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Date Issued: July 2022

For review: July 2024

Ref: B-438/JB/Oncology/Gliolan-5ALA v2

PDF: Gliolan leaflet final July 2019.pdf[pdf] 575KB

Contents

What is Gliolan® and what is it used for?

How does Gliolan® work?

What are the benefits of using Gliolan®?

How is Gliolan® taken?

What are the side effects of Gliolan®?

Read this leaflet carefully before you take this medicine because it contains important information for you.

• Keep this leaflet. You may need to read it again.

• If you have any further questions, ask your Nurse Specialist or Consultant.

• If you get any side effects, talk to your Nurse Specialist, Consultant or GP. This includes any possible side effects not listed in this leaflet.

1.What is Gliolan and what is it used for?

Gliolan® is used for the visualisation of certain brain tumours (called glioma) during tumour surgery.

Gliolan® contains a substance called aminolevulinic acid (5-ALA). 5-ALA accumulates preferably in tumour cells where it is transformed into another similar substance. If the tumour is then exposed to blue light, this new substance emits a red-violet light which helps to better distinguish between normal brain tissue and what is tumour tissue. This helps the surgeon to remove the tumour while sparing healthy brain tissue.

2. What you need to know before you take Gliolan

  Do not take Gliolan®

• If you are allergic to 5-ALA or porphyrins.

• If you have or suspect acute or chronic types of porphyria (i.e. inherited or acquired disorders of certain enzymes in the synthesis pathway of red blood pigment).

• If you are or could be pregnant.

Warnings and precautions: talk to your specialist nurse before taking Gliolan®.

• For 24 hours after administration of this medicine, protect your eyes and skin from strong light (for example direct sunlight or brightly focused indoor light).

• If you have heart disease or have had heart disease in the past, you should tell your doctor. In this case, this medicine should be used with caution because your blood pressure may be decreased.

   Gliolan® with food and drink:

• This medicine is generally used once only. It is usually administered 2-4 hours before anaesthesia and is used for certain brain tumours called glioma.

  Pregnancy and Breastfeeding:

• It is not known whether this medicine enters breastmilk. Mothers should not breastfeed for 24 hours after treatment with this medicine.

Other medicines and Gliolan®

Tell your doctor or pharmacist what medications you are taking, both prescribed and over the counter. They particularly need to know medicines that may cause skin problems when the skin is exposed to strong light.

One case of severe sunburn lasting for 5 days has been reported in a patient after having taken this medicine and a hypericin extract. You should not take any such products up to 2 weeks after you have taken Gliolan®.

Within 24 hours of taking Gliolan®, avoid any other medicines that may harm the liver.

3. How to take Gliolan®

This medicine comes in powder form and is mixed with drinking water prior to administered.  You will be given the Gliolan pre surgery by the ward nurse. If the anaesthesia or surgery is delayed by some hours, additional doses of this medicine must not be given. If the surgery is delayed by one or more days, another dose of this medicine can be taken 2 – 4 hours before anaesthesia

4. Possible side effects

Like all medicines, Gliolan may cause side effects, although not everybody gets them.

Frequently observed side effects are vomiting (sickness), nausea (feeling sick) and slight increase of some enzymes (transaminases,      γ-GT, amylase) or bilirubin (a bile pigment produced in the liver by breakdown of red blood pigment) in the blood.

Serious side effects include mild alterations of blood cell counts (red and white cells, platelets), neurological disorders (disorders that affect the nervous system like hemiparesis [partial paralysis of one side of the body] and thromboembolism (blood clots that may obstruct blood vessels).

Tell your doctor immediately if you experience any complaints.

Side effects are divided into the following two categories:

One: Immediate side effects can occur after taking Gliolan® and before anaesthesia: Uncommon side effects may affect up to 1 in 100 people: Nausea (feeling sick), decrease of blood pressure, skin reactions (for example rash, looking like sunburn).

Two: In combination with anaesthesia and tumour resection further side effects may occur:

Very common side effects 1 in 10 people

• Mild alterations of blood cell counts (red and white cells, platelets), and slight increase of some enzymes (transaminases, γ-GT, amylase) or bilirubin (a bile pigment produced in the liver by breakdown of red blood pigment) in the blood. These changes peak between 7 and 14 days after surgery. The changes will completely resolve within a few weeks. Usually you will not experience any symptoms when these changes occur.

Common side effects (up to 1 in 10 patients)

• Nausea (feeling sick), vomiting (sickness), neurological disorders (disorders that affect the nervous system like hemiparesis [partial paralysis of one side of the body], aphasia [total or partial loss of ability to use or understand language], convulsions [seizures] and hemianopsia [blindness for half the field of vision in one or both eyes]), and thromboembolism (blood clots that may obstruct blood vessels).

Uncommon side effects (1 in 100 patients)

• Decrease of blood pressure, brain oedema (brain swelling).

Very rare side effects (1 in 10,000 patients)

• Hypaesthesia (decrease of your sense of touch), and diarrhoea (loose or watery stools).

If you have any queries please contact the Neuro-oncology Specialist Nursing Team on 01752 431210