{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:24:48Z","timestamp":1791347088867,"version":"4.3.1"},"reference-count":15,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T00:00:00Z","timestamp":1717632000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Pharma and Therapeutics"],"published-print":{"date-parts":[[2024,12]]},"abstract":"Many drug labels contain precautions of use in G6PD\u2010deficient patients due to hemolytic concerns, but much of this is based on scarce clinical, epidemiological, or structural data. In this real\u2010world study, we aimed to examine if the administration of presumably risky medications for G6PD\u2010deficient patients was followed by hemolysis. The study is based on data from Clalit Health Services database that provides inclusive health care for more than half of the Israeli population (~\u20094.7 million). Within the database, we identified all G6PD\u2010deficient patients by G6PD\u2009<6\u2009U\/g Hb. Within the G6PD\u2010deficient cohort, we identified all hospitalizations with a discharge diagnosis of hemolysis (January 1, 2010 to December 31, 2022), validated the cases, and identified the culprit event. For the rest of the G6PD\u2010deficient patients with no\u2010hemolysis, we recorded filled prescriptions of medications listed as presumably risky. We identified 31,962 G6PD\u2010deficient patients. Within the cohort, there were 71 cases of major hemolysis requiring hospitalization (0.2% of the cohort), of whom 51 (71.8%) had been caused by ingestion of fava beans, six (8.5%) were associated with an infection, and three (4.2%) suggested to be associated with medications (nitrofurantoin, phenazopyridine, and a \u201cpain killer\u201d). Within the 31,875 patients with no major hemolysis, nitrofurantoin has been prescribed safely to 1,366 G6PD\u2010deficient males and females; hundreds\/thousands of G6PD\u2010deficient patients had been prescribed safely ciprofloxacin, glibenclamide, ofloxacin, phenazopyridine, sulfamethoxazole\/cotrimoxazole, sulfasalazine, hydroxychloroquine, glimepiride, mesalazine, and sulfacetamide. In this real\u2010world study, we are showing that a list of medications, suspected previously as carrying risks for hemolysis in G6PD\u2010deficient patients, have been prescribed safely to G6PD\u2010deficient patients, providing reassurance to patients, prescribers, and regulators.<\/jats:p>","DOI":"10.1002\/cpt.3333","type":"journal-article","created":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T10:12:48Z","timestamp":1717668768000},"page":"1537-1543","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Medications and Acute Hemolysis in G6PD\u2010Deficient Patients \u2013 A Real\u2010World Study"],"prefix":"10.1002","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4369-6813","authenticated-orcid":false,"given":"Naomi","family":"Gronich","sequence":"first","affiliation":[{"name":"Department of Community Medicine and Epidemiology Lady Davis Carmel Medical Center Haifa Israel"},{"name":"Ruth and Bruce Rappaport Faculty of Medicine Technion\u2010Israel Institute of Technology Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5895-4320","authenticated-orcid":false,"given":"Bar","family":"Rosh","sequence":"additional","affiliation":[{"name":"Ruth and Bruce Rappaport Faculty of Medicine Technion\u2010Israel Institute of Technology Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7602-7363","authenticated-orcid":false,"given":"Nili","family":"Stein","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and Epidemiology Lady Davis Carmel Medical Center Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0440-3611","authenticated-orcid":false,"given":"Walid","family":"Saliba","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and Epidemiology Lady Davis Carmel Medical Center Haifa Israel"},{"name":"Ruth and Bruce Rappaport Faculty of Medicine Technion\u2010Israel Institute of Technology Haifa Israel"},{"name":"Research Authority Lady Davis Carmel Medical Center Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,6]]},"reference":[{"key":"e_1_2_10_1_1","unstructured":"Malaria Policy Advisory Group Meeting Technical consultation to review the classification of glucose\u20106\u2010phosphate dehydrogenase (G6PD). "},{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bcmd.2008.12.005"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00218277"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2019000944"},{"key":"e_1_2_10_5_1","unstructured":"Entry \u2013 *305900 \u2013 GLUCOSE\u20106\u2010PHOSPHATE DEHYDROGENASE; G6PD \u2013 OMIM. Accessed February 4 2024."},{"key":"e_1_2_10_6_1","unstructured":"FDA.Table of pharmacogenomic biomarkers in drug labeling Accessed May 6 2024."},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.2165\/11536520-000000000-00000"},{"key":"e_1_2_10_8_1","unstructured":" Accessed May 6 2024."},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.2735"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu15020343"},{"key":"e_1_2_10_11_1","first-page":"601","article-title":"Glucose\u20106\u2010phosphate dehydrogenase deficiency","volume":"67","author":"WHO Working Group","year":"1989","journal-title":"Bull. World Health Organ."},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41436-020-0779-4"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.18943"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/children10071172"},{"key":"e_1_2_10_15_1","unstructured":"CPIC\u00ae Guideline for G6PD \u2013 CPIC. Accessed February 4 2024."}],"container-title":["Clinical Pharmacology & Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascpt.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cpt.3333","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T06:24:34Z","timestamp":1731651874000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascpt.onlinelibrary.wiley.com\/doi\/10.1002\/cpt.3333"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,6]]},"references-count":15,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1002\/cpt.3333"],"URL":"https:\/\/doi.org\/10.1002\/cpt.3333","archive":["Portico"],"relation":{},"ISSN":["0009-9236","1532-6535"],"issn-type":[{"value":"0009-9236","type":"print"},{"value":"1532-6535","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,6]]},"assertion":[{"value":"2024-02-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}