Levulan
Levulan Kerastick is made up of aminolevulinic acid 20% topical solution. It's a photosensitizing agent that's used to treat actinic keratoses (sun spots) on adults. Levulan Kerastick (aminolevulinic acid) is applied directly to the spots on the skin by a healthcare provider at their office or clinic. Afterwards, your provider will use blue light photodynamic therapy (PDT) to activate the medication. If needed, you can repeat the treatment again after 2 months. Some of the more common side effects of Levulan Kerastick (aminolevulinic acid) include swelling, stinging, or scaling around the treated skin areas.
What is Levulan Kerastick (aminolevulinic acid)?
What is Levulan Kerastick (aminolevulinic acid) used for?
- Minimally to moderately thick actinic keratoses of the face, scalp, or arms and hands (in combination with photodynamic therapy)
How Levulan Kerastick (aminolevulinic acid) works
Levulan Kerastick (aminolevulinic acid) is a photosensitizing agent. It's activated ("turned on") by light and kills skin cells that cause actinic keratoses.
Drug facts
| Common Brands | Levulan Kerastick |
|---|---|
| Drug Class | Topical skin product |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
Side effects of Levulan Kerastick (aminolevulinic acid)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Redness (up to 100%)
- Stinging or burning (up to 96%)
- Dryness, peeling, or crusting on the skin (64-87%)
- Skin color changes (22-73%)
- Swelling (up to 56%)
- Fluid-filled blisters (up to 41%)
- Itchy skin (14-25%)
Less Common Side Effects
- Damaged skin
- Welts
- Bleeding
- Scabbing
- Tingling sensation
The following Levulan Kerastick (aminolevulinic acid) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
persistent non-healing sore
pink growth
reddish patch or irritated area
scabbing
shiny bump
spots on your skin resembling a blister or pimple
stinging, burning, pain, redness, swelling, scaling, crusting, lightening or darkening of the skin, itching, cracking, crusting, or dryness of the skin at the application site
tenderness
white, yellow or waxy scar-like area
Less common
Bleeding during lesion preparation
blistering or irritation of the skin
flaking, pain, peeling, itching rash, breaking down of the skin
Incidence not known
Difficulty seeing at night
double vision
increased sensitivity of the eyes to sunlight
loss of memory
problems with memory
red, sore eyes
seeing double
swelling of the eyelids
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Burning, crawling, itching, numbness, prickling, “pins and needles,” stinging, or tingling feelings
darkening or lightening of the treated skin
skin sore
small, red, raised, itchy bumps
swelling of the skin
Less common
headache
oozing
open sore on the skin
pain or tenderness around the eyes and cheekbones
pus filled blister or pimple
raw skin
stuffy or runny nose
tenderness
tightness of the chest
troubled breathing
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Levulan Kerastick (aminolevulinic acid)
Pros
- Only need one or two treatments
- Many people had clear skin 3 months after the first treatment
- Skin can stay clear for as long as a year after treatment for some people
Cons
- Up to 18 hour (for face and scalp) waiting period before PDT
- Can cause irritation and discomfort on treated areas
- Must avoid sunlight or bright indoor light for at least 40 hours after treatment
Pharmacist tips for Levulan Kerastick (aminolevulinic acid)
- Make sure to bring a wide-brimmed hat, gloves, and/or a long-sleeved shirt to your appointment so you can protect the treated areas from the sun or bright indoor light when you leave. You'll need to avoid light for at least 2 days to minimize burning and stinging in these areas. Keep in mind that sunscreen won't protect you from visible light.
- If you aren't able to return to your provider's office for light therapy after Levulan Kerastick (aminolevulinic acid) has been applied, call the office for further instructions.
- Some medications, such as certain antibiotics or acne medication, can make your skin even more sensitive to sunlight during treatment with Levulan Kerastick (aminolevulinic acid). Tell your provider all of the medications you're taking so they can check if they're safe to use with Levulan Kerastick (aminolevulinic acid).
- After treatment with Levulan Kerastick (aminolevulinic acid), it's normal to experience irritation, crusting, oozing, itching, and dryness at the sites where you had it applied. These side effects are temporary and should get better over the next 1 to 2 months. If anything concerns you, call your provider to discuss.
- If your sun spots don't start to fade within 2 months, contact your provider. You might need another treatment with Levulan Kerastick (aminolevulinic acid).
- It isn't known if Levulan Kerastick (aminolevulinic acid) causes harm to unborn babies or breastfed babies. If you're pregnant or breastfeeding, discuss the risks and benefits for you and your baby with your provider.
Risks and warnings for Levulan Kerastick (aminolevulinic acid)
Levulan Kerastick (aminolevulinic acid) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Temporary memory problems
Though rare, some people reported temporary memory problems after using Levulan Kerastick (aminolevulinic acid) with photodynamic therapy (PDT). If you feel confused or have trouble remembering things after your treatment, contact your provider.
Higher sensitivity to light
- Risk factors: Taking medications that make your skin more sensitive to light
Levulan Kerastick (aminolevulinic acid) makes your skin more sensitive to light. Your risk for skin damage from light exposure is higher if you're taking other medications that make your skin more sensitive to light. After getting treatment with Levulan Kerastick (aminolevulinic acid), avoid sunlight, tanning beds, and bright indoor light for 2 days, even if you aren't exposed to light therapy.
You can protect the treated areas of your skin by wearing a wide-brimmed hat, long-sleeved shirts, or gloves. Doing so can help prevent stinging, burning, irritation, and swelling at the treatment sites on your skin. Keep in mind that wearing sunscreen won't protect your skin from visible light.
Skin irritation
- Risk factors: Covering the treated area for longer than 3 hours Levulan Kerastick (aminolevulinic acid) contains alcohol, which can cause skin irritations. Your provider will be very careful to avoid putting this medication too close to the eyes or mouth. If you experience bothersome skin irritation, let your provider know.
Risk of bleeding
- Risk factors: Taking blood thinners | Bleeding problems
It isn't known if Levulan Kerastick (aminolevulinic acid) is safe to use in people with bleeding problems. Let your provider know if you're taking blood-thinning medications (e.g., warfarin (Coumadin)) or if you have a history of bleeding problems. Your provider will look out for any signs of bleeding while applying Levulan Kerastick (aminolevulinic acid), and can talk with you about the benefits and risks of using this medication.
Levulan Kerastick (aminolevulinic acid) dosage
Typical dosage for Levulan Kerastick (aminolevulinic acid)
Levulan Kerastick is made up of aminolevulinic acid 20% topical solution.
- Adults: Levulan Kerastick (aminolevulinic acid) is applied to the sun spots (on the scalp, face, or arms and hands only) by a healthcare provider at their clinic. Your provider will let the medication sit on the skin for a certain amount of time (14-18 hours for face and scalp; 3 hours for arms and hands). Afterwards, you'll receive photodynamic therapy (PDT) with the BLU-U Illuminator for about 16 minutes.
If needed, your provider can prescribe this treatment again after 2 months.
Interactions between Levulan Kerastick (aminolevulinic acid) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
Levulan Kerastick (aminolevulinic acid) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Levulan Kerastick (aminolevulinic acid) will not be safe for you to take.
- Skin that's sensitive to visible light (wavelengths of 400 nm to 450 nm)
- Porphyria (a genetic condition where your body has problems making a protein called heme)
- Allergies to porphyrins
