# Glucose-6-Phosphate Dehydrogenase Deficiency (Favism) - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: Egyptian National Drug Formulary - Blood Disorder Medications 2025 (folic acid monograph) · Paracetamol 500mg SmPC (https://www.medicines.org.uk/emc/product/5192/smpc) · WHO Working Group on G6PD Deficiency 2022 - Verified date: 2026-08 ## Verified against - Egyptian National Drug Formulary - Blood Disorder Medications 2025 (folic acid monograph) - Paracetamol 500mg SmPC (https://www.medicines.org.uk/emc/product/5192/smpc) - Glucose-6-Phosphate Dehydrogenase Deficiency - disease-level clinical article (g6pd-deficiency-full.txt) ## Treatment metadata - Referral & safety-netting (no drug therapy) - Folic acid — 5 mg — oral.solid ## Complete treatment card ```text GLUCOSE-6-PHOSPHATE DEHYDROGENASE DEFICIENCY (FAVISM) Sources: Egyptian National Drug Formulary - Blood Disorder Medications 2025 (folic acid monograph) · Paracetamol 500mg SmPC (https://www.medicines.org.uk/emc/product/5192/smpc) · WHO Working Group on G6PD Deficiency 2022 Review status: REVIEWED against Egyptian National Drug Formulary - Blood Disorder Medications 2025 (folic acid monograph), Paracetamol 500mg SmPC (https://www.medicines.org.uk/emc/product/5192/smpc), Glucose-6-Phosphate Dehydrogenase Deficiency - disease-level clinical article (g6pd-deficiency-full.txt) (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (3) - Most affected people have no symptoms at baseline; presentation depends on age and the specific trigger - Affected newborns carry roughly 1.6 to 2 times the general risk of significant jaundice [jaundice] - In older children and adults, infection, certain drugs, or specific foods trigger hemolysis with pallor, jaundice, fatigue, and dark urine [fatigue · haemolysis · jaundice · pallor] SIGNS - what you find (1) - An enlarged spleen from red-cell sequestration can be found during a hemolytic episode [splenomegaly] TESTS (5) - Because visual assessment of newborn jaundice is unreliable, an objective bilirubin level - total, fractionated, or transcutaneous - should be measured - G6PD testing is advised for newborn jaundice with no clear cause, a rising level despite intensive phototherapy, or a sudden spike or rebound - The fluorescent spot test screens qualitatively but can miss heterozygous female carriers, who need a quantitative enzyme assay instead - Hemolysis workup shows falling hemoglobin, reticulocytosis, indirect hyperbilirubinemia, high LDH, and low haptoglobin, with bite and blister cells on smear - A G6PD enzyme activity assay confirms the diagnosis, with molecular testing reserved for identifying the specific variant IF NOT THIS - what else fits (9) - Autoimmune hemolytic anemia - ABO or Rh blood group hemolytic disease of the newborn - Breastmilk jaundice - Crigler-Najjar syndrome, types I and II - Gilbert syndrome - Pyruvate kinase deficiency - Hereditary spherocytosis - Sickle cell anemia - Thalassemia Source StatPearls "Glucose-6-Phosphate Dehydrogenase Deficiency" - disease-level clinical article Status traced to the source above 1. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult Source Glucose-6-Phosphate Dehydrogenase Deficiency - disease-level clinical article (g6pd- deficiency-full.txt) Why Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen. Caution RED FLAG - Methylene blue is contraindicated in G6PD deficiency. 2. FOLIC ACID [add-on - not a substitute] Adult 5 mg once daily during acute post-haemolytic recovery Peds 1 to 12 years: 2.5 to 5 mg once daily 12 to 18 years: 5 to 10 mg once daily (Child 1-12 years: 2.5 mg-5 mg once daily. Child 12-18 years: 5-10 mg once daily.) Source Egyptian National Drug Formulary - Blood Disorder Medications 2025 (folic acid monograph) Why Vitamin cofactor for red-cell production, used during the acute recovery phase after a haemolytic episode to support the marrow's replacement of destroyed red cells; it does not treat the underlying enzyme deficiency or prevent further haemolysis, which relies on strict avoidance of oxidative triggers. Caution Supports active erythropoiesis following an oxidative haemolytic episode. Not required continuously in asymptomatic individuals without ongoing haemolysis. Strictly avoid oxidative drugs: cotrimoxazole, nitrofurantoin, dapsone, primaquine, rasburicase, methylene blue, and fava beans. Patients with vitamin B12 deficiency should not be treated with folic acid unless administered with adequate amounts of hydroxocobalamin, as it can mask the symptoms while the subacute irreversible damage to the nervous system will continue. Egypt FOLIC ACID (EL NILE) 5 MG 50 TAB. EL NILE. 26.25 EGP (0.53/unit) FOLIC ACID (MEMPHIS) 5 MG 30 TAB. MEMPHIS 15.75 EGP (0.53/unit) FOLICINAD 5 MG 50 TABS. INAD PHARMA 50.00 EGP (1.00/unit) FOLIC ACID (EIPICO) 5 MG 20 TAB. EIPICO 24.00 EGP (1.20/unit) FOLIC ACID (EL NILE) 5 MG 30 TAB. EL NILE. 36.00 EGP (1.20/unit) FOLIRAQ 5000 MCG 30 CAPSULES HP PHARMA 45.00 EGP (1.50/unit) FOLIDDOX 400 MCG / 5 ML LIQUID 150 ML MADDOX PHARMA 150.00 EGP -> ? strength differs, ? different route - not oral solid Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)