10 H13 N O2 High Medit., Asian Note[9]
Naphtalene, Pure (naphtalin) C10 H8 High All
Beta-Naphthol (2-Naphthol) C10 H8 O High All
Sulfapyridine C11 H11 N3 O2 S High All
Phenazopyridine C11 H11 N5 High Medit., Asian
Chloramphenicol C11 H12 C12 N2 O5 High Medit., Asian
Phenazone (antipyrine) C11 H12 N2 O Low All
Sulfamerazine C11 H12 N4 O2 S Low All
Sulfamethoxypyridazine C11 H12 N4 O3 S Low All
Sulfafurazole (sulfafurazone, sulfisoxazole) C11 H13 N3 O3 S High Medit., Asian
Proguanil (chlorguanidine) C11 H16 Cl N5 Low All
Menadiol Sodium Sulfate (Vitamin k4 sodium sulfate) C11 H8 Na2 O8 S2 High All Note[10]
Menadione (menaphtone) C11 H8 O2 High All Note[11]
Menadione sodium Bisulfite (Vitamin K3 sodium bisulfite) C11 H8 O2 NaHSO3 High All Note[12]
Dapsone (diaphenylsulfone) C12 H12 N2 O2 S High All Note[13]
Nalidixic Acid C12 H12 N2 O3 High Medit., Asian Note[14]
Pyrimethamine C12 H13 Cl N4 Low All
Sulfadimidine C12 H14 N4 O2 S High All
Sulfacytine C12 H14 N4 O3 S Low All
Stibophen (2-(2-Oxido-3,5-Disulphonatophenoxy)-1,3,2,Benzodioxastibole-4-6-Disulphonate) C12 H4 Na5 O16 S4 Sb High All
Aminophenazone (aminopyrine) C13 H17 N3 O Low All
Probenecid C13 H19 NO4 S High All
Procainamide C13 H21 N3 O Low All
Tiaprofenic Acid C14 H12 O3 S Low All
Aldesulfone sodium (sulfoxone) C14 H14 N2 Na2 O6 S3 High All
Trimethoprim C14 H18 N4 O3 Low All Note[15]
Tolonium Chloride, Tolonium Chloride (toluidine blue) C15 H16 Cl N3 S High All
Primaquine C15 H21 N3 O High All Note[16]
Methyltioninium Chloride (methylene blue) C16 H18 Cl N3 S High All
Norfloxacin C16 H18 F N3 O3 Low All
Tripelennamine C16 H21 N3 Low Medit., Asian
Ciprofloxacin C17 H18 F N3 O3 High Medit., Asian Note[17]
Antazoline (antistine) C17 H19 N3 Low All
Diphenhydramine (difenilhydramine) C17 H21 N O Low All
Sulfasalazine, Salazosulfapyridine (salazopyrin) C18 H14 N4 O5 S High All
Chloroquine C18 H26 Cl N3 High Medit., Asian Note[18]
Pentaquine C18 H27 N3 O High All
Phenylbutazone C19 H20 N2 O2 Low All
Phenytoin C19 H20 N2 O2 Low All
Quinidine C20 H24 N2 O2 Low All
Quinine C20 H24 N2 O2 Low All
Trihexyphynidyl (benzhexol) C20 H31 N O Low All

NOTE:

[1] Low risk means that for common G6PD deficiency variants these may be considered safe in most cases, when taken in normal therapeutic doses. However, they might provoke hemolysis when taken in large doses (accidental ingestion, poisoning, special treatments) or in the period preceding birth, or in presence of other pathologies.
[2] Hemolytic reactions to this substance have been reported only in few, isolated cases and no written reference exists as of this time.
[3] These substances taken in high quantities might cause hemolysis also with normal subjects.
[4] Among the alternatives are Paracetamol, which is generally considered safe, and flurbiprophene.
[5] See http://marineyes.com/glaucoma/medications.html
[6] See http://marineyes.com/glaucoma/medications.html
[7] These substances taken in high quantities might cause hemolysis also with normal subjects.
[8] A component, together with Trimetroprim, of Co-trimoxazole.
[9] Probably safe in moderate doses.
[10] Synthetic substitutes of natural Vitamin K. Other substitutes non listed here are: menadiole diacetate, menadiole sodium phosphate (anhydrous salt). As treatment of hemorrhage in newborns, a single dose of this substance may be given (via parenteral) on the first day after birth and is well tolerated. The writers of these note (2,16) generally consider all Vitamin K substitutes as potentially hemolysis inducing substances. It is probable that natural Vitamin K1 (phyto-menadione) presents a lower risk.
[11] Synthetic substitutes of natural Vitamin K. Other substitutes non listed here are: menadiole diacetate, menadiole sodium phosphate (anhydrous salt). As treatment of hemorrhage in newborns, a single dose of this substance may be given (via parenteral) on the first day after birth and is well tolerated. The writers of these note (2,16) generally consider all Vitamin K substitutes as potentially hemolysis inducing substances. It is probable that natural Vitamin K1 (phyto-menadione) presents a lower risk.
[12] Synthetic substitutes of natural Vitamin K. Other substitutes non listed here are: menadiole diacetate, menadiole sodium phosphate (anhydrous salt). As treatment of hemorrhage in newborns, a single dose of this substance may be given (via parenteral) on the first day after birth and is well tolerated. The writers of these note (2,16) generally consider all Vitamin K substitutes as potentially hemolysis inducing substances. It is probable that natural Vitamin K1 (phyto-menadione) presents a lower risk.
[13] These substances taken in high quantities might cause hemolysis also with normal subjects.
[14] Hemolytic reactions to this substance have been reported only in few, isolated cases and no written reference exists as of this time.
[15] Component, together with Sulfametossazole, of Co-trimoxazolo.
[16] May be given in reduces doses under medical supervision.
[17] Hemolytic reactions to this substance have been reported only in few, isolated cases and no written reference exists as of this time.
[18] If required, this substance may be taken under medical supervision as a preventive treatment or cure of malaria.


