Front Desk: 469-391-0070
Apomorphine Treatment: Uses, Benefits, and Dosage Guide
Summary of Key Points
Apomorphine is primarily used to manage Parkinson’s disease but is also effective in treating erectile dysfunction and restless legs syndrome. As a dopamine agonist, Apomorphine activates dopamine receptors in the brain, helping to improve movement and alleviate other symptoms. It is available in various forms and strengths, so it is crucial to follow your healthcare provider’s instructions carefully. Always consult your doctor before making any changes to your Apomorphine dosage.
Names of Medication
US Brand Name: Apokyn (Apomorphine)
The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. The generic name is listed in parentheses.
Pharmacologic Category
Dopamine Agonist
Other medications in this category include pramipexole (Mirapex) and ropinirole (Requip).
Apomorphine Dosage
Apomorphine is prescribed for various adult conditions, with dosages tailored to the specific condition being treated. Always consult your healthcare provider before making any adjustments to your Apomorphine regimen. You can also schedule a telemedicine appointment with one of our providers for personalized guidance.
Apomorphine for Parkinson’s Disease
Initial Dose: 2 mg subcutaneously (under the skin) as needed for “off” episodes.
Maintenance Dose: The dose may be increased by 1 mg every few days, depending on your response and tolerance, up to a maximum of 6 mg per dose.
Frequency: Up to 5 times per day.
Length of Treatment: Long-term, as directed by your healthcare provider.
Apomorphine for Erectile Dysfunction
Initial Dose: 2 mg subcutaneously, 30 minutes before sexual activity.
Maintenance Dose: The dose may be adjusted based on your response, up to a maximum of 3 mg per dose.
Frequency: As needed, but no more than once per day.
Length of Treatment: As directed by your healthcare provider.
Apomorphine for Restless Legs Syndrome
Initial Dose: 1 mg subcutaneously at bedtime.
Maintenance Dose: The dose may be increased by 1 mg every few days, up to a maximum of 4 mg per dose.
Frequency: Once daily, typically at bedtime.
Length of Treatment: Long-term, as directed by your healthcare provider.
Apomorphine for Hyperprolactinemia
Initial Dose: 1 mg subcutaneously, as needed.
Maintenance Dose: The dose may be increased by 1 mg every few days, up to a maximum of 4 mg per dose.
Frequency: As needed.
Length of Treatment: As directed by your healthcare provider.
Apomorphine for Acute Migraine
Initial Dose: 2 mg subcutaneously at the onset of migraine symptoms.
Maintenance Dose: The dose may be increased by 1 mg every few days, up to a maximum of 6 mg per dose.
Frequency: As needed, but no more than once per day.
Length of Treatment: As directed by your healthcare provider.
Apomorphine for Cluster Headache
Initial Dose: 2 mg subcutaneously at the onset of a cluster headache.
Maintenance Dose: The dose may be increased by 1 mg every few days, up to a maximum of 6 mg per dose.
Frequency: As needed, but no more than once per day.
Length of Treatment: As directed by your healthcare provider.
Apomorphine for Opioid-Induced Constipation
Initial Dose: 1 mg subcutaneously as needed.
Maintenance Dose: The dose may be increased by 1 mg every few days, up to a maximum of 4 mg per dose.
Frequency: As needed.
Length of Treatment: As directed by your healthcare provider.
Apomorphine for Nausea and Vomiting
Initial Dose: 1 mg subcutaneously as needed.
Maintenance Dose: The dose may be increased by 1 mg every few days, up to a maximum of 4 mg per dose.
Frequency: As needed.
Length of Treatment: As directed by your healthcare provider.
Apomorphine for Schizophrenia
Initial Dose: 1 mg subcutaneously as needed.
Maintenance Dose: The dose may be increased by 1 mg every few days, up to a maximum of 4 mg per dose.
Frequency: As needed.
Length of Treatment: As directed by your healthcare provider.
Dosage Forms and Strengths
Subcutaneous Injection: 10 mg/mL in pre-filled syringes or cartridges.
Apomorphine Injection Administration Instructions
Apomorphine is typically administered as a subcutaneous injection. Your healthcare provider will guide you on how to inject the medication correctly. It is important to rotate injection sites to prevent irritation. Avoid injecting into areas of skin that are red, swollen, or irritated. If you encounter any difficulties with the injection process, contact your healthcare provider or schedule a telemedicine appointment for further assistance.
Contraindications for Apomorphine Treatment
A contraindication is a specific condition where a medication should not be used due to potential harm. For Apomorphine, several factors make its use unsafe. These contraindications must be carefully considered before starting Apomorphine therapy.
Allergy to Apomorphine or its ingredients: If you are allergic to Apomorphine or any of its components, taking it could trigger a serious allergic reaction, including hives, swelling, or difficulty breathing.
Use of 5HT3 antagonists (e.g., ondansetron, granisetron): These medications, commonly used to prevent nausea and vomiting, can cause a dangerous drop in blood pressure when combined with Apomorphine, leading to fainting or dizziness.
