Apomorphine

Generic Name: apomorphine (A-poe-MOR-feen)
Brand Name: Apokyn

Apomorphine is used for:

Treating loss of control of body movements such as muscle stiffness, slow movements, or trouble moving associated with advanced Parkinson disease.

Apomorphine is a dopamine agonist. It works by stimulating dopamine receptors, which helps improve motor function.

Do NOT use apomorphine if:

  • you are allergic to any ingredient in apomorphine (especially a sulfite)
  • you have decreased consciousness, seizures, or very low blood pressure
  • you are taking a 5-HT3 antagonist antiemetic (eg, ondansetron, dolasetron, granisetron, palonosetron, alosetron)

Contact your doctor or health care provider right away if any of these apply to you.

Slideshow: 11 Signs of Alzheimer's Disease - Or Are You Just Getting Older?

Before using apomorphine:

Some medical conditions may interact with apomorphine. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have had a severe allergic reaction (eg, severe rash, hives, difficulty breathing, dizziness) to sulfites
  • if you have a history of low blood pressure, dizziness, fainting, heart problems (eg, irregular or slow heartbeat), a certain type of irregular heartbeat (eg, QT prolongation), low blood magnesium or potassium levels, asthma, liver problems, kidney problems, mental or mood problems, sleep problems (eg, falling asleep without warning), blood vessel problems, or a stroke or other brain problems
  • if you regularly drink alcohol or if you have a history of alcohol or substance abuse
  • if you are taking any medicine that may increase the risk of QT prolongation. Ask your doctor or pharmacist if you are unsure if any of your medicines may increase the risk of this type of irregular heartbeat

Some MEDICINES MAY INTERACT with apomorphine. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • 5-HT3 antagonist antiemetics (eg, ondansetron, dolasetron, granisetron, palonosetron, alosetron) because the risk of severe low blood pressure and loss of consciousness may be increased
  • Antiarrhythmics (eg, amiodarone, quinidine, sotalol), arsenic, azole antifungals (eg, ketoconazole), bepridil, cisapride, droperidol, H1 antagonists (eg, astemizole, terfenadine), ketolides (eg, telithromycin), macrolide antibiotics (eg, erythromycin), phenothiazines (eg, thioridazine), phosphodiesterase type 5 inhibitors (eg, vardenafil), pimozide, quinolone antibiotics (eg, ciprofloxacin), serotonin receptor antagonist antiemetics (eg, dolasetron), tricyclic antidepressants (eg, imipramine), or ziprasidone because the risk of serious side effects, such as abnormal heart rhythms, may be increased
  • Medicine for high blood pressure or nitrates (eg, nitroglycerin, isosorbide) or other vasodilators (eg, minoxidil) because they may increase the risk of apomorphine's side effects
  • Butyrophenones (eg, haloperidol), metoclopramide, phenothiazines (eg, chlorpromazine), or thioxanthenes (eg, thiothixene) because they may decrease apomorphine's effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if apomorphine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use apomorphine:

Use apomorphine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • An extra patient leaflet is available with apomorphine. Talk to your pharmacist if you have questions about this information.
  • Apomorphine is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using apomorphine at home, a health care provider will teach you how to use it. Be sure you understand how to use apomorphine. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
  • Apomorphine is for injection under the skin only. Do not inject apomorphine into a vein. Blood clots (in the lungs) have happened when apomorphine was given into a vein. Talk with your doctor.
  • Make sure you understand how to properly measure each dose of apomorphine before injecting it. Ask your pharmacist for help if you are unsure of how to measure your dose.
  • Rotate sites where the medicine is injected. Do not always use the same site.
  • Do not inject medicine into a site that is sore, red, infected, or damaged.
  • Do not use apomorphine if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
  • Your doctor may prescribe another medicine called an antiemetic before you start taking apomorphine to lessen the nausea and vomiting that can occur when taking apomorphine. You may need to continue taking the antiemetic for the first 2 months of therapy.
  • Keep this product, as well as syringes and needles, out of the reach of children and away from pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
  • If you miss a dose of apomorphine, call your doctor to find out what to do.

