This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

G6PDH and malaria prophylaxis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

What do I advise for the traveller with Glucose 6-phosphate dehydrogenase deficiency?

Glucose 6-phosphate dehydrogenase (G6PD) is an enzyme in the hexose monophosphate shunt of the glycolytic pathway

  • this shunt supports the red cell's protection against oxidative damage
  • absence of G6PD renders the red cell liable to haemolysis in the presence of some drugs

The most common G6PD deficiency allele in Africa (G6PD A-) has been shown to confer some resistance to malaria in both hemizygous males and heterozygous females

  • however, all G6PD-deficient travellers to malarious areas still require appropriate chemoprophylaxis (1)


  • a theoretical risk of haemolysis in some G6PD-deficient individuals who receive chloroquine
    • this risk is acceptable in acute malaria (1) and G6PD levels are not usually checked before using chloroquine in treatment doses

    • haemolysis does not appear to be a problem when chloroquine is given in the dose recommended for malaria chemoprophylaxis, so there is no need to withhold chloroquine prophylaxis from those known to be G6PD-deficient.

Atovaquone-proguanil, doxycycline, mefloquine or proguanil prophylaxis

  • there is no need to withhold any of these agents from those known to be G6PD-deficient.


  • this drug is not currently recommended as a first line agent for malaria prevention in UK travellers, but may be considered in special circumstances on expert advice (1)
    • there is a definite risk of haemolysis in G6PD-deficient individuals. The traveller's G6PD level must be checked before primaquine is prescribed and G6PD deficiency contraindicates its use for prophylaxis (1)


  • Public Health England. Guidelines for malaria prevention in travellers from the UK 2019

Related pages

Create an account to add page annotations

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.