Can paracetamol be used for favism?

Late one night, a doctor came to the pharmacy to ask a question: "Can paracetamol be used for favism?" So the question is, what is favism? And what medicines can't be used for it?

Favism is a hereditary disease, a phenotype of erythrocyte glucose-6-phosphate dehydrogenase (G-6-PD) deficiency. When the baby lacks G-6-PD, the red blood cells in the blood are easily damaged by oxides, which leads to red blood cell rupture and hemolysis. This disease is more common in children and is more common in southern my country, with the highest incidence in Guangdong, Guangxi, Sichuan, Hunan and Jiangxi.

The following are the main types of drugs that should be avoided for favism:

1. Traditional Chinese Medicine

There is currently clear research showing that patients with favism should avoid using Chinese medicines such as bezoar, honeysuckle, Sichuan lotus, pearl powder, and wintersweet flowers, or Chinese patent medicines containing the above ingredients.

2. Western medicine

1) Antimicrobial drugs

Levofloxacin, moxifloxacin, ciprofloxacin, co-sulfamethoxazole, furazolidone, nitrofuracil, chloroquine, primaquine, streptomycin, isoniazid, chloramphenicol, etc.

2) Antidiabetic drugs

Such as glibenclamide, gliclazide, glimepiride, glipizide, etc.

3) Vitamins

Such as vitamin K3, vitamin K4, vitamin K1, and vitamin C.

4) Antipyretic and analgesic drugs

Such as acetaminophen, analgin, aspirin, aminopyrine, etc.

5) Others

Hydroxychloroquine, isosorbide dinitrate, sulfasalazine, methylene blue, bupivacaine. Drugs with lower risks include chlorpheniramine, diphenhydramine, colchicine, dopamine, doxorubicin, matrine, levodopa, phenytoin sodium, trihexyphenidyl, etc.

Therefore, for babies with favism who have fever, acetaminophen (paracetamol) should be avoided, and ibuprofen can be used to reduce fever.

(Duan Tingting, Qingdao Women and Children's Hospital)