Introduction: Galactosemia describes four diseases resulting from mutations in genes which code for enzymes involved in the metabolism of galactose and its derivatives. It has a wide range of symptoms ranging from the relatively mild (early onset cataracts) to severe damage to the liver, brain and ovaries which results in significant physical and cognitive disability. The only treatment is the removal or reduction of galactose in the diet. This treatment is unsatisfactory, particularly in the most severe forms of the disease. Considerable research efforts are being made to develop specific therapies for galactosemia. These include gene therapies, pharmacological chaperones, drugs to block the production of potentially toxic metabolites and enzyme replacement therapy. However, these are unlikely to be translated into the clinic for at least a decade.Areas covered: This review considers existing drugs, nutrients and treatments which could be relatively rapidly repurposed for the treatment of galactosemia. If successful, these would enable an improvement in the prognosis for galactosemia patients. Expert opinion: Dietary antioxidants which are already widely used and generally considered safe (e.g. resveratrol, purple sweet potato colour) should be tested for their efficacy in galactosemia.Pharmaceutical antioxidants (e.g. idebenone) should also be considered. Phosphate supplementation, along with careful monitoring of phosphate levels in the patient's diet should also be considered. Efforts to develop specific therapies for galactosemia should continue.