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Drug Interactions between apomorphine and kava

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

kava apomorphine

Applies to: kava and apomorphine

GENERALLY AVOID: Coadministration with kava may diminish the therapeutic effects of levodopa and other dopamine agonists. In addition, the central nervous system depressant effects of these agents may be additively or synergistically increased when taken together. Kava reportedly possesses central antidopaminergic activity, thus it can antagonize the effects of some antiparkinson medications. Extrapyramidal adverse effects including dyskinesia and dystonic reactions have been reported in association with kava use. There has also been a case report of a patient receiving levodopa for Parkinson's disease whose frequency and duration of daily 'off' periods increased significantly within 10 days after she began taking a kava extract twice daily. She returned to her normal baseline pattern of 'on' and 'off' periods two days after discontinuing the kava.

MANAGEMENT: In general, patients should consult a healthcare provider before taking any herbal or alternative medicine. Patients receiving treatment for Parkinson's disease should preferably avoid kava, since it may worsen the condition. If kava is used, patients should be alerted to the possibility of excessive sedation and monitored for potentially diminished therapeutic response to their dopaminergic therapy.

References (3)
  1. Pepping J (1999) "Kava: Piper methysticum." Am J Health Syst Pharm, 56, p. 957-60
  2. Izzo AA, Ernst E (2001) "Interactions between herbal medicines and prescribed drugs: a systematic review." Drugs, 61, p. 2163-75
  3. Schlosky L, Raffauf C, Jendroska K, Poewe W (1995) "Kava and dopamine antagonism." J Neurol Neurosurg Psychiatry, 58, p. 639-40

Drug and food interactions

Moderate

apomorphine food

Applies to: apomorphine

GENERALLY AVOID: Alcohol and apomorphine may have additive hypotensive and sedative effects. Coadministration of 0.6 or 0.3 g/kg of ethanol with apomorphine in healthy subjects resulted in greater decreases in blood pressure compared to apomorphine alone. The mean largest decrease (the mean of each subject's largest drop in blood pressure measured within 6 hours after apomorphine administration) in standing systolic and diastolic blood pressure was 6.7 and 8.4 mmHg, respectively, with apomorphine alone. When coadministered with 0.6 g/kg of ethanol (equivalent to approximately 3 standardized alcohol-containing beverages), the mean largest decrease in standing systolic and diastolic blood pressure was 11.3 and 12.6 mmHg, respectively (standing systolic and diastolic blood pressure decreased by as much as 61 and 51 mmHg, respectively, in this group). When coadministered with 0.3 g/kg of ethanol, the mean largest decrease in standing systolic and diastolic blood pressure was 8.4 and 7.1 mmHg, respectively.

MANAGEMENT: Patients should be advised to avoid consumption of alcohol during apomorphine treatment.

References (5)
  1. (2022) "Product Information. Apokyn (apomorphine)." US WorldMeds LLC
  2. (2022) "Product Information. Kynmobi (apomorphine)." Sunovion Pharmaceuticals Inc
  3. (2023) "Product Information. Dacepton (apomorphine)." Ever Pharma UK Ltd
  4. (2024) "Product Information. aPomine Intermittent (apomorphine)." Pfizer Australia Pty Ltd, 1.1
  5. (2024) "Product Information. Movapo (apomorphine)." Stada Pharmaceuticals Australia Pty Ltd

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

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

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