Severe liver or kidney disease: Apomorphine is processed by the liver and kidneys. If these organs are impaired, the medication may accumulate in the body, potentially leading to toxic effects.
Low blood pressure (hypotension): Apomorphine can lower blood pressure, so if you already have low blood pressure, it could increase the risk of fainting or dizziness.
Severe cardiovascular disease: Apomorphine can affect heart function and should not be used in patients with serious heart conditions, such as uncontrolled high blood pressure or a history of heart attacks.
Drug to Drug Interactions
Apomorphine can interact with other medications, potentially increasing side effects or reducing the effectiveness of either drug. It’s important to inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements. Some key medications that may interact with Apomorphine include:
- Ondansetron (Zofran): This anti-nausea medication can cause a dangerous drop in blood pressure when combined with Apomorphine.
- Granisetron (Kytril): Another anti-nausea drug that may lead to severe low blood pressure when used with Apomorphine.
- Levodopa (Sinemet): Commonly used to treat Parkinson’s disease, combining it with Apomorphine may increase the risk of side effects such as confusion or hallucinations.
- Blood pressure medications (e.g., Lisinopril, Amlodipine): Since Apomorphine can lower blood pressure, taking it alongside other blood pressure-lowering drugs may heighten the risk of dizziness or fainting.
- Antipsychotic medications (e.g., Risperidone, Olanzapine): These drugs can reduce the effectiveness of Apomorphine in managing Parkinson’s symptoms.
Apomorphine in Pregnancy
Is it safe to take Apomorphine during pregnancy?
Research on the safety of Apomorphine during pregnancy is limited. Animal studies suggest potential risks, but it’s unclear if these findings apply to humans. If you are pregnant or planning to become pregnant, it’s essential to discuss the risks and benefits of Apomorphine with your healthcare provider. They can help you make an informed decision about the best treatment plan for your condition.
Apomorphine while Breastfeeding
Is it safe to take Apomorphine while breastfeeding?
There is not enough information to determine whether Apomorphine is safe to use while breastfeeding. It is unknown if the drug passes into breast milk or what effects it might have on a nursing infant. If you are breastfeeding, consult your healthcare provider before starting Apomorphine. They may recommend an alternative treatment or advise you to stop breastfeeding while using the medication.
Estimated Cost of Apomorphine
The cost of Apomorphine can vary depending on the pharmacy and location. Without insurance, a 30-day supply using a GoodRx coupon is estimated to cost between $1,500 and $2,000. Prices may fluctuate, so it’s a good idea to check with your local pharmacy or use a discount service like GoodRx to find the most affordable option.
Possible Alternatives to Apomorphine
If Apomorphine isn’t the right option for you, or if you’re considering other treatments, several alternatives are available depending on the condition being treated. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to discuss these options further.
- Parkinson’s disease: Alternatives include Levodopa (Sinemet), dopamine agonists like Pramipexole (Mirapex), or lifestyle changes such as regular exercise and physical therapy.
- Erectile dysfunction: Common alternatives include Sildenafil (Viagra), Tadalafil (Cialis), or lifestyle changes like improving diet, increasing physical activity, and managing stress.
- Restless legs syndrome: Alternatives include Gabapentin (Neurontin), Ropinirole (Requip), or lifestyle changes such as reducing caffeine intake and improving sleep hygiene.
- Hyperprolactinemia: Alternatives include Bromocriptine (Parlodel) or Cabergoline (Dostinex), which help lower prolactin levels.
- Acute migraine: Alternatives include Sumatriptan (Imitrex), Rizatriptan (Maxalt), or lifestyle changes such as identifying and avoiding migraine triggers.
- Cluster headache: Alternatives include Verapamil, Sumatriptan (Imitrex), or oxygen therapy.
- Opioid-induced constipation: Alternatives include Methylnaltrexone (Relistor), Naloxegol (Movantik), or increasing fiber intake and hydration.
- Nausea and vomiting: Alternatives include Ondansetron (Zofran), Metoclopramide (Reglan), or lifestyle changes like eating smaller, more frequent meals.
- Schizophrenia: Alternatives include antipsychotic medications such as Risperidone (Risperdal), Olanzapine (Zyprexa), or cognitive behavioral therapy (CBT).
Recent Updates on Apomorphine Research
Recent research on Apomorphine has focused on improving delivery methods and minimizing side effects. Studies are exploring new formulations, such as sublingual tablets, which may offer more convenient dosing compared to injections. Additionally, researchers are investigating the use of Apomorphine in combination with other medications to enhance its effectiveness in treating Parkinson’s disease and other conditions.
Ongoing clinical trials are also examining Apomorphine’s potential to treat other neurological conditions, such as Alzheimer’s disease and dementia, due to its effects on dopamine receptors. While these studies are still in the early stages, they offer hope for expanding Apomorphine’s use in the future.
