Apomorphine

Apomorphine may be found in some form under the following brand names:

• Apokyn

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of apomorphine, there are no specific foods that you must exclude from your diet when receiving this medication.

Recieve apomorphine exactly as prescribed.

• This medication comes in an injectable form to be given directly under the skin, typically at the onset of an 'off period'. 
• Do not inject apomorphine unless you and your caregiver have been taught the correct way and both of you understand all of the directions. Ask your healthcare provider if you do not understand something.
• Your healthcare provider will tell you what dose of apomorphine to use and how often you should take it. Your healthcare provider will also tell you how to change your dose of apomorphine, if needed. Do not change your dose of apomorphine or use it more often unless your healthcare provider has told you to.

Injecting apomorphine:

• Apomorphine is a clear and colorless liquid. Do not use apomorphine if it appears cloudy, colored, or to contain particles, and call your pharmacist.
• Choose an injection site on your stomach area, upper arm, or upper leg. Change your injection site each time apomorphine is used, this will lower your chances of having a skin reaction at the site where you inject apomorphine. Do not inject apomorphine into an area of skin that is sore, red, infected or damaged.
• Inject apomorphine under your skin (subcutaneously). Do not inject apomorphine into a vein.
• Keep a record of how much apomorphine you have used each time you inject or your care partner gives you an injection.
• Use a new needle with each injection. Never reuse a needle.
• Do not give another dose of apomorphine sooner than 2 hours after the last dose.
• The maximum dosing is 5 times per day and with total daily doses greater than 2 mL (20 mg).
• Your healthcare provider will prescribe apomorphine that comes in prefilled glass cartridges that are used with a special multiple-dose injector pen.
• Your apomorphine pen is dosed in milliliters (mL), not milligrams (mg). Make sure your prescription tells you how many milliliters (mL) to use.
• Your healthcare provider may prescribe another medicine called an antiemetic to take while you are using apomorphine. Antiemetic medicines help to decrease the symptoms of nausea and vomiting that can happen with apomorphine.
• If you take too much apomorphine, you may experience more side effects than usual and they may be stronger than usual. If you are experiencing severe or serious side effects, such as such as chest pain or prolonged erection lasting more than 4 hours,contact your healthcare provider immediately. If you are unable to contact your healthcare provider, you should have someone take you to the Emergency Room.

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

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.

(a poe MOR feen)

Supine and standing blood pressure and pulse predose and 20, 40, and 60 minutes postdose with each test dose; signs and symptoms of orthostatic hypotension; drowsiness or sleepiness; mental status and behavioral changes; periodic skin examinations.

• 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.

In patients with mild to moderate renal impairment, the starting dose should be reduced to 0.1 mL (1 mg).

No data available in patients with severe renal impairment.