Apomorphine | Side Effects, Dosage, Uses & More

Generic Name:

apomorphine, Injectable Solution

All Brands

  • Apokyn
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Highlights for apomorphine

Injectable Solution
1

Apomorphine is used to treat “off” episodes in people with advanced Parkinson’s disease. An “off” episode is when your medications start to wear off and you’re not able to move the way you want.

2

Apomorphine is given as an injection under your skin by your doctor. With your doctor’s approval, you may be able to give yourself the injection at home.

3

Apomorphine is available as the brand-name drug Apokyn. It’s not available as a generic drug.

4

The more common side effects can include yawning, runny nose, confusion, or swelling of your hands, arms, legs, or feet.

5

Serious side effects can include blood clots, nausea, vomiting, hallucinations, heart problems, movement problems, or falls caused by suddenly falling asleep or extreme dizziness. They can also include intense urges, such as a strong desire to engage in gambling or sexual activity.

IMPORTANT INFORMATION

Mental health effects

Apomorphine may cause hallucinations (sensing things that aren’t real), paranoia, delusions (believing in things that aren’t true), or impulsive behaviors.

Falls

Apomorphine may cause you to fall. This can be related to other drug symptoms such as increased dizziness, fainting, or suddenly falling asleep.

Heart problems

In rare cases, apomorphine can cause heart attacks or abnormal heart rhythms. It can even cause cardiac arrest (stopping of your heart), which results in sudden death.

Dyskinesia (movement problems)

Apomorphine may cause new or worsening problems with being able to move the way you want.

Drug features

Apomorphine is a prescription drug. It’s injected under the skin by your doctor using a pen needle. You may be able to self-inject this drug if your doctor thinks you can administer it safely.

Apomorphine is available as the brand-name drug Apokyn. It’s not available as a generic drug.

Apomorphine may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it's used

Apomorphine is used to treat “off” episodes in people with advanced Parkinson’s disease. An “off” episode is when your medications start to wear off and you’re not able to move the way you want.

How it works

Apomorphine belongs to a class of drugs called dopamine agonists. A class of drugs is a group of medications that work in a similar way.

More Details

How it works

Apomorphine belongs to a class of drugs called dopamine agonists. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

The exact way apomorphine works for Parkinson’s disease isn’t known. It may work by stimulating dopamine receptors in your brain.

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apomorphine Side Effects

Injectable Solution

More Common Side Effects

The more common side effects that can occur with use of apomorphine include:

  • yawning

  • runny nose

  • confusion

  • swelling of your hands, arms, legs, or feet

  • nausea

  • vomiting

  • drowsiness

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

  • Allergic reaction. Symptoms can include:

    • hives
    • itching
    • rash
    • swelling of your face, tongue, or the skin around your eyes
    • trouble breathing or swallowing
  • Blood clots. These can occur if apomorphine is injected into a vein. Symptoms can include:

    • swelling in one arm or leg
    • reddish or bluish skin color changes
    • skin warmth in one leg or arm
    • sudden, severe trouble breathing
    • coughing up blood
  • Excessive sleepiness. Symptoms can include:

    • getting sleepy during the day
    • falling asleep without warning while doing daily activities such as talking, eating, or driving a car
  • Hallucinations or abnormal behavior. Symptoms can include:

    • hallucinations (seeing or hearing things that are not real)
    • confusion
    • paranoia (excessive suspicion)
    • aggressive behavior
    • agitation
    • delusional beliefs (believing in things that are not real)
    • disorganized thinking
  • Intense urges. Symptoms can include:

    • new or increased gambling urges
    • increased sexual urges
    • urges to binge-eat
    • strong urges to shop
  • Heart problems. If you have these symptoms, call your doctor or 9-1-1 right away:

    • shortness of breath
    • fast heartbeat
    • angina (chest pain)
    • lightheadedness
    • sweating
  • Serious heart rhythm changes (QT prolongation). Tell your doctor right away if you have these symptoms:

    • a fast or irregular heartbeat
    • feeling your heart skipping beats
    • dizziness
    • fainting
  • Injection site problems. Symptoms can include:

    • bruising
    • swelling
    • itching
  • Melanoma (skin cancer). Some people with Parkinson’s disease are at increased risk of a skin cancer called melanoma. Symptoms can include:

    • lesions (areas of damaged tissue) that are blue or blue-black
    • any mole or spot that changes in color or size over time
  • Tissue changes (fibrotic complications). Symptoms can include:

    • shortness of breath
    • sharp chest pain
    • dull pain in the back or abdomen (stomach area)
    • swelling in one or both legs
    • cough
  • Priapism (a prolonged, painful erection). If you have an erection that lasts more than 4 hours, call your doctor or go to the nearest emergency room right away.javascript:void(0);

  • Edema. Symptoms can include:

    • swelling, especially in your ankles or legs
  • Extreme dizziness or faintness that can lead to falls

  • Dyskinesia (sudden, uncontrolled movements)

