Apomorphine (a-poe-MOR-feen)

Treats loss of muscle movement control from Parkinson disease.

Brand Name(s):

Apokyn

When This Medicine Should Not Be Used:

How to Use This Medicine:

Injectable

• Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given as a shot under your skin.
• A nurse or other health provider will give you this medicine.
• You may be taught how to give your medicine at home. Make sure you understand all instructions before giving yourself an injection. Do not use more medicine or use it more often than your doctor tells you to.
• You will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas.
• Check the liquid in the pen. It should be clear or colorless. Do not use the medicine if it is cloudy, discolored, or has particles in it.
• Do not get the liquid in the cartridge on your skin or into your eyes. Rinse it off with water right away if it does get in these areas.
• You must prime the pen before using it. To prime:
  • Set the dose knob of the pen to 0.1 milliliter (mL) to get rid of any air bubbles.
  • Remove the inner needle shield. Do not let the needle touch anything.
  • Point the needle up and firmly push the injection button. Hold it for at least 5 seconds. A small stream of medicine must come out of the end of the needle. If there is none, repeat the steps until medicine comes out of the needle.
  • This medicine can stain fabric and other surfaces. Be careful where you prime it.
• Your doctor may give you other medicines (including trimethobenzamide) 3 days before starting this medicine and for up to 2 months to prevent nausea and vomiting. Your doctor may also start this medicine at a lower dose to help prevent nausea and vomiting.
• Use a new needle and syringe each time you inject your medicine.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
• Missed dose: Call your doctor or pharmacist for instructions. Do not inject another dose of this medicine less than 2 hours after the last dose.
• If you store this medicine at home, keep it at room temperature, away from heat and direct light.
• Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not take this medicine together with alosetron, dolasetron, granisetron, ondansetron, or palonosetron.
• Some medicines can affect how apomorphine works. Tell your doctor if you are using any of the following:
  • Carbidopa/levodopa, metoclopramide
  • Blood pressure medicine (including atenolol, lisinopril, metoprolol, nitroglycerin)
  • Diuretic (water pill)
  • Medicine to treat mental illness (including flupenthixol, haloperidol, phenothiazine)
• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol.
• Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, heart or blood vessel disease, heart rhythm problems, mental illness, low blood pressure, asthma, sleeping problems, or an allergy to sulfa medicines.
• This medicine may cause the following problems:
  • Changes in mood or behavior, including hallucinations
  • New or worsening dyskinesia (trouble controlling movements)
  • Blood problem, including hemolytic anemia
  • Unusual changes in thoughts or behavior, including an urge to gamble or spend money or an increased sex drive
  • Increased risk of heart rhythm problems, chest pain, or heart attack
  • Fibrotic problems (tissue changes in the pelvis, lungs, and heart valves)
  • Prolonged or painful erection (in males)
• This medicine may make you dizzy or drowsy, or cause trouble with controlling body movements, which may lead to falls. It may also cause you to fall asleep without warning. This could happen while you are driving, eating, or talking. Tell your doctor right away if this happens. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. Standing up slowly from a sitting or lying position can help prevent getting dizzy.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• Call your doctor if your symptoms do not improve or if they get worse.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Chest pain that may spread to your arms, jaw, back, or neck, trouble breathing, unusual sweating
• Dizziness, lightheadedness, or fainting, severe sleepiness
• Fast, pounding, or uneven heartbeat
• Fever, loss of appetite, lower stomach or back pain, cough
• Prolonged or painful erection, which lasts for more than 4 hours (in males)
• Tiredness, yellow skin or eyes
• Twitching, twisting, uncontrolled repetitive movements of the tongue, lips, face, arms, or legs
• Unusual mood or behavior, anxiety, irritability, seeing, hearing, or feeling things that are not there, trouble sleeping

If you notice these less serious side effects, talk with your doctor:

• Redness, pain, or swelling where the shot is given
• Runny nose
• Yawning

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088