Apomorphine, sold under the brand name Apokyn, among others, is an aporphine that acts as a non-selective dopamine agonist. Historically, it was used to reduce anxiety and cravings for alcoholics. However, it is now often used to treat episodes of hypomobility associated with advanced Parkinson’s disease.
- How does apomorphine (Apokyn) work?
- What is apomorphine (Apokyn) used for?
- What are the side effects of apomorphine (Apokyn)?
- How do you inject apomorphine (Apokyn)?
- How much does apomorphine (Apokyn) cost?
- What should you avoid while taking apomorphine (Apokyn)?
1. How does apomorphine (Apokyn) work?
Apomorphine belongs to the class of medications called dopamine agonists and works by acting in place of dopamine at certain dopamine receptors. Dopamine is a necessary substance in the brain for controlling movement. By stimulating dopamine receptors, apomorphine provides relief for patients with Parkinson’s during“off” hypomobility episodes.
2. What is apomorphine (Apokyn) used for?
As mentioned above, apomorphine is used for treating “off” episodes (intermittent hypomobility episodes) in patients with advanced Parkinson’s disease. It can be used once during each episode and may be prescribed as a mini-pump.
In theory, patients can remain in the “on” state throughout the entire day with a continuous apomorphine infusion. But studies have shown that a continuous infusion reduces about half of daily “off” time.
3. What are the side effects of apomorphine (Apokyn)?
Generally, apomorphine is considered to have relatively mild side effects. However, it is still possible that it could produce side effects ranging from mild to severe. Mild side effects typically go away after a few days or weeks of consistent medication-taking, but if they persist or worsen you should speak with your doctor. The following is not a complete list but includes the most common side effects experienced by patients.
Common Side Effects:
- Mild confusion or head fog
- Runny nose or cold-like symptoms
- Irritation at the injection site
- Low blood pressure when moving between lying, sitting, and standing positions
Serious Side Effects:
- Twitching or uncontrollable movements
- Worsening of symptoms
- Chest pain or irregular heartbeat
- Feeling light-headed
- Painful or long-lasting erection
- Unexplained pain
Some patients also may experience increased sexual urges or other unusual and intense urges. If you notice this occurring, speak with your doctor.
If you experience any of these serious side effects, you should speak with your doctor or seek immediate medical attention if it is an emergency.
In some rare cases, patients can experience allergic reactions. Seek emergency medical care if you experience any of the following symptoms after taking apomorphine.
- Skin rash
- Tightness in the throat or chest
- Difficulty talking or breathing
- Swelling of the face, lips, tongue, or throat
4. How do you inject apomorphine (Apokyn)?
Since there are multiple methods and types of apomorphine injections there is no one definitive answer to this question. However, some guidelines are applicable regardless. The first is to carefully read the entirety of the usage instructions provided with your medicine. If part of the instructions is unclear, or you do not understand, you should ask your doctor or pharmacist for clarification.
When preparing an injection, you should check to make sure the medicine has not changed colors, become cloudy, or gathered particles. If you do notice any changes in the medicine’s appearance, call your pharmacist for new medicine.
When injecting apomorphine you should take care never to inject it into a vein and not to prepare the injection until you are ready to take it. You should also be careful not to inject it into the same location twice. Take care to ensure that you measure your dosage correctly based on your prescription. You may be prescribed other medications alongside apomorphine to help prevent nausea and vomiting. It is critical that you only take the anti-nausea medication that your doctor prescribes as other anti-nausea drugs may increase apomorphine’s side effects.
5. How much does apomorphine (Apokyn) cost?
There is no one answer for patients wondering about the cost of apomorphine. It will vary greatly based on the location and insurance coverage of the individual. Even the cash price will depend on the dosage prescribed by your doctor. One pen typically costs $42.95 and contains 3 mL. The recommended dose is between 0.2 to 0.6 mL per episode with a maximum of 2 mL daily. This means that the average monthly cost of the drug is between $129 and $645.
6. What should you avoid while taking apomorphine (Apokyn)?
Before taking apomorphine it's important to consider potential interactions and activities that should be avoided. Some patients have fallen asleep during normal daytime activities. For that reason, those starting treatment with apomorphine should avoid driving or operating any machinery until they understand how apomorphine affects them. Patients should also take care to avoid standing up too fast as it may lead to dizziness. Finally, do not drink alcohol. Alcohol can further reduce your blood pressure and may increase the negative side effects of apomorphine.
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