Foods and Drugs to Avoid in Alpha Thalassemia

Medications and Products to Avoid* in Thalassemia

*The medical literature suggests that these medications and products may cause problems for people with hemoglobin H disease; however, no studies have been conducted to prove that these substances are actually harmful for people with hemoglobin H disease.

In an effort to avoid hemolytic episodes that cause the destruction of red blood cells and lower the hemoglobin level suddenly, it is suggested that the following be avoided. Any type of chemical fumes can be added to this list as to be avoided.

Fava beans, known as favism (some people report problems with other beans and legumes, such as peanuts). If prone to sudden drops in Hb, try keeping a food diary to see if certain foods may be causing hemolysis, the destruction of red blood cells. In general, similar chemical fumes can pose a hemolysis risk in some people. I have even heard anecdotal evidence about chemical fragrances from daily life setting off hemolysis. Fabric softener dryer sheets were mentioned, but again, if Hb suddenly drops, review if there has been any food, drug or chemical exposure that may have set it off.

7/20/14 I have been informed that cigarette smoke can also be a factor that can suddenly reduce the HB level in alpha thalassemics. As always, observation of exposures once you have a hemolytic crisis will tell you what you need to avoid.

Sulfa Drugs

Sulfacetamide (eye drops)
Sulfapyridine
Salfasalazine (Salicylazosulfapyridine)
Sulfanilamide
Dapsone

Analgesics

Aspirin (acetaminophen is safe as alternative)
Phenacetin
Acetanilide

Antimalarials

Primaquine
Chloroquine
Hydroxychloroquine sulfate

Tuberculosis Drugs

Isoniazid
Rifampin


Folic Acid Antagonists

Pyrimethamine


Other Antibacterials

Nalidixic acid (Negram)
Nitrofurantoins
Furazolidone
Chloramphenicol
Beta-amniosalicylic acid
Ciprofloxacin
Doxycycline
  
Other Items

Iron supplements ¹
Vitamin K analogues
Quinidine gluconate
Phenazopyridine (pyridium)
Toluidine Blue (a dye)
Methylene Blue (a dye)
Naphthalene (mothballs)


¹Unless laboratory-proven iron deficiency.

Thanks Andy for this important reference

Manal

hi, my daughter is always given Bactrim for her urinary tract infections as it is narrow spectrum antibiotic. which is good. should beta thal minors stay away from all sulfa drugs or just the ones mentioned. it is made from sulfamethoxazole and trimethoprim
thanks

Beta minors usually do not have hemolytic reactions from these drugs. If you see no reaction, assume they are safe. If there is sudden tiredness and fatigue, it is a sign that hemolysis is taking place, so the drug should be stopped. As long as you see no changes, carry on with the treatment.

Wow..more things are getting clear now 
Very young I couldn't endure the commute in Rio de Janeiro Brazil. The fumes around buses and trains made me sick but also I had lots of fainting spells throughout my childhood and teenager hood. I also remember fainting in a deep pool during a swimming class  what just made me more fearful to swim.
So much from my past .. I 'm just starting to understand...

Is there any list of foods and medications which should be avoided in Beta or E-beta thalasemia  ?

If exist, please give me the link.

Right, I have the same request. It would be very helpful if some list for betas exists...

Thanks Andy.

Any suggestions for E- Beta thallassemia..Please..

All thals should avoid drugs with sulfur in them, as it can cause hemolysis. Beta thals do not normally have the same sensitivity as alpha thals, and don't often have problems with hemolysis due to exposure to various substances. For those who do have this sensitivity, we have compiled a list of substances to avoid at http://www.thalassemiapatientsandfriends.com/index.php/topic,3410.msg34830.html#msg34830