Pharmacist's Advice
Healthline Pharmacist Editorial Team
  • Apomorphine may cause drowsiness. This can cause you to fall asleep without warning while doing daily activities such as talking, eating, or driving a car. Don’t drive or use machinery until you know how this drug affects you.
  • Apomorphine can lower your blood pressure and cause dizziness. Dizziness can occur when treatment is started, or when the dose is increased. Don’t get up too fast from sitting or after lying down, especially if you have been sitting or lying down for a long period of time.
  • Apomorphine can cause severe nausea and vomiting within 5 or 10 minutes of receiving it. Your healthcare provider may prescribe a medication called trimethobenzamide to help prevent this.
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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apomorphine May Interact with Other Medications

Injectable Solution

Apomorphine can interact with other medications, herbs, or vitamins you might be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well. Your healthcare provider will look out for interactions with your current medications. Always be sure to tell your doctor about all medications, herbs, or vitamins you’re taking.

Alcohol interaction

The use of drinks that contain alcohol can increase certain risks related to taking apomorphine. These include the risk of increased drowsiness, low blood pressure, extreme dizziness that raises the risk of falls, or joint injuries caused by falls. If you drink alcohol, talk to your doctor about whether it’s safe for you to take this drug.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with kidney problems

If you have kidney problems or a history of kidney disease, your kidneys may not be able to clear this drug from your body well. This may increase the levels of apomorphine in your body and cause more side effects.

People with liver problems

If you have liver problems or a history of liver disease, your liver may not be able to process this drug well. This may increase the levels of apomorphine in your body and cause more side effects.

People with a history of heart attack or stroke

Apomorphine can increase your risk of having a heart attack or stroke. Your risk is further increased if you’ve had a heart attack or stroke in the past.

People with psychotic disorders

Apomorphine can worsen your disorder. Talk with your doctor about whether this drug is safe for you.

People with movement problems

Dyskinesia (not being able to move how you want) or movements that you can’t control are common symptoms of Parkinson’s disease. Taking apomorphine may make these problems worse.

Pregnant women

Apomorphine is a category C pregnancy drug. That means two things: 

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should be used only if the potential benefit justifies the potential risk to the fetus.

Women who are breast-feeding

It isn’t known if apomorphine passes into breast milk and causes side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your child. You may need to decide whether to stop breast-feeding or stop taking this medication.

When to call the doctor

Call your doctor if:

  • Your “off” episodes stay the same or occur more often.
  • You become pregnant while taking this drug.

Allergies

Apomorphine can cause a severe allergic reaction. Symptoms can include:

  • hives
  • itching
  • rash
  • swelling of your face, tongue, lips, or the skin around your eyes
  • trouble breathing or swallowing 

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Patients with a sulfite sensitivity are more likely to have an allergic reaction. Let your doctor know if you think you’re sensitive to sulfites.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

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How to Take apomorphine (Dosage)

Injectable Solution

Your doctor will determine a dosage that’s right for you based on your individual needs. Your general health may affect your dosage. Tell your doctor about all health conditions you have before your healthcare provider administers the drug to you.

Your doctor will give you the first dose of apomorphine when you are in an “off” state. You will return to a clinic to receive more doses as needed to treat “off” episodes. Your dosage may be increased if your symptoms don’t improve.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Apomorphine comes with risks if you don’t take it as prescribed.      

If you stop taking the drug suddenly or don’t take it at all

If you don’t take this drug, you may continue to have “off” episodes. If you stop taking it suddenly, you may develop a fever or experience confusion.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

  • low blood pressure
  • slow heart rate
  • nausea
  • fainting

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away. 

What to do if you miss a dose/appointment

If you miss an appointment, call your doctor right away to find out what to do.

How to tell if the drug is working

Any “off” episodes you have should be shorter than before. They may also go away entirely.

Apomorphine is used for long-term drug treatment.

How long does it take?

Your injection will likely take about a minute. For your first injection and for dosage changes, you should expect to stay at the clinic at least one hour or longer after the injection. Your blood pressure and pulse will be monitored.

Can I drive home after?

Apomorphine may make you dizzy or sleepy. You may need a friend or loved one to drive you home after your infusion.

Don’t drive or use machinery while you’re on this medication until you know how it affects you.

Travel

While traveling, if you normally receive your doses from a healthcare provider at a clinic, you will need to either:

  • learn how to self-inject apomorphine with your doctor’s approval, or
  • arrange an injection with a healthcare provider where you’re traveling.

You may need additional equipment

If your doctor has given you approval to self-inject this drug, you’ll need:

  • pen needles (29 g x 1/2")
  • alcohol wipes
  • a sharps disposal container

Clinical monitoring

Your doctor will monitor you for side effects of apomorphine. You may need to have some tests to make sure your heart is working well. Your doctor may also check your:

  • blood pressure
  • pulse
  • skin, to look for skin cancer (Parkinson’s disease raises the risk of melanoma.)

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

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How Much Does apomorphine Cost?

Injectable Solution

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These prices represent the lowest priced national pharmacies for apomorphine on GoodRx. They may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on October 27, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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