Ask your health care provider any questions you may have about how to use apomorphine.

Important safety information:

  • Apomorphine may cause drowsiness, dizziness, or cause you to fall asleep without warning. These effects may be worse if you take it with alcohol or certain medicines. Use apomorphine with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Some patients who take apomorphine have reported suddenly falling asleep while performing daily activities (eg, driving, eating, talking). Some patients did not experience drowsiness and felt that they were alert immediately before suddenly falling asleep. Some of these events have been reported as late as 1 year after apomorphine was started. Use caution when driving, operating machinery, or performing other activities that could be dangerous. Inform your doctor if you experience unusual drowsiness or sleepiness while using apomorphine.
  • Apomorphine may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using apomorphine; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • Do NOT use more than the recommended dose of apomorphine or use it more often than prescribed without checking with your doctor.
  • Have your blood pressure and heart rate checked often. Talk with your doctor.
  • Some of these products contain sulfites. Sulfites may cause an allergic reaction in some patients (eg, asthma patients). If you have ever had an allergic reaction to sulfites, ask your pharmacist if your product has sulfites in it.
  • Patients with Parkinson disease may have an increased risk of developing a certain type of skin cancer (melanoma). It is not known if apomorphine also increases the risk of melanoma. You may need to have skin exams while you are using apomorphine. Tell your doctor if you notice any unusual skin growths or a change in the appearance of a mole. Discuss any questions or concerns with your doctor.
  • Some people have experienced new, unusual, or increased urges (eg, gambling, sexual urges) while using apomorphine. Tell your doctor right away if you notice such effects.
  • Apomorphine may rarely cause a prolonged, painful erection. This could happen even when you are not having sex. If this is not treated right away, it could lead to permanent sexual problems such as impotence. Contact your doctor right away if this happens.
  • Chest pain, heart attack, and sudden death have rarely happened with apomorphine. Discuss any questions or concerns with your doctor.
  • Do not suddenly stop taking apomorphine. Doing so may cause withdrawal symptoms like fever; stiff muscles; confusion; abnormal thinking; and fast or irregular heartbeat. Check with your doctor before you change your dose or stop apomorphine.
  • Lab tests, including skin exams, may be performed while you use apomorphine. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Use apomorphine with caution in the ELDERLY; they may be more sensitive to its effects, especially confusion; falling; hallucinations; and heart, lung, and stomach problems.
  • Apomorphine should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using apomorphine while you are pregnant. It is not known if apomorphine is found in breast milk. Do not breast-feed while taking apomorphine.

Possible side effects of apomorphine:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Bruising, itching, pain, swelling, or redness at the injection site; dizziness; drowsiness; flushing; headache; nausea; pale skin; runny nose; vomiting; yawning.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); abnormal thinking; agitation; behavior changes (eg, aggression, paranoia); chest, jaw, or left arm pain; confusion; difficulty moving; fainting; falling down; fast or irregular heartbeat; hallucinations; increased sweating; mental or mood changes (eg, depression); new, unusual, or increased urges (eg, gambling, sexual urges); one-sided weakness; painful or prolonged erection; severe or persistent dizziness, drowsiness, nausea, or vomiting; severe or persistent headache; shortness of breath; sudden, uncontrollable movements; swelling of the arms, hands, legs, or feet; unusual change in the appearance of a mole or other skin growths; vision or speech changes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of apomorphine:

Store apomorphine at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep apomorphine out of the reach of children and away from pets.

General information:

  • If you have any questions about apomorphine, please talk with your doctor, pharmacist, or other health care provider.
  • Apomorphine is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take apomorphine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about apomorphine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to apomorphine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using apomorphine.

Issue Date: November 5, 2014
Database Edition 14.4.1.002
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

Hide
(web2)