Gliolan (Aminolevulinic Acid Hydrochloride)

Gliolan is indicated for fluorescence‑guided resection of malignant glioma during neurosurgical procedures.

• Enhances intra‑operative visualization of tumor tissue under blue‑light excitation.
• Assists surgeons in distinguishing tumor margins from surrounding healthy brain tissue.
• Supports maximal safe resection while preserving functional cortex.
• Can be combined with standard imaging modalities such as MRI or neuronavigation for comprehensive surgical planning.
• Used in adult patients with suspected or confirmed high‑grade glioma.

Adverse reactions reported with Gliolan are generally related to its photosensitizing properties and to systemic exposure to the prodrug.

Common

• Transient nausea or vomiting after oral intake.
• Mild headache or dizziness during the procedure.
• Temporary skin photosensitivity resulting in mild erythema when exposed to strong light.
• Elevated liver enzymes that resolve without intervention.

Serious

• Severe photosensitivity leading to blistering or ulceration of exposed skin.
• Anaphylactic or severe hypersensitivity reactions, including rash, bronchospasm, or hypotension.
• Acute hepatic injury manifested by marked transaminase elevation and jaundice.

When prescribing Gliolan, clinicians should evaluate patient-specific factors and follow safety measures to minimize risks.

• Confirm diagnosis of malignant glioma and suitability for fluorescence‑guided surgery.
• Perform baseline liver function tests; avoid use in patients with severe hepatic impairment.
• Advise patients to avoid direct sunlight and intense indoor lighting for 24‑48 hours after dosing.
• Ensure adequate hydration to reduce the risk of renal concentration of the drug.
• Review any history of photosensitivity disorders or porphyria before administration.
• Monitor for signs of allergic reaction during and after infusion.
• Use protective eye coverings during illumination to prevent ocular phototoxicity.

Gliolan may interact with other medications or substances that affect photosensitivity, hepatic metabolism, or porphyrin pathways.

Avoid

• Concomitant use of other photosensitizing agents such as tetracyclines, sulfonamides, or psoralen derivatives.
• Strong CYP450 inducers that could reduce aminolevulinic acid exposure (e.g., rifampin, carbamazepine).
• Medications known to precipitate porphyria attacks, including certain antiepileptics.
• High‑dose vitamin A supplements, which may increase photosensitivity.

Use with caution

• Anticoagulants, because intra‑operative bleeding may be influenced by surgical visualization.
• Drugs affecting liver function (e.g., acetaminophen overdose) that could alter drug metabolism.
• Anesthetic agents that may mask early signs of hypersensitivity.
• Diuretics that may affect renal clearance of metabolites.