Apomorphine injection

What is Apomorphine injection?

APOMORPHINE (Apokyn™, Apokyn™ Pen) is used to treat 'off' episodes of advanced Parkinson's disease which affect your ability to move or perform tasks. Apomorphine will not cure Parkinson's disease, but it will help to control the symptoms. Generic apomorphine injection is not available.

What should my health care professional know before I receive Apomorphine?

They need to know if you have any of these conditions:

• frequently drink alcoholic beverages

• asthma or other breathing problems

• decreased alertness

• depression

• dizziness or fainting spells

• heart disease

• irregular heart beat

• kidney disease

• liver disease

• low blood pressure

• nausea or vomiting

• schizophrenia

• seizures

• stroke

• an unusual reaction to Apomorphine, other medicines foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

How should this medicine be used?

Apomorphine is given as an injection under the skin. Follow the directions on the prescription label. Do not take your medicine more often than directed. Do not stop taking except on your prescriber's advice. Apomorphine is usually given with a medicine to help prevent nausea and vomiting. Your health care provider will teach you or your caregiver how to use apomorphine injections.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

Elderly patients over 65 years old may have a stronger reaction to this medicine and may need smaller doses.

What if I miss a dose?

Apomorphine is not taken at regular intervals, but is used as needed to treat 'off' episodes of Parkinson's disease which affect your ability to move or perform tasks. Contact your health care provider if your symptoms do not respond to the first dose for a particular 'off' episode. Do not use a second dose for that episode. Do not use double or extra doses.

What drug(s) may interact with Apomorphine?

• alcohol

• alfuzosin

• some antibiotics (clarithromycin, erythromycin, gatifloxacin, gemifloxacin, grepafloxacin, levofloxacin, moxifloxacin, sparfloxacin, troleandomycin)

• antihistamines that cause drowsiness (examples: diphenhydramine, doxylamine)

• medicines for anxiety or sleep problems

• arsenic trioxide

• astemizole

• bepridil

• chloroquine

• cisapride

• some medicines for depression (examples: amitriptyline, amoxapine, maprotiline, mirtazapine, nefazodone, nortriptyline)

• halofantrine

• halothane

• medicines for irregular heart beat (examples: amiodarone, disopyramide, dofetilide, flecainide, ibutilide, quinidine, procainamide, sotalol)

• levomethadyl

• mefloquine

• some medicines for nausea (examples: alosetron, dolasetron, dronabinol, droperidol, granisetron, ondansetron, palonesetron)

• some medicines for mental disturbances (examples: clozapine, haloperidol, molindone, olanzapine, pimozide, quetiapine, risperidone, ziprasidone)

• metoclopramide

• muscle relaxants

• some medicines for Parkinson's disease (entacapone, pramipexole, ropinirole, tolcapone)

• pentamidine

• prescription pain medicines such as codeine, methadone, morphine, tramadol, and others

• probucol

• tacrolimus

• terfenadine

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking Apomorphine?

Visit your prescriber or health care profressional for regular checks on your progress.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how apomorphine affects you. You may experience flushing, nausea, vomiting, pale skin, or sweating before dizziness or fainting occurs. Do not get up too quickly from a lying or sitting position. Report any dizziness or related symptoms to your health care provider as soon as possible. Alcohol may increase dizziness and drowsiness. Avoid alcoholic drinks. Do not take any medications that cause drowsiness without first checking with your health care provider.

Apomorphine may cause severe nausea and vomiting. Your doctor may prescribe a medication to prevent these symptoms. Do not treat yourself. Not all medicines for nausea and vomiting can be used with apomorphine. Talk to your doctor about which one may be right for you.

If you are going to have surgery, tell your prescriber or health care professional that you are taking apomorphine.

What side effects may I notice from receiving Apomorphine?

Side effects that you should report to your prescriber or health care professional as soon as possible:

• abnormal or unusual body movements

• blood pressure changes

• confusion, hallucinations (seeing or hearing things that are not really there)

• depression or depressed mood

• difficulty breathing or swallowing

• dizziness or lightheadedness

• excess flushing

• excess sweating

• fainting spells

• irregular or fast, pounding heartbeat, palpitations

• mouth sores or infection

• skin rash, redness, paleness, or itching

• swelling in arms, hands, legs, or feet

• vomiting

• unusual weakness or tiredness

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

• drowsiness

• hand trembling

• headache

• nausea

• restlessness

• excess saliva in mouth

• unpleasant taste in mouth

• yawning

Where can I keep my medicine?

Keep out of the reach of children in a container that small children cannot open.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees). Throw away any unused medicine after the expiration date.