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Apomorphine Injection

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Why is this medication prescribed?

Apomorphine injection is used to treat “off” episodes in patients with advanced Parkinson’s disease (PD; a disorder of the nervous system that causes difficulties with movement, muscle control, and balance) who are taking other medications for their condition. Off episodes are times when it is difficult to move, walk, and speak and may occur as medication wears off or at random. Dopamine agonists are a class of drugs that includes apomorphine injection. It functions by taking the place of dopamine, a chemical produced naturally in the brain and essential for controlling movement.

How should this medicine be used?

Apomorphine is available as a subcutaneous injection solution (just under the skin). When necessary, a doctor will prescribe an injection of apomorphine. Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Administer apomorphine injection as prescribed. Use it only as directed by your doctor, neither more nor less often.

To treat the same “off” episode, do not provide an additional dosage of apomorphine injection. Between dosages, allow at least 2 hours.

When you start using apomorphine injection, your doctor will prescribe you trimethobenzamide (Tigan), another drug. In particular at the beginning of treatment, this drug will aid in lowering your risk of experiencing nausea and vomiting while using apomorphine injection. Most likely, your doctor would advise you to start taking trimethobenzamide a few days before to using apomorphine injection and to keep doing so for up to two months. You should be aware that combining trimethobenzamide with apomorphine injection may raise your chance of falling asleep, feeling lightheaded, and other side effects. But never stop taking trimethobenzamide without first consulting your physician.

Most likely, your doctor will begin you on a modest dose of apomorphine injection and gradually increase it, not more frequently than once every few days. If you don’t use apomorphine injection for more than a week, ask your doctor what to do. Most likely, your doctor would advise you to take this medicine again at a low dose and gradually raise it.

Glass cartridges containing apomorphine solution are provided for use with injector pens. Your pen comes with a few needles, and extra needles can be purchased separately. If you’re uncertain about the kind of needle you require, consult your physician or pharmacist. For every injection, make sure to use a fresh, sterilised needle. Never reuse needles, and only let a needle touch the area where you will administer the medication. A needle-attached injector pen should never be kept or carried around. Put discarded needles in a container that won’t puncture and keep it out of kids’ reach. How to get rid of the puncture-resistant container should be discussed with your doctor or pharmacist.

Your first apomorphine injection will be administered in a hospital setting so that your doctor can carefully watch over your health. After that, your doctor can advise you to administer the apomorphine injections alone or with the help of a friend or relative. Read the enclosed written instructions before administering apomorphine injection on your own for the first time. To learn how to inject a medicine, ask your doctor or pharmacist to demonstrate it to you or the person doing the injecting.

Make sure you are familiar with the injector pen’s dose-indicating numbers. Although the pen is marked in millilitres rather than milligrammes, your doctor may have instructed you to use milligrammes. If you are unsure of where to locate your dose on the injector pen, see your doctor or pharmacist.

One individual may use the apomorphine injector pen. Don’t let anyone else use your pen.

Avoid injecting apomorphine into your eyes or onto your skin. If you do accidentally inject yourself with apomorphine, wash your skin or immediately flush your eyes with cold water.

Apomorphine injection sites include the upper arm, upper leg, and stomach region. Never inject into a vein or into skin that is red, inflamed, bruised, scarred, diseased, or otherwise aberrant. For each injection, select a new location from the ones you’ve been instructed to use. Note the time and location of each injection. Never use the same place twice in a row.

Before injecting your apomorphine solution, always check it. It should be free of particulates, clean, and colourless. Apomorphine should not be used if it is foggy, green, includes particles, or has past its expiration date on the box.

To know when to change the medication cartridge, keep track of how much apomorphine injection you use each time you receive an injection.

If necessary, you can wipe down your apomorphine injector pen with a moist towel. Never wash your pen under running water or use powerful disinfectants.

Other uses for this medicine

Ask your doctor or pharmacist for more details if you believe this drug should be used for something else.

What special precautions should I follow?

