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Kynmobi (Generic Apomorphine Sublingual)

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Why is this medication prescribed?

Kynmobi is a prescription medication that contains the active ingredient apomorphine hydrochloride. It is primarily prescribed for the treatment of “off” episodes in patients with Parkinson’s disease.

Parkinson’s disease is a progressive neurological disorder that affects movement and coordination. As the disease progresses, individuals with Parkinson’s may experience fluctuations in their response to medication. “Off” episodes refer to periods when the symptoms of Parkinson’s disease, such as muscle stiffness, tremors, and difficulty with movement, become more pronounced or re-emerge despite regular treatment.

Kynmobi is specifically indicated for the acute, intermittent treatment of “off” episodes in patients with Parkinson’s disease who are already receiving other medications to manage their symptoms, such as levodopa/carbidopa. It is not meant for the routine treatment of Parkinson’s disease symptoms.

How should this medicine be used?

Kynmobi is a prescription medication that comes in the form of a film strip that dissolves on the tongue. It is used for the acute, intermittent treatment of “off” episodes in patients with Parkinson’s disease who are already receiving other medications for their symptoms.

Here are the general guidelines for using Kynmobi:

  • Administration: Place the Kynmobi film strip on the tongue. It will dissolve quickly, usually within 3 to 6 seconds. You do not need to drink water or swallow the film strip.
  • Starting dose: The recommended starting dose is 10 mg. Your healthcare professional will determine the appropriate dose for you based on your individual needs and response.
  • Dose adjustment: If the initial dose is not providing adequate symptom relief, your healthcare professional may increase the dose gradually, typically in increments of 5 mg. The maximum recommended dose per episode is 35 mg.
  • Timing of administration: Kynmobi should be taken only when needed to treat “off” episodes. It should be used as a rescue medication, meaning it is taken to provide relief when other Parkinson’s medications are not effectively controlling symptoms. At least two hours should elapse between each dose of Kynmobi.
  • Frequency of use: The frequency of Kynmobi administration should be determined by your healthcare professional. They will provide specific instructions on how often you can take Kynmobi in a day and how many doses are allowed within a 24-hour period.
  • Avoid redosing: If a dose of Kynmobi does not provide adequate relief or if symptoms return, do not take an additional dose of Kynmobi within the same “off” episode. Instead, wait until the next “off” episode occurs before using Kynmobi again.

It’s important to carefully follow the instructions provided by your healthcare professional and the information provided in the medication guide. If you have any questions or concerns about the use of Kynmobi, it’s best to consult with your healthcare provider for personalized guidance.

Other uses for this medicine

Kynmobi (apomorphine hydrochloride) is primarily prescribed for the treatment of “off” episodes in patients with Parkinson’s disease. However, it’s important to note that there may be off-label uses for medications that are not approved by regulatory authorities but are prescribed by healthcare professionals based on their clinical judgment and the individual patient’s needs. It’s best to consult with a healthcare professional regarding any potential off-label uses of Kynmobi.

What special precautions should I follow?

Regarding special precautions, here are some important considerations:

  • Hypersensitivity: Kynmobi should not be used in individuals who have a known hypersensitivity or allergy to apomorphine hydrochloride or any other ingredients in the medication. Signs of an allergic reaction may include rash, itching, swelling, dizziness, or difficulty breathing. If you experience any of these symptoms, seek immediate medical attention.
  • Cardiovascular effects: Apomorphine, the active ingredient in Kynmobi, may lower blood pressure and cause orthostatic hypotension (a drop in blood pressure upon standing). This can lead to dizziness or fainting. Individuals with cardiovascular disease or a history of hypotension should use Kynmobi with caution and be monitored closely.
  • Nausea and vomiting: Kynmobi may cause nausea and vomiting, especially at higher doses. This can be managed by using antiemetic medications as prescribed by your healthcare professional.
  • Sleepiness and sudden onset of sleep: Kynmobi can cause drowsiness, including sudden onset of sleep during daily activities. Patients should be advised to exercise caution while driving or operating machinery. If excessive daytime sleepiness or sudden sleep onset occurs, it’s important to inform your healthcare provider.
  • Impulse control disorders: Some individuals taking Kynmobi or other medications for Parkinson’s disease may experience impulse control disorders, such as compulsive gambling, excessive spending, or increased libido. If you notice any changes in your behavior, inform your healthcare professional.
  • Interaction with other medications: Kynmobi may interact with other medications, including certain antidepressants and medications that affect the heart or blood pressure. It’s important to inform your healthcare professional about all the medications you are taking, including over-the-counter drugs and supplements.
  • Withdrawal symptoms: Abrupt discontinuation of Kynmobi may lead to withdrawal symptoms, such as high fever, confusion, and severe muscle stiffness. If you need to stop using Kynmobi, your healthcare professional will provide guidance on gradually tapering the dose.

