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Is Nifuroxazide Safe For G-6_PD Deficiency?

Posted on Mon, 22 Jun 2015

Question: Hi Doctor,

I'm G6PDD and I used to use a medicine called "Antinal" -nifuroxazide- for intestinal antiseptic, but I've seen some sites claiming that "nifuroxazide" is not safe for G6PDD.

My question is: is "nifuroxazide" safe for G6PDD? and if not what is the alternative that I can use safely?

Thank you and regards,
XXXXXXX

Answered by Dr. Shailja Puri (35 minutes later)

Brief Answer:
Nifuroxazie is not to be used in G-6_PD deficiency

Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.

You must well aware about the cause and clinical features of G-6-PD deficiency disease.
It is caused due to deficiency of enzyme G-6-PD and as a effect it leads to hemolysis of red blood cells ultimately leading to anemia.
hemolysis of red blood cells takes place under specific conditions like infections, oxidative stress due to certain chemicals or drugs.
The group of drugs which causes oxidative stress are anti-malarial, sulpha drugs, nitrofuran group of antibiotics etc.
Nifuroxaide is one of the drugs of nitrofuran group and is not recommended to patients of G-6-PD deficiency.
Alternative antibiotic can be used.
Sulpha group, quinolone group have also to be avoided.
You can used cephalosporin or aminoglycoside group, however, under supervision of your doctor.
I suggest you to stop the antibiotic all together and consult your hematologist to get a list of food items and drugs to be avoided.

I hope I am able to address your query completely.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Shailja Puri (24 hours later)

Dear Dr Shailja Puri,

Thank you for your answer.

I'm concerned now about my mother and daughter because according to inheritance chart in most medical and nonmedical websites such as http://g6pddeficiency.org/;

my mother must be also G6PD deficient and my daughter may be a partially G6PD deficient, but nothing is 100% confirmed.

My question is; what is the test other than G6PD qualitative and quantitative blood test that my mother and daughter should undergo to be completely sure if they are G6PD deficient or not, so they avoid contradiction food and drug list or this is the only test available so far?

and what is the most accurate medical database to check if a drug should be avoided, I use the database of the website http://g6pddeficiency.org/ and it's very useful, but I appreciate if you can help me with an authorative medical website if possible?

Thank you for your help and support.
XXXXXXX XXXXXXX

Answered by Dr. Shailja Puri (10 minutes later)

Brief Answer:
G-6-PD gene mutation by RT-PCR, information on website is satisfactory

Detailed Answer:
Hello and welcome again,

The quantitative test for G-6-PD enzyme is good enough to assess whether any type of deficiency is present in any of your family members.
But you can go for G-6-PD gene mutation by RT PCR to look for presence of mutation. This is the gold standard to assess whether the enzyme is sufficient or not.
The website mentioned by you is authentic enough to follow.
However, if you are not satisfied with the information on internet, you can consult your hematologist.
In fact a list of food items and medicines is given to the patient when he/ she is diagnosed with G-6-PD deficiency. I am sure you too must have got one.

If you want to see medical literature (cases reports, researches, etc) as posted by researchers, you can visit pubmed, medline, cochrane database of systematic reviews and medical textbooks.

I hope all your concerns are addressed.

Thanks and take care
Dr Shailja Puri

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Above answer was peer-reviewed by : Dr. Vaishalee Punj