G6PD is an enzyme (I'm not sure what its function is), and I'm G6PD
deficient. I know I can't have aspirine, but now I heard I can't have
Ibuprofen either.

Can someone with G6PD deficiency safely have Ibuprofen, and if not: what can
go wrong if you do use it, and are there any good alternatives?

Hi Juerd!

First and foremost, you should discuss this issue with your physician.
 He or she should be familiar with your case and can make the best
recommendation possible.

Below is information that should provide you with further information:

MEDLINEplus Medical Encyclopedia:  Glucose-6-phosphate dehydrogenase
deficiency
http://www.nlm.nih.gov/medlineplus/ency/article/000528.htm

"Drugs that can precipitate this reaction include: 
* antimalarial agents 
* sulfonamides (antibiotic) 
* aspirin 
* nonsteroidal antiinflammatory drugs (NSAIDs) 
* nitrofurantoin 
* quinidine 
* quinine 
* others

Also: 
* exposure to certain chemicals such as those in mothballs"


Favism & G5PD Brochure
http://www.rialto.com/favism/brochure.pdf
--Includes a list of medicines to avoid.  The "avoid" list does not
include ibuprofen, however it is also not on the "safe" list. 
Acetominophen IS on the safe list so is a possible alternative pain
reliever for you.


The Merck Manual:  Factors Affecting Drug Response
http://www.merck.com/pubs/mmanual_home/sec2/8.htm

"Glucose-6-phosphate dehydrogenase, or G6PD, is an enzyme normally
present in red blood cells that protects these cells from certain
toxic chemicals. About 10 percent of black men and fewer black women
have G6PD deficiency. Some drugs (for example, chloroquine, pamaquine,
and primaquine, used to treat malaria, and aspirin, probenecid, and
vitamin K) destroy the red blood cells in people with G6PD deficiency,
causing hemolytic anemia."


Blood Disorders:  G6PD
http://www.methodisthealth.com/blood/glucose.htm
--Includes drugs to avoid; ibuprofen not listed.

***

From a Forum site:
--NOTE:  These are the quoted personal experiences of individuals, NOT
input from a medical expert):

Favism Open Forum Site
http://www.rialto.com/favism/favdigst.htm

"Ibuprofen? 

Su-Laine Yeo syeo@lightspeed.bc.ca 
Sun, 23 Feb 1997, 23:3 
Does anyone know if ibuprofen and other anti-inflammatory drugs are
contra-indicated for people with G6PD deficiency?

Kathy kkmrk5@ix.netcom.com 
Sat, 12 Apr 1997, 12:51 
My father and 2 of my sons have the severe G6PD defic. and take Advil
regularly. My father takes 2400 mg. of Ibuprofen and does not have any
problems. He has done this for 20 plus yrs.

Jennifer jah@utsi.com 
Tue, 15 Apr 1997, 17:41 
I am 22 yrs. and have never had any problems with Ibuprofen. I just
try not to overdo it.

Joe D'Amico jdamico@ix.netcom.com 
Wed, 2 Jul 1997, 10:29 
I and many of my family have G6PD, and use NON Aprin pain relievers
all the time and never have had a problem, My uncle is a hemotologist,
and says stay away from aspirin and fava beans, but just about all
else is fine.

Capt. Jamshed Parakh jdparakh@hotmail.com 
Fri, 28 Nov 1997, 3:49 
I have been taking Ibuprofen for a while and it hasent affected me --
but recently there is a medical thesis which is trying to show that
Ibuprofen at times causes internal hemmoraging if taken for long
periods -- specially so in elders,therefore we all need to be careful
and take it only when absolutely necessary and not get addicted !!!

George J. Reclos Ph.D. reklos@mail.otenet.gr 
Thu, 24 Sep 1998, 04:44 
It is true that most drugs are "stated" to be safe. Even aspirin is
said to be safe !! If you search Medline (a database for medical
articles) you will be surprised to see that even aspirin is regarded
to be safe.

Following a recent work that we plan to put forward, there is great
suspicion that in most elderly patients receiving these drugs
(aspirin, ibuprofen etc), there may be a subclinical haemolytic
situation which is counterbalanced by the organism up to a point. This
shoudl be a very fragile equilibrium and could be destroyed any
minute. In short, drugs which are listed as (potentially) dangerous,
should be always avoided. After all, it may affect only 1% of the
deficient patients. If this happens to you then it is 100% for your
case. Statistics is merely numbers."

***

SEARCH STRATEGY

To continue researching, click on the search results below:

g6pd deficiency ibuprofen
://www.google.com/search?num=100&hl=en&lr=&ie=UTF-8&oe=UTF8&q=g6pd+deficiency+ibuprofen&spell=1

g6pd ibuprofen site:.edu
://www.google.com/search?as_q=g6pd+ibuprofen&num=100&hl=en&ie=UTF-8&oe=UTF8&btnG=Google+Search&as_epq=&as_oq=&as_eq=&lr=&as_ft=i&as_filetype=&as_qdr=all&as_occt=any&as_dt=i&as_sitesearch=.edu&safe=images

Glucose-6-phosphate dehydrogenase deficiency ibuprofen
://www.google.com/search?num=100&hl=en&lr=&ie=UTF-8&oe=UTF8&as_qdr=all&q=Glucose-6-phosphate+dehydrogenase+deficiency+ibuprofen

***

As I indicated at the onset of this answer, you should definitely
speak with your doctor about what's best for you.

Please don't hesitate to request clarification if you need further
information!  I'm happy to provide more details.

>Librarygopher

---

Clarification of Answer by librarygopher-ga on 01 Jul 2002 10:55 PDT

Glad I could help!  

>Librarygopher

A very thorough answer that answered not only my question but also
some question that I didn't even ask :)

Thanks!

Perhaps you could show your doctor this article, just to add some more
info on the subject. It is about a compound chemically related to
ibuprofen, named ketoprofen lysine salt, which appears to be safe (it
has been used in 19 children with G6PD deficiency). However, a single
article normally is not considered as conclusive evidence on a complex
subject like Medicine is.
Regards,
Tom136

Pediatr Med Chir 1996 Jul-Aug;18(4):391-4	

[Use of the NSAID ketoprofen lysine salt in glucose-6-phosphate
dehydrogenase (G6PD) deficiency in inflammatory disease in children]

[Article in Italian]

Corda R, Carnelli V.

Clinica Pediatrica Universitaria di Cagliari, Italia.

Nineteen young females, aged 4 months-13 years, suffering from
intermediate erythrocyte G6PD deficiency plus 14 hemizygote males,
aged 6 months and 16 years, and one dizigote and completely deficient
female were treated with ketoprofen lysine salt for upper and lower
respiratory tract diseases. The drug was administered rectally at the
dose of 30 or 60 mg twice or thrice a day according to the weight of
the patients, i.e. around 2,5 mg ketoprofen lysine salt pro kg.
Concomitant drugs were present in 6 cases, i.e. antibiotics and or
inhaled corticosteroids. Fever disappeared within two days in 80% of
cases. No systemic and/or local adverse event or haemolysis was
evident both clinically and at laboratory analysis. Ketoprofen lysine
salt, when administered for a short time period, is effective and safe
also in G6PD deficient patients.

I have been force fed Motrin and Ibuprfen for 20 years in the military
for any and every pain known to man.  I just found out today that I
have the deficiency.  To my knowledge, I have had no effects from it. 
Can someone tell me what kind of side effects that there are.  From
not so extreme to just fall down OUCH.