These are just some of the precautions associated with Kynmobi. It’s crucial to consult with a healthcare professional for comprehensive information on precautions, potential interactions, and any other specific considerations based on your individual medical history and current medications.

What special dietary instructions should I follow?

There are no specific dietary instructions for Kynmobi (apomorphine hydrochloride). However, it’s generally recommended to follow a balanced and healthy diet while taking any medication, unless otherwise advised by your healthcare professional. If you have any specific concerns or dietary restrictions, it’s best to consult with a healthcare provider or a registered dietitian for personalized guidance.

What should I do if I forget a dose?

If you forget a dose of Kynmobi, it’s important to follow these guidelines:

  • Take it as soon as you remember: If you realize that you missed a dose of Kynmobi, take it as soon as you remember. However, if it’s close to the time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule.
  • Do not double the dose: Do not take a double dose to make up for the missed one. Taking more than the recommended dose can increase the risk of side effects.
  • Follow your healthcare professional’s instructions: If you are unsure about what to do when you miss a dose or if you have any concerns, it’s best to consult with your healthcare professional. They can provide specific guidance based on your individual circumstances.

What side effects can this medication cause?

Kynmobi (apomorphine hydrochloride) may cause side effects. Not all individuals will experience these side effects, and their severity can vary. It’s important to note that the list below may not include all possible side effects, and some effects may be rare but severe. If you experience any unusual or bothersome symptoms while taking Kynmobi, it is recommended to contact your healthcare provider for further guidance. Here are some common side effects associated with Kynmobi:

  • Nausea and vomiting: These are the most commonly reported side effects of Kynmobi. They can occur at the beginning of treatment but tend to decrease with continued use. Your healthcare provider may prescribe anti-nausea medication to help manage these symptoms.
  • Dizziness and low blood pressure: Kynmobi can cause dizziness, lightheadedness, or low blood pressure (hypotension). It’s important to get up slowly from a sitting or lying position to minimize the risk of falls. If you experience persistent dizziness or significant drops in blood pressure, notify your healthcare provider.
  • Sleepiness and drowsiness: Kynmobi may cause excessive sleepiness or drowsiness. It is important to avoid activities that require alertness, such as driving or operating machinery, until you know how the medication affects you.
  • Dyskinesia: Kynmobi may cause or worsen abnormal involuntary movements known as dyskinesia, which are often associated with Parkinson’s disease. If you notice any new or worsening involuntary movements, inform your healthcare provider.
  • Injection site reactions: Kynmobi is administered as a subcutaneous injection, and injection site reactions such as redness, swelling, itching, or pain may occur. Rotate injection sites and follow your healthcare provider’s instructions on proper injection techniques.
  • Orthostatic hypotension: Kynmobi may cause a drop in blood pressure upon standing, leading to orthostatic hypotension. This can result in dizziness or fainting upon standing up. To minimize the risk, rise slowly from a seated or lying position.
  • Hallucinations and psychosis: Some individuals taking Kynmobi may experience hallucinations or psychosis, characterized by seeing or hearing things that are not there. If you experience any changes in perception or behavior, inform your healthcare provider immediately.
  • Other common side effects: Additional side effects that may occur include fatigue, headache, constipation, dry mouth, loss of appetite, difficulty sleeping, anxiety, and urinary tract infection.

It’s essential to discuss any concerns or potential side effects with your healthcare provider. They can provide personalized advice and guidance based on your specific situation.

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

  • Storage: Kynmobi should be stored at room temperature, away from moisture, heat, and direct light. Follow the storage instructions provided by your healthcare provider or as mentioned on the medication packaging.
  • Disposal: It is important to properly dispose of unused or expired Kynmobi to prevent accidental ingestion or misuse. Do not flush it down the toilet or pour it into a drain unless specifically instructed to do so. Contact your local pharmacy or healthcare provider for guidance on the proper disposal methods, which may include take-back programs or special disposal containers.

In case of emergency/overdose

In case of an emergency or suspected overdose, it is crucial to seek immediate medical attention. Contact your local emergency services or poison control center. You can reach poison control in the United States by calling 1-800-222-1222. Provide them with as much information as possible, including the dosage taken, time of ingestion, and any symptoms experienced.

What other information should I know?

  • Follow your healthcare provider’s instructions carefully regarding the use of Kynmobi.
  • Inform your healthcare provider about any other medications, supplements, or herbal products you are taking before starting Kynmobi, as they may interact with it.
  • Kynmobi may cause drowsiness, dizziness, or low blood pressure, which can affect your ability to drive or operate machinery. Use caution until you know how the medication affects you.
  • Inform your healthcare provider if you experience any side effects or if your symptoms worsen or do not improve.
  • Keep a list of all your medications and share it with your healthcare provider to prevent any potential drug interactions.

It’s important to consult your healthcare provider or pharmacist for specific instructions and guidelines regarding the use, storage, disposal, and emergencies related to Kynmobi, as they can provide personalized advice based on your medical history and current condition.

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