What is apomorphine?

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.

Apomorphine is used to treat "wearing-off” episodes (muscle stiffness, loss of muscle control) in people with advanced Parkinson’s disease.

Apomorphine may also be used for other purposes not listed in this medication guide.

Precautions

You should not use this medication if you are allergic to apomorphine, or if you are using any of the following medications:

  • alosetron (Lotronex);
  • dolasetron (Anzemet);
  • granisetron (Kytril);
  • ondansetron (Zofran); or
  • palonosetron (Aloxi).

Before using apomorphine, tell your doctor if you are allergic to any drugs, or if you have:

  • an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);
  • a slow heart rate;
  • a personal or family history of "Long QT syndrome";
  • a history of stroke or heart attack;
  • asthma;
  • liver disease;
  • kidney disease;
  • a psychiatric disorder such as schizophrenia; or
  • low blood pressure.

If you have any of these conditions, you may need a dose adjustment or special tests to safely use apomorphine.

Some people using apomorphine have fallen asleep during normal daytime activities such as working, talking, eating, or driving. You may fall asleep suddenly, even after feeling alert. Tell your doctor if you have any problems with daytime sleepiness or drowsiness. If you are unsure of how this medicine will affect you, be careful if you drive or do anything that requires you to be awake and alert.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Apomorphine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Avoid drinking alcohol. It can increase some of the side effects of apomorphine.

Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by apomorphine. Tell your doctor if you regularly use any of these other medicines.

Apomorphine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

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Instructions

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include nausea, extreme drowsiness, or fainting.

Use the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.

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Side Effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • nausea or vomiting that continues after taking an anti-nausea medication;
  • feeling light-headed (especially when you stand up);
  • falling or passing out;
  • chest pain or heavy feeling, pain spreading to the arm or shoulder, sweating, general ill feeling;
  • confusion, hallucinations;
  • restless muscle movements in your eyes, tongue, jaw, or neck;
  • tremor (uncontrolled shaking); or
  • penis erection that is painful or lasts 4 hours or longer.

Less serious side effects may include:

  • bruising, itching, or hardening of your skin where the injection was given;
  • increased sexual desire;
  • depressed mood, headache;
  • pale skin, increased sweating;
  • warmth, redness, or tingling under your skin;
  • dizziness, drowsiness, yawning;
  • runny nose;
  • swelling in your hands or feet;
  • sleep problems (insomnia);
  • joint pain; or
  • constipation or diarrhea.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

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Interactions

Before using apomorphine, tell your doctor if you are using any of the following drugs:

  • arsenic trioxide (Trisenox);
  • bepridil (Vascor);
  • blood pressure medications;
  • cisapride (Propulsid);
  • chloroquine (Arelan) or halofantrine (Halfan);
  • metoclopramide (Reglan);
  • niacin (nicotinic acid, Niacor, Niaspan, and others);
  • sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra);
  • narcotic medication such as fentanyl (Actiq, Duragesic), hydrocodone (Vicodin), hydromorphone (Dilaudid), levomethadyl (Orlaam), methadone (Methadose), morphine (Kadian, MS Contin), oxycodone (OxyContin, Percocet), oxymorphone (Opana), pentazocine (Talwin), or propoxyphene (Darvon);
  • antibiotics such as azithromycin (Zithromax), clarithromycin (Biaxin), dirithromycin (Dynabac), erythromycin (E-Mycin, E.E.S., Erythrocin, Ery-Tab), pentamidine (NebuPent, Pentam), sparfloxacin (Zagam), telithromycin (Ketek);
  • medicines to treat psychiatric disorders, such as haloperidol (Haldol), droperidol (Inapsine), chlorpromazine (Thorazine), fluphenazine (Prolixin), mesoridazine (Serentil), perphenazine (Trilafon), prochlorperazine (Compazine), thioridazine (Mellaril), or trifluperazine (Stelazine); or
  • heart rhythm medicine such as amiodarone (Cordarone, Pacerone), dofetilide (Tikosyn), disopyramide (Norpace), procainamide (Procan, Pronestyl), quinidine (Cardioquin, Quinaglute), or sotalol (Betapace).

This list is not complete and there may be other drugs that can interact with apomorphine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Other Names

APO-Go, APO-Go Pen, Apokyn, Uprima, and apomorphine

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Disclaimer

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2004 Cerner Multum, Inc. Version 2.05. Revision date 8/23/04

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