What is Apokyn (Apomorphine)?

Apomorphine has some of the same effects as a chemical called dopamine, which occurs naturally in your body. Low levels of dopamine in the brain are associated with Parkinson’s disease.

Apomorphine is used to treat “wearing-off” episodes (muscle stiffness, loss of muscle control) in people with advanced Parkinson’s disease.

Apomorphine may also be used for other purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking Apokyn (Apomorphine)?

You should not use this medication if you are allergic to apomorphine, or if you are using any of the following medications:

• alosetron (Lotronex)
• dolasetron (Anzemet)
• granisetron (Kytril)
• ondansetron (Zofran); or
• palonosetron (Aloxi)

Before using apomorphine, tell your doctor if you are allergic to any drugs, or if you have:

• an electrolyte imbalance (such as low levels of potassium or magnesium in your blood)
• a slow heart rate
• a personal or family history of “Long QT syndrome”
• a history of stroke or heart attack
• asthma
• liver disease
• kidney disease
• a psychiatric disorder such as schizophrenia; or
• low blood pressure

If you have any of these conditions, you may need a dose adjustment or special tests to safely use apomorphine.

Some people using apomorphine have fallen asleep during normal daytime activities such as working, talking, eating, or driving. You may fall asleep suddenly, even after feeling alert. Tell your doctor if you have any problems with daytime sleepiness or drowsiness. If you are unsure of how this medicine will affect you, be careful if you drive or do anything that requires you to be awake and alert.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Apomorphine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Apokyn Side Effects

What are the possible side effects of Apokyn (Apomorphine)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

• nausea or vomiting that continues after taking an anti-nausea medication
• feeling light-headed (especially when you stand up)
• falling or passing out
• chest pain or heavy feeling, pain spreading to the arm or shoulder, sweating, general ill feeling
• confusion, hallucinations
• restless muscle movements in your eyes, tongue, jaw, or neck
• tremor (uncontrolled shaking); or
• penis erection that is painful or lasts 4 hours or longer

Less serious side effects may include:

• bruising, itching, or hardening of your skin where the injection was given
• increased sexual desire
• depressed mood, headache
• pale skin, increased sweating
• warmth, redness, or tingling under your skin
• dizziness, drowsiness, yawning
• runny nose
• swelling in your hands or feet
• sleep problems (insomnia)
• joint pain; or
• constipation or diarrhea

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Apokyn Interactions

What other drugs affect Apokyn (Apomorphine)?

Before using apomorphine, tell your doctor if you are using any of the following drugs:

• arsenic trioxide (Trisenox)
• bepridil (Vascor)
• blood pressure medications
• cisapride (Propulsid)
• chloroquine (Arelan) or halofantrine (Halfan)
• metoclopramide (Reglan)
• niacin (nicotinic acid, Niacor, Niaspan, and others)
• sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra)
• narcotic medication such as fentanyl (Actiq, Duragesic), hydrocodone (Vicodin), hydromorphone (Dilaudid), levomethadyl (Orlaam), methadone (Methadose), morphine (Kadian, MS Contin), oxycodone (OxyContin, Percocet), oxymorphone (Opana), pentazocine (Talwin), or propoxyphene (Darvon)
• antibiotics such as azithromycin (Zithromax), clarithromycin (Biaxin), dirithromycin (Dynabac), erythromycin (E-Mycin, E.E.S., Erythrocin, Ery-Tab), pentamidine (NebuPent, Pentam), sparfloxacin (Zagam), telithromycin (Ketek)
• medicines to treat psychiatric disorders, such as haloperidol (Haldol), droperidol (Inapsine), chlorpromazine (Thorazine), fluphenazine (Prolixin), mesoridazine (Serentil), perphenazine (Trilafon), prochlorperazine (Compazine), thioridazine (Mellaril), or trifluperazine (Stelazine); or
• heart rhythm medicine such as amiodarone (Cordarone, Pacerone), dofetilide (Tikosyn), disopyramide (Norpace), procainamide (Procan, Pronestyl), quinidine (Cardioquin, Quinaglute), or sotalol (Betapace)

This list is not complete and there may be other drugs that can interact with apomorphine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

What should I avoid while taking Apokyn (Apomorphine)?

Avoid drinking alcohol. It can increase some of the side effects of apomorphine.

Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by apomorphine. Tell your doctor if you regularly use any of these other medicines.

Apomorphine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Apokyn Dosage

How should I take Apokyn (Apomorphine)?

Apomorphine is given as an injection under the skin of your stomach, upper arm, or upper thigh. Your doctor, nurse, or other healthcare provider will give you this injection. You may be shown how to inject your medicine at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Do not inject apomorphine into a vein.

Measuring your apomorphine dose correctly is extremely important. If you use an injector pen with your apomorphine, the medication is measured in milliliters (mL) marked on the pen. However, your prescribed dose may be in milligrams (mg). One milligram, or 1 mg, of apomorphine is equal to 0.1 mL marked on the dosing pen.

Use a different place on your stomach, arm, or thigh each time you give yourself an injection. Do not inject apomorphine into the same place two times in a row.

Use each disposable needle only one time. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

Apomorphine can cause severe nausea and vomiting. For this reason, your doctor may prescribe an anti-nausea medication for you to start taking a few days before you begin using apomorphine. You may also need to keep using the anti-nausea medicine throughout your treatment with apomorphine.

You may have withdrawal symptoms such as fever, muscle stiffness, and feeling light-headed or fainting, when you stop using this medication after using it over a long period of time. Do not stop using apomorphine suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely.

If you stop using apomorphine for a week or longer, ask your doctor before restarting the medication. You may need to restart with a lower dose.

Store this medication at room temperature, away from heat, moisture, and light.

What happens if I overdose on Apokyn (Apomorphine)?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include nausea, extreme drowsiness, or fainting.

What happens if I miss a dose of Apokyn (Apomorphine)?

Use the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.

Edited from everydayhealth.com