Important information on Gilolan® (5-aminolevulinic acid): What to do in case of delayed surgery and information on fluorescence in non high-grade glioma

A Dear Healthcare Professional Letter has been issued by Link Healthcare Singapore Pte Ltd to inform healthcare professionals on the use of Gliolan^® (5-aminolevulinic acid, 5-ALA) in case of delayed surgery and information on fluorescence in non high-grade glioma. Occasionally, delays and postponement of surgery may occur despite 5- ALA having been administered. As it is unknown how long useful fluorescence persists in tumour cells beyond the defined window of lucid contrast, healthcare professionals are advised to reschedule surgery that is delayed by > 12 hours for the next day or later, in which case another dose of 5-ALA can be administered two to four hours before anaesthesia. Re-administration of 5-ALA on the same day should not be considered as there is no available information on the safety of early repeated dosing or on the specificity of fluorescence. Healthcare professionals are also reminded that false negative and false positive results may occur with the use of 5-ALA for intraoperative visualisation of malignant glioma. Non-fluorescing tissue in the surgical field does not rule out the presence of tumour in patients with glioma. On the other hand, fluorescence may be seen in areas of abnormal brain tissue, necrotic tissue, inflammation, infections, CNS lymphoma or metastases from other tumour types. The package insert for Gilolan^® will be updated accordingly to reflect the above information. Please refer to the letter for details. Published: 2 Feb 2021

Dear Healthcare Professional Letters