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Apokyn

Generic Name: apomorphine (a poe MOR feen)
Brand Names: Apokyn

Medically reviewed by P. Thornton, DipPharm Last updated on Sep 10, 2019.

What is Apokyn?

Apokyn (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.

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.

Important Information

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.

Before taking this medicine

You should not use Apokyn if you are allergic apomorphine.

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

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;

  • a stroke;

  • liver or kidney disease;

  • mental illness or psychosis; or

  • if you drink alcohol.

Tell your doctor if you are pregnant or breastfeeding.

How should I use Apokyn?

Use Apokyn exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Apokyn is injected under the skin. A healthcare provider may teach you how to properly use the medication by yourself.

Do not inject Apokyn into a vein.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you don't understand all instructions.

Prepare an Apokyn injection only when you are ready to give it. Do not use if the medicine looks cloudy, has changed colors, or has particles in it. Call your pharmacist for new medicine.

Measuring your dose correctly is extremely important. The dose in an Apokyn injection pen 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 injection pen.

Your care provider will show you where to on your body to inject Apokyn. Use a different place each time you give an injection. Do not inject into the same place two times in a row.

You may be given other medications to help prevent nausea and vomiting. Use only the anti-nausea medicine prescribed by your doctor. Some anti-nausea medicines can increase certain side effects of apomorphine, or can make your Parkinson's symptoms worse.

Your blood pressure will need to be checked often.

The medicine from an injection pen can cause irritation if it gets in your eyes or on your skin. If this happens, rinse with water.

Do not stop using Apokyn suddenly, or you could have unpleasant withdrawal symptoms such as fever and confusion. Ask your doctor how to safely stop using this medicine.

If you stop using this medicine for 7 days or longer, ask your doctor before restarting the medication. You may need to restart with a lower dose.

Store Apokyn cartridges at room temperature away from moisture and heat.

Use a needle and syringe only once and then place them in a puncture-proof "sharps" container. Follow state or local laws about how to dispose of this container. Keep it out of the reach of children and pets.

Apokyn dosing information

Usual Adult Dose for Parkinson's Disease:

Test dose: 0.2 mL (2 mg) during "Off" period.

Initial: 0.2 mL (2 mg) subcutaneously during the 'Off" period, up to three times per day, if test dose tolerated and provided good response.

Maintenance: Titrate every few days in 0.1 mL (1 mg) increments upwards to a maximum of 0.6 mL (6 mg) per dose.

Maximum single dose is 0.6 mL (6 mg),.

Maximum: do not administer more than 5 times per day, and do not exceed 2 mL (20 mg) per day.

What happens if I miss a dose?

Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time. Allow at least 2 hours to pass between doses.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using Apokyn?

Some people using Apokyn have fallen asleep during normal daytime activities such as working, talking, eating, or driving. Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Do not drink alcohol. It can further lower your blood pressure and may increase certain side effects of apomorphine.

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:

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

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

  • worsening of your Parkinson symptoms;

  • chest pain, fast or slow heart beats, shortness of breath;

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

  • daytime sleepiness or drowsiness;

  • confusion, hallucinations, unusual thoughts or behavior;

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

  • unexplained pain in your stomach, back, or leg;

  • swelling in your lower legs; or

  • penis erection that is painful or lasts 4 hours or longer.

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:

  • swelling;

  • confusion;

  • yawning;

  • runny nose; or

  • itching, bruising, or swelling where the medicine was injected.

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.

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 interact with apomorphine, especially:

  • heart or blood pressure medication;

  • medicine to treat or prevent nausea and vomiting; 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.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Apokyn only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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