Which medication holds a definite risk of haemolysis in most individuals with G6PD deficiency?

Which medication holds a definite risk of haemolysis in most individuals with G6PD deficiency?

• A. Paracetamol
• B. Ibuprofen
• C. Ciprofloxacin
• D. Amoxicillin

Answer: (C)

G6PD deficiency makes red blood cells particularly sensitive to oxidative stress because NADPH production and reduced glutathione regeneration are impaired, so drugs that create oxidative burden can trigger intravascular hemolysis. Drugs that are most consistently linked to hemolysis in people with this deficiency are those that generate oxidative stress, such as sulfonamides (e.g., certain antibiotics like sulfamethoxazole-trimethoprim), nitrofurantoin, dapsone, primaquine, and methylene blue (with some antimalarials also carrying risk in certain cases). Many other commonly used medicines do not pose a definite risk at standard doses. Among the options listed, paracetamol, ibuprofen, ciprofloxacin, and amoxicillin are not classically associated with a definite risk of hemolysis in most individuals with G6PD deficiency. If you encounter a question like this on an exam, it reflects the distinction between high-risk oxidant drugs and those generally considered safe in G6PD deficiency; always favor alternatives when a patient’s G6PD status is known.

G6PD deficiency makes red blood cells particularly sensitive to oxidative stress because NADPH production and reduced glutathione regeneration are impaired, so drugs that create oxidative burden can trigger intravascular hemolysis.

Drugs that are most consistently linked to hemolysis in people with this deficiency are those that generate oxidative stress, such as sulfonamides (e.g., certain antibiotics like sulfamethoxazole-trimethoprim), nitrofurantoin, dapsone, primaquine, and methylene blue (with some antimalarials also carrying risk in certain cases). Many other commonly used medicines do not pose a definite risk at standard doses.

Among the options listed, paracetamol, ibuprofen, ciprofloxacin, and amoxicillin are not classically associated with a definite risk of hemolysis in most individuals with G6PD deficiency. If you encounter a question like this on an exam, it reflects the distinction between high-risk oxidant drugs and those generally considered safe in G6PD deficiency; always favor alternatives when a patient’s G6PD status is known.