For >4GB support, three things are needed: a 64-bit-aware filesystem, a 64-bit-aware scsi.device, and a 64-bit-aware HDToolbox (or similar prep tool). PFS works for the filesystem. HDToolbox and scsi.device work out-of-the-box if you're using 3.5, 3.9, 3.1.4, or 3.2.
Otherwise you need patches. It's been ages since I've used it, but I don't think IDEFix one of them.
If you don't want to mess around with patches, scsi2sd has a config feature to artificially limit the size of the SD card, so you can make it appear to your Amiga that you've only got a 4GB drive.