Apomorphine Injection

What is this medication?

APOMORPHINE (a poe MOR feen) treats the symptoms of Parkinson disease. It works by acting like dopamine, a substance in your body that helps manage movements and coordination. This reduces the symptoms of Parkinson, such as body stiffness and tremors.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Apokyn

What should I tell my care team before I take this medication?

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

• Asthma
• Feel very sleepy during the day, fall asleep suddenly during the day
• Frequently drink alcohol
• Have had a stroke
• Heart disease
• History of fainting
• Irregular heartbeat or rhythm
• Kidney disease
• Liver disease
• Low blood pressure
• Mental health conditions
• An unusual or allergic reaction to apomorphine, sulfites, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breastfeeding

How should I use this medication?

This medication is injected under the skin. You will be taught how to prepare and give it. Take it as directed on the prescription label. Do not use it more often than directed. Keep taking this medication unless your care team tells you to stop. Stopping it too quickly can cause serious side effects. It can also make your condition worse.

It is important that you put your used needles and syringes in a special sharps container. Do not put them in a trash can. If you do not have a sharps container, call your pharmacist or care team to get one.

This medication comes with INSTRUCTIONS FOR USE. Ask your pharmacist for directions on how to use this medication. Read the information carefully. Talk to your pharmacist or care team if you have questions.

Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

This does not apply. This medication is not for regular use.

What may interact with this medication?

Do not take this medication with any of the following:

• Certain medications for nausea or vomiting, such as dolasetron, granisetron, ondansetron, palonosetron
• Dronedarone
• Ketoconazole
• Levoketoconazole
• Pimozide
• Thioridazine

This medication may also interact with the following:

• Alcohol
• Benzodiazepines, such as alprazolam, diazepam, lorazepam
• Certain medications for anxiety or sleep
• Certain medications for blood pressure
• Haloperidol
• Metoclopramide
• Nitroglycerin
• Opioids
• Other medications that cause heart rhythm changes
• Phenothiazines, such as chlorpromazine or prochlorperazine
• Thiothixene

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular checks on your progress. Tell your care team if your symptoms do not start to get better or if they get worse.

This medication may cause nausea and vomiting, which can be severe. Your care team may give you medication to decrease your symptoms. Do not treat yourself. Not all medications for nausea and vomiting can be used with this medication. Your care team can help you find the option that is right for you.

This medication may affect your coordination, reaction time, or judgment. Do not drive or operate machinery until you know how this medication affects you. Sit up or stand slowly to reduce the risk of dizzy or fainting spells. Drinking alcohol with this medication can increase the risk of these side effects.

When taking this medication, you may fall asleep without notice. You may be doing activities, such as driving a car, talking, or eating. You may not feel drowsy before it happens. Contact your care team right away if this happens to you.

Taking nitroglycerin with this medication can cause a sudden drop in blood pressure. This can cause dizziness and fainting. If you need to take nitroglycerin while on this medication, lie down first. Then, place the nitroglycerin under your tongue. Keep lying down for at least 45 minutes.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions or angioedema—skin rash, itching or hives, swelling of the face, eyes, lips, tongue, arms, or legs, trouble swallowing or breathing
• Chest pain (angina)—pain, pressure, or tightness in the chest, neck, back, or arms
• Falling asleep during daily activities
• Hallucinations
• Heart attack—pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded
• Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
• Hemolytic anemia—unusual weakness or fatigue, dizziness, headache, trouble breathing, dark urine, yellowing skin or eyes
• Low blood pressure—dizziness, feeling faint or lightheaded, blurry vision
• New or worsening uncontrolled and repetitive movements of the face, mouth, or upper body
• Prolonged or painful erection
• Unusual changes in behavior
• Urges to engage in impulsive behaviors such as gambling, binge eating, sexual activity, or shopping in ways that are unusual for you

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

• Dizziness
• Drowsiness
• Nausea
• Runny or stuffy nose
• Swelling of the ankles, hands, or feet
• Vomiting

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Get rid of any unused medication after the expiration date.

To get rid of medications that are no longer needed or have expired:

• Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
• If you cannot return the medication, ask your pharmacist or care team how to get rid of this medication safely.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.