Adult Dosing
Cystoscopic imaging of non-muscle invasive papillary bladder cancer
- Recommended dose: 50 mL of reconstituted solution intravesicular via urinary catheter
Notes:- Retain the solution in the bladder for at least 1 hr (Max: 3 hrs) before evacuating and performing cystoscopic examination
- Evacuate the solution and empty the bladder prior to cystoscopy; the patient may void and completely empty the bladder prior to the procedure
- Use catheters made of vinyl, latex or silicone for instillation
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
See Supplemental Patient Information
- Anaphylaxis, including anaphylactoid shock, may occur with the use of hexaminolevulinate. Appropriate treatment options and trained health professionals should be readily available for the management of anaphylaxis
- Product not indicated for repetitive use
- Certain bladder tumors and malignant lesions may not be detected by hexaminolevulinate. This agent is not a replacement for random biopsies and other commonly followed cystoscopic procedures for cancer screening
- Do not evaluate with blue light alone as some malignant lesions may be missed unless initially examined under white light
- Blood or urine present within the bladder may interfere with the detection of tissue fluorescence. To enhance the diagnostic utility of this product, ensure complete emptying of the bladder prior to instillation of fluids and perform biopsy/resection of bladder mucosal lesions only after completion of white and blue light cystoscopy
- Detection of fluorescent areas during blue light cystoscopy may not always indicate a bladder mucosal lesion. False fluorescence may occur due to inflammation, cystoscopic trauma, scar tissue or bladder mucosal biopsy from a previous cystoscopy
- Avoid use of catheters embedded/coated with antibiotics or silver
Supplemental Patient Information
- Instruct patients to retain the solution in the bladder for at least 1 hr from instillation of the agent to the start of cytoscopic examination
Pregnancy Category:C
Breastfeeding: Safety unknown. Manufacturer advises caution when administering to nursing women.
