Glucose-6-phosphate dehydrogenase (G6PD) deficiency is associated with development of acute hemolytic anemia in the setting of oxidative stress, which can be caused by medication exposure. Regulatory agencies worldwide warn against the use of certain medications in persons with G6PD deficiency, but in many cases, this information is conflicting, and the clinical evidence is sparse. This guideline provides information on using G6PD genotype as part of the diagnosis of G6PD deficiency and classifies medications that have been previously implicated as unsafe in individuals with G6PD deficiency by one or more sources. We classify these medications as high, medium, or low to no risk based on a systematic review of the published evidence of the gene–drug associations and regulatory warnings. In patients with G6PD deficiency, high-risk medications should be avoided, medium-risk medications should be used with caution, and low-to-no risk medications can be used with standard precautions, without regard to G6PD phenotype. This new document replaces the prior Clinical Pharmacogenetics Implementation Consortium guideline for rasburicase therapy in the context of G6PD genotype (updates at: www.cpicpgx.org).

中文翻译：

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G6PD 基因型背景下药物使用的扩展临床药物遗传学实施联盟指南

6-磷酸葡萄糖脱氢酶 (G6PD) 缺乏症与氧化应激情况下急性溶血性贫血的发生有关，氧化应激可能是由药物暴露引起的。世界各地的监管机构警告不要对 G6PD 缺乏症患者使用某些药物，但在许多情况下，这些信息是相互矛盾的，而且临床证据也很少。本指南提供有关使用G6PD 的信息基因型作为 G6PD 缺乏症诊断的一部分，并对之前因一种或多种来源而被认为对 G6PD 缺乏症患者不安全的药物进行分类。根据对已发表的基因药物关联证据和监管警告的系统审查，我们将这些药物分为高风险、中风险、低风险甚至无风险。对于 G6PD 缺乏的患者，应避免使用高风险药物，应谨慎使用中风险药物，在标准预防措施下可使用低风险至无风险药物，而不考虑 G6PD 表型。这份新文件取代了之前的临床药物遗传学实施联盟针对G6PD基因型拉布立酶治疗的指南（更新于：www.cpicpgx.org）。