Before using apomorphine injection,

  • If you have an allergy to apomorphine, any other drugs, sulfites, or any other components of apomorphine injection, let your doctor and pharmacist know right once. Request a list of the components from your pharmacist.
  • Apomorphine and some drugs shouldn’t be combined. Before starting apomorphine, be sure to talk to your doctor and pharmacist about any prescription and over-the-counter medicines, vitamins, nutritional supplements, and herbal items you are currently taking or intend to use. Consult your doctor or pharmacist before beginning, stopping, or changing any medications while using apomorphine.
  • You should be aware that taking nitroglycerin sublingually while utilising an apomorphine injection could result in low blood pressure and lightheadedness. You should lie down for at least 45 minutes after putting nitroglycerin tablets under your tongue. Avoid standing during this period.
  • If you consume alcohol, have asthma, dizziness, fainting spells, slow or irregular heartbeat, low blood pressure, low potassium or magnesium levels in the blood, mental illness, sleep disorder, stroke, mini-stroke, or other brain issues, sudden uncontrolled movements and falls, or heart, kidney, or liver disease, let your doctor know.
  • If you are breastfeeding a child or intend to become pregnant, let your doctor know. Call your doctor if you become pregnant while taking apomorphine injection.
  • Inform the surgeon or dentist that you are using apomorphine injection if you are having surgery, including dental surgery.
  • It’s important to be aware that apomorphine injections can cause drowsiness. Until you are certain of how this drug affects you, avoid operating machinery, driving a car, or engaging in any activity that could put you in danger of injury.
  • You should be aware that if you use apomorphine injection, you could find yourself falling asleep unexpectedly while going about your normal everyday activities. Before you go to sleep, you might not feel sleepy. Call your doctor if you find yourself falling asleep mid-activity, such as eating, conversing, or watching television. Until you speak with your doctor, avoid operating machinery or driving a car.
  • Alcohol should not be consumed when using apomorphine injection. The negative effects of apomorphine injection can be exacerbated by alcohol.
  • You should be informed that some users of medications like apomorphine injection experienced problems with gambling or other intensely compulsive or strange urges or behaviours, such as heightened sexual drives or behaviours. There isn’t enough information to say if the individuals’ problems were caused by their drug use or anything else. Call your doctor if you struggle to control your behaviour, experience strong impulses, or find it difficult to control your temptation to gamble. Even if you are unaware that your gambling or any other intense urges or weird behaviours have become a problem, letting your family know about this risk can allow them to seek medical assistance.
  • You should be aware that taking apomorphine injections can make you feel faint, lightheaded, queasy, sweaty, and dizzy if you stand up too rapidly from a laying or seated position. This happens most frequently just after an increase in dose or when you initially start using apomorphine injection. To prevent this issue, slowly get out of bed or stand up from a seated posture, putting your feet down for a short period of time before standing up.

What special dietary instructions should I follow?

Keep eating normally unless your doctor instructs you otherwise.

What should I do if I forget a dose?

This medication is usually used as needed.

What side effects can this medication cause?

Apomorphine injectable adverse effects are possible. If any of these symptoms are severe or do not go away, let your doctor know right once:

  • Nausea
  • Vomiting
  • Constipation
  • Diarrhea
  • Headache
  • Yawning
  • Clogged nose
  • Weakness
  • Back, arm, or leg pain
  • Difficulty urinating or discomfort
  • Pain, bruising, swelling, itching, or other symptoms in the area where you administered the apomorphine injection.

Some adverse effects can be very harmful. Call your doctor right away if you encounter any of these symptoms, or seek emergency care:

  • Rash, itching, hives, swelling of the cheeks, lips, tongue, or throat; trouble breathing; shortness of breath; cough; or hoarseness
  • Fainting
  • A hammering or rapid heartbeat
  • Hands, foot, ankles, or lower legs swelling
  • Bruising
  • Sudden, erratic motions
  • Falling over
  • Aggressive conduct, anger, the impression that others are hostile toward you, or jumbled thoughts are all examples of
  • Hallucinations (seeing or hearing things or voices that are not there).
  • Depression
  • Fever
  • Confusion
  • An intractable erection that is painful
  • Fatigue, heartache, and breathlessness

After receiving an injection of apomorphine, some laboratory animals experienced eye problems. If apomorphine injection raises a person’s risk of eye illness, it remains unknown. Discuss the dangers of using this drug with your doctor.

Other negative consequences of apomorphine are possible. If you experience any strange issues while taking this drug, call your doctor right away.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medication out of the reach of children and in the original cartridge it came in. Keep it at room temperature in the carrying case, away from light, excessive heat, and moisture (not in the bathroom).

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medicines website at for additional information.

As many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning.

In case of emergency/overdose

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Additionally, information can be found online at Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

Overdose signs could include the following:

  • Nausea
  • Fainting
  • Dizziness
  • Distorted vision
  • Sluggish heartbeat
  • Abnormal conduct
  • Hllucinations
  • Sudden, erratic motions

What other information should I know?

Keep all of your doctor’s appointments.

Any queries you may have regarding medication refills should be directed to your pharmacist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.

Brand names

  • Apokyn®
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