Apokyn

Generic name: Apomorphine Injection
Drug class: Dopaminergic antiparkinsonism agents

Usage of Apokyn

Apokyn 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.

Apokyn is a prescription medicine used to treat "wearing-off" episodes (muscle stiffness, loss of muscle control) in people with advanced Parkinson's disease.

It is not known if Apokyn is safe and effective in children.

Apokyn side effects

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

Call your doctor at once if you have:

a light-headed feeling, like you might pass out;

extreme drowsiness, falling asleep suddenly, even after feeling alert;

confusion, hallucinations, unusual thoughts or behavior;

twitching or uncontrollable movements of your eyes, lips, tongue, face, arms, or legs;

fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness (like you might pass out);

ongoing nausea or vomiting (even after taking anti-nausea medicine);

new or worsening cough, fever, pain when you breathe, feeling short of breath while lying down;

penis erection that is painful or lasts 4 hours or longer;

worsening of your Parkinson symptoms;

pale or yellowed skin, dark colored urine, fever, confusion or weakness; or

severe nervous system reaction - very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Serious side effects may be more likely in older adults.

You may have increased sexual urges, unusual urges to gamble, or other intense urges while using this medicine. Talk with your doctor if this occurs.

Common Apokyn side effects may include:

dizziness, drowsiness;

nausea, vomiting;

pain or swelling in your nose, mouth, or throat;

numbness, tingling, burning pain;

swelling in your hands or feet;

confusion, hallucinations;

yawning;

runny nose; or

uncontrolled muscle movements.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Before taking Apokyn

You should not use Apokyn if you are allergic to apomorphine.

Many drugs can interact and cause dangerous effects. Some drugs should not be used together with Apokyn. Your doctor may change your treatment plan if you also use:

alosetron;

dolasetron;

granisetron;

ondansetron (Zofran); or

palonosetron.

To make sure Apokyn is safe for you, tell your doctor if you have ever had:

asthma or a sulfite allergy;

low blood pressure or dizzy spells;

narcolepsy, falling asleep during the daytime;

heart problems, long QT syndrome;

a stroke;

liver or kidney disease;

mental illness or psychosis; or

if you drink alcohol.

Tell your doctor if you are pregnant or breastfeeding.

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How to use Apokyn

Usual Adult Dose of Apokyn for Parkinson's Disease:

Dose initiation should be supervised by a healthcare provider: Antiemetic premedication should be initiated prior to therapy due to high incidence of nausea and vomiting Initial dose: 2 mg (0.2 mL) subcutaneously during an "off" episode -First dose: Obtain pulse, supine and standing blood pressure pre-dose, 20, 40, and 60 minutes post-dose; if significant hypotension is present 60 minutes post-dose, recheck after 60 minutes; if significant hypotension occurs in response to initial dose, patients should not be considered good candidates for treatment -Titration: If initial dose is tolerated, but response is insufficient, may increase in 2 mg increments up to 6 mg (under medical supervision) or in increments of 1 mg every few days up to 3 mg (outpatient) for subsequent "off" episodes; allow at least 2 hours between doses; assess response until an effective and tolerable dose is achieved Maintenance dose: 2 to 6 mg subcutaneously during an "off" episode; doses should be separated by at least 2 hours; average dosing frequency in clinical trials was 3 times per day Maximum single dose: 6 mg (0.6 mL) Maximum dosing frequency: 5 times per day Maximum daily dose: 20 mg (2 mL) per day

Warnings

Serious drug interactions can occur when certain medicines are used together with Apokyn. Tell each of your healthcare providers about all medicines you use now, and any medicine you start or stop using.

You should not use Apokyn if you also taking alosetron (Lotronex), dolasetron (Anzemet), granisetron (Kytril), ondansetron (Zofran), or palonosetron (Aloxi).

Before using Apokyn, tell your doctor if you have an electrolyte imbalance (such as low levels of potassium or magnesium in your blood), a slow heart rate, low blood pressure or dizzy spells, a history of "Long QT syndrome," a history of stroke or heart attack, asthma, sulfite allergy, or liver or kidney disease.

You may have increased sexual urges, unusual urges to gamble, or other intense urges while taking this medication. Talk with your doctor if you believe you have any intense or unusual urges while taking Apokyn.

What other drugs will affect Apokyn

Using Apokyn with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

If you also take nitroglycerin (under the tongue), your blood pressure may drop and you may feel dizzy. Lie down for at least 45 minutes if possible.

Tell your doctor about all your current medicines. Many drugs can affect apomorphine, especially:

metoclopramide;

heart or blood pressure medication; or

medicine to treat anxiety, mood disorders, or mental illness such as schizophrenia.

This list is not complete and many other drugs may interact with apomorphine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Popular FAQ

Yes, Apokyn has been reported as causing dyskinesia or worsening pre-existing dyskinesia in up to 24% of patients in clinical studies. Dyskinesia is an uncontrolled, involuntary muscle movement. This side effect resulted in 2% of patients dropping out of the studies.

Apokyn (generic name: apomorphine) is not a controlled substance or an opioid (narcotic) pain medicine. Apokyn is a dopamine agonist agent used to treat "off" episodes in patients with Parkinson's disease. Despite its name, apomorphine does not contain the controlled substance morphine.

Apokyn (apomorphine) injected subcutaneously (under the skin) starts to work to decrease your "off" episode symptoms within 10 minutes. Most people see results within 20 minutes, but the peak effect may take up to 60 minutes.

Apokyn (apomorphine) comes in a pen injector and is injected subcutaneously (under the skin) after training. Your first dose is given under medical supervision. Do not inject Apokyn into a vein.

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