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Apokyn

Generic Name: Apomorphine injection [a-poe-MOR-feen]
Class of Drugs: Dopaminergic antiparkinsonism agents

What is Apokyn?

Apokyn is associated with similar effects as a chemical known as dopamine, which is a natural substance in the body. Dopamine levels that are low in the brain are linked with Parkinson's disease.

Apokyn is a prescribed medicine that is prescribed to treat "wearing-off" episodes (muscle stiffness or losing muscle coordination) in patients suffering from advanced Parkinson's disease.

It isn't known whether Apokyn is safe and effective for children.

Warnings

Drug interactions that are serious can happen when certain medications are used alongside Apokyn. Be sure to inform your healthcare professionals about all medicines you take now as well as any medication you stop or start taking.

Apokyn should not be taken if you're also taking the alosetron (Lotronex) and dolasetron (Anzemet) or the granisetron (Kytril) as well as ondansetron (Zofran) as well as palonosetron (Aloxi).

Before you take Apokyn, consult your doctor if you are suffering from unbalanced electrolytes (such as low concentrations of magnesium or potassium present in the blood) as well as a slow heart rate, low blood pressure, dizzy spells, a background of "long QT syndrome," an occurrence of a heart attack or stroke, asthma, sulfite allergies, or kidney or liver disease.

You might experience more sexual cravings, unusual urges towards gambling, or other extreme cravings when you are taking this drug. Discuss this with your physician. If you suspect you are experiencing an unusual or extreme urge when taking Apokyn,

Before You Take This Drug

It is not recommended to take Apokyn if you are allergic to the chemical apomorphine.

A variety of drugs interact and create dangerous consequences. Certain drugs are not recommended to be taken with Apokyn. Your doctor could alter the treatment plan when you are also using:

  • Alosetron;

  • Dolasetron;

  • Granisetron;

  • Ondansetron (Zofran);

  • palonosetron.

To be sure Apokyn is suitable for you, ask your physician if you've ever experienced:

  • Asthma or an allergy to sulfite;

  • Low blood pressure or dizzy spells

  • Narcolepsy sleeping in the day;

  • Heart problems, long QT syndrome;

  • A stroke;

  • kidney or liver disease;

  • Mental illness, psychosis,

  • If you consume alcohol.

Consult your physician if you are nursing or pregnant.

How To Take Apokyn?

You should take Apokyn exactly as prescribed. Follow the directions on the prescription label and review all medication manuals or instruction sheets. Your doctor may alter your dosage.

Apokyn injections are injected through the skin. The healthcare professional will administer the first dose and guide you on how to apply the medication yourself.Don't inject Apokyn into a vein.

Take note of and follow the instructions for use that are included in your medication. Talk to your pharmacist or doctor for clarification if you aren't sure about the instructions.

Make an injection only once you are ready to administer it. Don't use any medicine that appears cloudy, changes color, or contains particles in it. Consult your pharmacist about new medications.

Making sure you measure your Apokyn dosage accurately is crucial. The dosage in the apomorphine pen can be measured in milliliters (mL), which is printed on the marker. The dose you are prescribed could be in milligrammes (mg). One milligramme, which is 1 mg of apomorphine, is 0.1 milliliters, as indicated on the pen for injection.

Your physician will tell you where to administer Apokyn. Make sure to inject at a different location every time you administer an injection. Don't inject the same area twice in the same row.

You might be prescribed other medications to treat vomiting and nausea. Make sure you only take the anti-nausea medication recommended by your physician. Certain anti-nausea medications Anti-nausea medications can cause an increase in certain adverse effects associated with apomorphine or may make your Parkinson's symptoms more severe.

Your blood pressure is likely to be monitored regularly.The medication contained in the Apokyn injection pen may cause irritation if it comes into contact with your eyes or face. If this happens, then rinse your eyes with water.

Don't stop taking Apokyn at once, or you may experience unpleasant withdrawal symptoms like confusion and fever. Consult your physician about how to stop taking the medication.

If you stop taking Apokyn injections for seven days or more, consult your physician prior to resuming use of the treatment. It is possible that you will need to start using a lower dosage.Place it in a cool, dry place free of heat and moisture.

Make use of a needle and syringe just once, and then place them into a puncture-proof "sharps" container. Make sure you follow local or state laws regarding how to dispose of the container.

Make sure it is out of range of children and pets.

Details On Dosage

Adult Dose for Apokyn for Parkinson's Disease:

Dose initiation should be monitored by a medical professional. Premedication for antiemetic drugs must be taken prior to treatment due to the increased risk of nausea and vomiting.

