CPIC® Guideline for G6PD

Guideline overview presentation

Most recent guideline publication:

Expanded Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for Medication Use in the Context of G6PD Genotype (August 2022)

Tables  provided in the main manuscript of the guideline:

Table 1. Assignment of predicted G6PD phenotype based on genotype

Table 2. Drug-specific risk level and associated strength of recommendation for patients with G6PD deficiency

Table 3. Recommended therapeutic use of high risk drugs in relation to G6PD phenotype

Table 4. Recommended therapeutic use of medium risk drugs in relation to G6PD phenotype

Table 5. Recommended therapeutic use of low-to-no risk drugs in relation to G6PD phenotype

Table 6. Recommended therapeutic use of primaquine in relation to G6PD phenotype

Supplement to: Expanded Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for Medication Use in the Context of G6PD Genotype (August 2022)

Tables included in the supplement^a:

Table S1. Evidence linking G6PD deficiency to drug-induced hemolysis

Table S2. Association between allelic variants and G6PD activity as defined by the world health organization

Table S3. Summary of select regulatory agency warnings for medication use in patients with G6PD deficiency

G6PD allele definition table

G6PD allele functionality table

G6PD frequency table

G6PD diplotype-phenotype table

Gene resource mapping G6PD

Drug resource mapping aminosalicylic acid aspirin chloramphenicol chloroquine ciprofloxacin dapsone dimercaprol doxorubicin furazolidone glyburide hydroxychloroquine mafenide methylene blue nalidixic acid nitrofurantoin norfloxacin ofloxacin pegloticase phenazopyridine primaquine quinine rasburicase sulfadiazine sulfadimidine sulfamethoxazole / trimethoprim sulfanilamide sulfasalazine sulfisoxazole tafenoquine tolbutamide toluidine blue vitamin c vitamin k

Clinical decision supportb: Implementation workflow G6PD consult Pre- and post-test alerts: aminosalicylic acid aspirin chloramphenicol chloroquine ciprofloxacin dapsone dimercaprol doxorubicin furazolidone glyburide hydroxychloroquine mafenide methylene blue nalidixic acid nitrofurantoin norfloxacin ofloxacin pegloticase phenazopyridine primaquine quinine rasburicase sulfadiazine sulfadimidine sulfamethoxazole / trimethoprim sulfanilamide sulfasalazine sulfisoxazole tafenoquine tolbutamide toluidine blue vitamin c vitamin k

^aSome of the tables included in the guideline may have been updated on-line, particularly to reflect newly described or newly characterized alleles. These include the gene-specific information tables (https://www.pharmgkb.org/page/pgxGeneRef) that support CPIC guidelines by providing information regarding star (*) allele definitions, allele function, allele frequency by major ethnic groups, translations of diplotype to phenotype, and gene resource mappings.

^bThese resources support the adoption of CPIC guidelines into the electronic health record with clinical decision support and provide information that clinical implementers find helpful.

2014 guideline:

• Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for Rasburicase Therapy in the context of G6PD Deficiency Genotype (August 2014)

• 2014 supplement  

• September 2018 update to 2014 guideline: The CPIC authors recommend that the G6PD A variant be categorized as IV/normal function (previously II-IV/Deficient-Normal function) based on new evidence supporting function (PMID 27040960 and 30206300). This change has been incorporated into G6PD allele definition table.