Apomorphine Sublingual Film

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): KYNMOBI

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

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

• Dizzy or fainting spells
• Frequently drink alcohol
• Have had a stroke
• Have trouble staying awake during the day
• Heart disease
• Kidney disease
• Liver disease
• Low blood pressure
• Lung or breathing disease, such as asthma
• 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?

Take this medication by mouth. Take it as directed on the prescription label. Leave the film in the sealed foil pouch until you are ready to take it. With dry hands, open the pouch and gently remove the film. Place the film in the mouth under the tongue and allow it to dissolve. Do not cut, crush, or chew this medication. Do not take 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.

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 only given as needed to treat 'off' episodes in Parkinson's disease. Contact your care team 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 may interact with this medication?

Do not take this medication with any of the following:

• Cisapride
• Dronedarone
• Ketoconazole
• Levoketoconazole
• Pimozide
• Thioridazine
• Some medications for nausea and vomiting, such as dolasetron, granisetron, ondansetron, palonosetron

This medication may also interact with the following:

• Alcohol
• Benzodiazepines, such as alprazolam, diazepam, lorazepam
• Certain antihistamines
• Certain medications for depression, such as amitriptyline or trazodone
• Certain medications for seizures, such as phenobarbital or primidone
• Haloperidol
• Medications that cause drowsiness before a procedure, such as propofol
• Medications that help you fall asleep
• Medications that relax muscles
• Metoclopramide
• Nitroglycerin
• Opioids for pain or cough
• Other medications that cause heart rhythm changes
• Phenothiazines, such as chlorpromazine, prochlorperazine, thioridazine
• 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 under the tongue while on this medication, lie down first. Then, take the medication. Keep lying down for at least 45 minutes after you take it.

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
• Falling asleep during daily activities
• Hallucinations
• 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
• 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
• Headache
• Nausea
• Pain, irritation, or ulcers in the mouth at application site
• 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). Keep this medication in the foil pouch until you are ready to take it. 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.