Initial dose 2 mg (0.2 milliliters) subcutaneously in the course of an "off" episode

Initial dose: Check the pulse, supine, and standing blood pressure before the dose. 20–40, and 60 minutes after the dose If significant hypotension is evident 60 minutes post-dose, then recheck the results after 60 minutes. If significant hypotension develops after the first dose, patients should not be considered suitable candidates for treatment.

Titration: If the first dose is tolerated but the response isn't sufficient, the dose could be increased by increments of 2 mg to 6 mg (under medical supervision)

In increments of 1 mg every several days as high as 3 mg (outpatient) in the following "off" episodes; allow at least 2 hours between doses. Monitor the effects until the dose is

safe and effective dose is reached.

Maintenance dose: 2–6 mg subcutaneously in the course of an "off" episode; doses must be separated by at least two hours; the average frequency of dosing during clinical studies was three times daily.

Maximum single dose: 6 mg (0.6 mL)

Maximum dosing frequency: 5 times per day

Maximum daily dose: 20 mg (2 mL) in one day

What Happens If I Miss a Dose?

Utilize the medicine as soon as you are able, but do not miss your missed dose if you are close to the time for the next dose.

Don't take more than two doses at the same time.

What Happens If I Overdose?

For medical emergencies, seek emergency medical attention or contact the Poison Help line at 1-800-222-1222.

What Should Be Avoided?

Certain people taking Apokyn have experienced sleepiness during normal activities during the day like talking, working, eating, driving, or talking. Be cautious when driving and operating machines until you are aware of the effects of this medication on your body. Dizziness or excessive drowsiness may result in falls or other accidents.

Be careful not to rise too fast from sitting or lying or seated.

You could be dizzy.Don't drink alcohol. It can further lower your blood pressure and increase the negative effects of apomorphine.

Side Effects of  Apokyn

See a doctor immediately. If you are experiencing symptoms of an allergy reaction, Apokyn: hives, itching, difficulty breathing, swelling of your lips, face, and throat

See your doctor right away. If you suffer from:

  • An euphoric feeling, similar to when you're about to pass out.

  • extreme sleepiness, unexpectedly falling asleep despite feeling alert;

  • Hallucinations, confusion, bizarre thoughts, or behaviors;

  • The uncontrollable twitching of your lips, eyes, and tongues; your arms, face, or legs;

  • Rapid or pounding heartbeats The chest is thumping, there is breathlessness, and there is an abrupt dizziness (like you're going to faint);

  • Constant sickness and the feeling of vomiting (even after taking anti-nausea medications);

  • A new or worsening cough, discomfort in your chest, or feeling tired on your back;

  • Penis erections that are painful or last for 4 hours or more;

  • An increase in the severity of your Parkinson's symptoms;

  • Skin that is pale, yellowed, or dark coloured urine, weakness, confusion, ever,  or

  • Extreme nervous system reactions, extremely rigid (rigid) muscles and sweating; high fever and confusion; rapid or irregular heartbeats; tremors; and a feeling that you could faint.

The risk of serious side effects is higher in older people.

You might experience more sexual cravings, unusual urges for gambling, and other extreme cravings when you are taking this medication. Consult your physician when this happens.

Common side effects of Apokyn include:

  • Dizziness, drowsiness;

  • Nausea, vomiting;

  • Inflammation or pain in your mouth, nose, or throat;

  • Numbness, tingling, or burning pain;

  • Swelling of your feet or hands

  • Confusion, hallucinations;

  • Yawning;

  • Runny nose, 

  • Muscle movements that are not controlled

This is not a comprehensive list of possible side effects, and other side effects could be present. Consult your physician for advice regarding medical effects. You can report any side effects to the FDA at 1-800-FDA-1088.

Interaction With Other Drugs

When you take Apokyn in conjunction with other drugs that cause you to become drowsy, this could cause more of this. Consult your physician before taking opioids, sleeping pills, muscle relaxers, or any medication to treat an anxiety disorder as well as seizures.

If you are also taking nitroglycerin (under your tongue), your blood pressure might drop and you might be dizzy. Relax for at least 45 minutes if it is possible.

Inform your doctor about the medicines you are currently taking. A variety of drugs can affect the effects of apomorphine, particularly:

  • Metoclopramide;

  • The heart, blood pressure, or medications, and

  • Medication for treating anxiety, mood disorders, or mental illnesses like schizophrenia.

This isn't a complete list, and other drugs could be incompatible with apomorphine. This includes prescription and over-the-counter medicine, vitamins, and herbal products. Some interactions with drugs are listed here.

DRUG STATUS

Availability

Prescription only

Pregnancy & Lactation

CSA Schedule*

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