Hexvix (Hexaminolevulinate)

Hexvix is indicated for the detection of non‑muscle invasive bladder cancer during cystoscopic evaluation.

• Enhances fluorescence of malignant urothelial cells under blue light, facilitating identification of carcinoma in situ.
• Used in conjunction with standard white‑light cystoscopy to improve lesion detection rates.
• Applied intravesically before photodynamic examination, typically after bladder irrigation.
• Supports targeted biopsy by highlighting suspicious areas that may be missed with conventional imaging.
• Assists in surveillance protocols for patients with a history of bladder cancer.
• May be employed in combination with narrow‑band imaging to further increase diagnostic confidence.

• Hexvix contains hexaminolevulinate, a prodrug that is preferentially taken up by urothelial cells. Inside the cells, enzymatic conversion yields protoporphyrin IX, a photosensitizer that accumulates in malignant tissue. When the bladder is illuminated with blue light (approximately 405 nm), protoporphyrin IX emits red fluorescence, allowing clinicians to differentiate cancerous lesions from normal mucosa during cystoscopy. The selective fluorescence improves visual contrast without systemic exposure.

Adverse reactions to Hexvix are generally related to the intravesical administration and the photosensitizing properties of the drug.

Common

• Mild bladder irritation or burning sensation during or after instillation.
• Transient hematuria or blood‑tinged urine.
• Temporary urinary urgency or frequency.
• Light‑sensitivity reactions limited to the bladder mucosa, causing mild discomfort.
• Mild dysuria or discomfort during urination.

Serious

• Severe allergic reaction, including anaphylaxis.
• Persistent bladder inflammation or cystitis.
• Significant phototoxic injury to surrounding tissues if exposed to intense light.
• Acute urinary retention requiring catheterization.
• Rare cases of systemic photosensitivity