Lagundi Syrup Safety in G6PD Deficiency
Lagundi syrup can be used safely in individuals with G6PD deficiency, as there is no evidence contraindicating its use.
Evidence-Based Medication Classification in G6PD Deficiency
The most comprehensive and recent evidence systematically categorizes medications into risk levels for G6PD-deficient patients. Only seven medications have solid evidence for absolute contraindication 1, 2:
- High-risk medications to avoid completely:
Lagundi (Vitex negundo) Status
Lagundi syrup is not listed among contraindicated medications in any guideline or evidence-based review of G6PD deficiency 1, 3, 2, 4.
Supporting Evidence for Herbal Products
A systematic review specifically examining herbal and dietary supplements in G6PD deficiency found 5:
- Only henna showed evidence of causing hemolysis 5
- Most herbal products had insufficient evidence to contravene their use at therapeutic doses 5
- Vitamin C, vitamin E, vitamin K, Ginkgo biloba, and α-lipoic acid showed no evidence of harm 5
Real-World Safety Data
A large real-world study of 31,962 G6PD-deficient patients demonstrated 6:
- Only 71 cases (0.2%) experienced major hemolysis requiring hospitalization 6
- 71.8% of hemolytic episodes were caused by fava beans, not medications 6
- Only 3 cases (4.2%) were potentially medication-related 6
- Many previously suspected medications were prescribed safely to thousands of G6PD-deficient patients 6
Clinical Approach
Since lagundi is not among the seven definitively contraindicated medications and no case reports or evidence link it to hemolysis in G6PD deficiency, it can be prescribed with standard precautions 2, 4.
Important Caveats
- Monitor for signs of hemolysis when starting any new medication, including jaundice, dark urine, or pallor 3
- The most common trigger for hemolysis in G6PD-deficient patients is fava bean ingestion, not medications 6
- Many medications have been wrongly cited as causing hemolysis because they were given during infection-related hemolytic episodes 2