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To the Editor: Metvix cream (Laboratorios Galderma S.A.) contains methyl aminolevulinate (MAL, methyl 5-amino-4-oxo-pentanoate, Chemical Abstract Service number 33320-16-0), a methyl ester derivative of aminolevulinic acid (ALA), and 14 excipients (Table 1)

In summary, this compounded injection is contraindicated in anyone with allergies to its components, in neonates, and in patients in whom even moderate doses of B/B might pose unacceptable risks (e.g