Miscellaneous elements besides drugs that should be avoided:

Fava Beans

(Some, but only some, prefer also to avoid red wine, henna (see below), all legumes, blueberries [also yogurts containing these], soya products, tonic water: whether you should avoid any of these would depend on your enzyme deficit level and mutation.)

Henna

Black Henna (Indigofera tinctoria), Red Egyptian Henna (Lawsonia inermis) and other related dyes, used for both tattoos and hair dyes. Ann Trop in Pediatr 16: 287, 1996 and Kök AN, Ertekin MV, Ertekin V, Avci B. in Int J Clin Pract 58: 530, 2004) have shown that henna might trigger in G6PD deficient persons hemolytic crisis or at least an excessive hemolysis.

In vitro experiments suggest that the substance responsible for such hemolysis is 2-hydroxy-1,4-naphthoquinone (or lawsone: see Pediatrcis 97:707,1996).

[Information generously offered to the Association by Prof. Lucio Luzzatto, Scientific Director at the Istituto Toscano Tumori, Firenze, Italy; Consultant at the Department of Human Genetics and Division of Hematologic Oncology at the Department of Medicine Memorial Hospital for Cancer and Allied Diseases at the Memorial Sloan Kettering Cancer Center, New York].

Glaucoma

Please note that the following medications often prescribed to fight glaucoma are contraindicated for persons suffering from G6PD deficiency:
Dorzolamide (trade name, Trusopt), Brinzolamide (Azopt) and Acetazolamide (Diamox pills).
For a detailed list of eye drops or pills that can and cannot be taken by G6PD deficient persons who suffer from glaucoma please see:
http://marineyes.com/glaucoma/medications.html.


需要避免的中药

牛黄

Cattle Gallstone Bezoar
(Bos Taurus Domesticus)
Cool.
Influences the heart and liver channels. Opens up the senses, dissolves phlegm, extinguishes wind, neutralizes fire-toxins and stops tremors.
Commonly used to treat fainting, mental disorders, convulsions, high fever and all forms of hot, red swellings

金银花

Honeysuckle
(Lonicera Japonica)
Cold.
Influences the large intestine, lung and stomach channels. Clears dampness in the lower body, relieves externally caused wind and clears fire toxicity.
Commonly used to treat painful urination, fever, sore throat, headache, sores, swellings and abcesses

腊梅花

Chimonanthus Flower
(Chimonanthus Praecox)
Neutral.
Influences the liver and lung channels. Neutralizes heat-toxins, clears phlegm and activates blood and circulation.
Commonly used to treat fever, sore throat and painful eye problems. Also used to clear the last stage of measles

黄莲/川莲

Huang Lian (黄连)
Mainly yielded in the province of Si Chuan (四川), therefore it’s also called Chuan Lian (川连). Bitter in flavour, cold in property. Acting on heart, stomach, liver & large intestine channels. It clears away heat, dries dampness, purges fire and clears toxins. Commonly used to treat diarrhea, high fever and suppurative infections of the damp-heat type.
[Courtesy of John Lew, Physician, Traditional Chinese Medicine, www.lews.info]

珍珠粉

100% Pearl Powder
Used to clear excess heat, settle the mind and frequent, fitful dreams. It can also be applied externally for mild acne and to promote a clear and clean complexion.

Bergwolf
Everyday citizen, A gear