5-aminolevulinic acid at a glance
Medicine class
Photosensitiser used for fluorescence-guided surgery or photodynamic therapy.
Gliolan
An oral solution prepared by healthcare staff to help visualise malignant glioma during surgery.
Ameluz
A skin gel applied under professional guidance and activated by an appropriate light source.
Light precautions
Limit strong-light exposure after Gliolan. Protect Ameluz-treated and surrounding skin from sunlight after treatment.
What is 5-aminolevulinic acid used for?
The products have distinct licensed roles in adults:
Gliolan: visualisation of malignant tissue during surgery for WHO grade III or IV malignant glioma.
Ameluz: photodynamic treatment of mild-to-moderate actinic keratoses and affected fields of sun-damaged skin.
Ameluz: photodynamic treatment of superficial or nodular basal cell carcinoma when surgery is unsuitable because of expected morbidity or poor cosmetic outcome.
How does 5-aminolevulinic acid work?
Cells convert 5-ALA into the light-sensitive substance protoporphyrin IX. In malignant glioma it glows red-violet under blue light, helping the surgeon distinguish tissue. In Ameluz-treated skin, illumination generates reactive oxygen species that damage targeted abnormal cells.
5-aminolevulinic acid preparations and strengths
Gel
Route: Cutaneous
Strengths: 78 mg/g
Oral solution
Route: Oral
Strengths: 30 mg/mL
How to take 5-aminolevulinic acid
Administration depends on the product and is coordinated by specialist healthcare staff.
Gliolan is mixed with drinking water by a pharmacist or nurse and swallowed before anaesthesia. Do not prepare it yourself; follow the surgical team's fasting instructions.
After Gliolan, protect your eyes and skin from direct sunlight, focused indoor lighting and other strong light sources for 24 hours.
Ameluz is for skin use only. The lesion is prepared, the gel applied under professional guidance and then exposed to the selected therapeutic light.
Keep Ameluz away from the eyes and mucous membranes. Rinse accidental contact with water.
After Ameluz treatment, follow the clinic's dressing and skin-care instructions and avoid sunlight on treated and surrounding skin for approximately 48 hours.
5-aminolevulinic acid side effects
Common or expected effects
- Ameluz: application-site redness, burning, pain, irritation, itching, swelling, scabbing, scaling, hardening or tingling; headache can also occur.
- Gliolan and the associated operation: nausea or vomiting, temporary blood-count changes and raised liver-related blood tests.
Get urgent medical advice
- Severe allergic reaction.
- Sudden confusion, disorientation or temporary memory loss during or after Ameluz treatment.
- Gliolan-associated surgery: seizures, new weakness, speech or visual disturbance, brain swelling or thromboembolism.
- Marked or worsening skin swelling, blistering, discharge or other signs suggesting infection after photodynamic therapy.
5-aminolevulinic acid in pregnancy
Gliolan is contraindicated during pregnancy. Ameluz should preferably be avoided during pregnancy as a precaution because clinical experience is limited. Discuss pregnancy or possible pregnancy with the specialist before treatment.
5-aminolevulinic acid while breastfeeding
It is unknown whether 5-ALA or its metabolites enter human milk. Product information requires breastfeeding to be interrupted for 24 hours after Gliolan and 12 hours after Ameluz. Discuss expressing, storage and restarting with the clinical team beforehand.
5-aminolevulinic acid interactions
Tell the treating team about all prescribed, over-the-counter and herbal products, particularly those that increase light sensitivity or affect inflammation.
St John's wort or hypericin extracts
May intensify photosensitivity and phototoxic skin reactions; avoid around Gliolan and disclose before Ameluz treatment.
Tetracyclines, quinolones and sulphonamide antibiotics
Their photosensitising potential may increase light-related reactions.
Common questions about 5-aminolevulinic acid
Answers are fully visible for fast scanning and source review.
Are Gliolan and Ameluz interchangeable?
No. They contain the same active ingredient but have different formulations, licensed uses and administration methods.
Is 5-aminolevulinic acid hydrochloride chemotherapy?
It is classified as a photosensitiser. Gliolan is a surgical visualisation aid, while Ameluz is used with light to destroy targeted abnormal skin cells.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.