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What should I discuss with my healthcare provider before using apomorphine (Apokyn)?

You should not use this medication if you are allergic to apomorphine, or if you are using any of the following medications:

• alosetron (Lotronex);
• dolasetron (Anzemet);
• granisetron (Kytril);
• ondansetron (Zofran); or
• palonosetron (Aloxi).

If you have any of these other conditions, you may need an apomorphine dose adjustment or special tests:

• an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);
• schizophrenia or similar mental illness;
• a slow heart rate;
• low blood pressure or dizzy spells;
• a personal or family history of "Long QT syndrome";
• a history of stroke or heart attack;
• asthma or sulfite allergy;
• liver disease; or
• kidney disease.

FDA pregnancy category C. It is not known whether apomorphine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether apomorphine passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are taking apomorphine.

Some people taking Parkinson's disease medications have developed skin cancer (melanoma). However, people with Parkinson's disease may have a higher risk of melanoma. Talk to your doctor about this risk and what skin symptoms to watch for. You may need to have regular skin exams.

How should I use apomorphine (Apokyn)?

Never use apomorphine in larger amounts, or use it for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well.

Apomorphine is injected under the skin. You may be shown how to use injections at home. Do not self-inject this medicine if you or your caregivers do not fully understand how to give the injection and properly dispose of used needles and syringes.

Do not inject apomorphine into a vein.

Measuring your apomorphine dose correctly is extremely important. If you use an injector pen with your apomorphine, the medication is measured in milliliters (mL) marked on the pen. However, your prescribed dose may be in milligrams (mg). One milligram, or 1 mg, of apomorphine is equal to 0.1 mL marked on the dosing pen.

Do not use the medicine if it has changed colors, looks green or cloudy, or has particles in it. Call your doctor for a new prescription.

Use a different place on your stomach, arm, or thigh each time you give the injection. Your care provider will show you the best places on your body to inject the medication. Do not inject into the same place two times in a row.

Use a disposable needle only once. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

Apomorphine can cause severe nausea and vomiting. For this reason, your doctor may prescribe an anti-nausea medication for you to start taking a few days before you begin using apomorphine. You may also need to keep using the anti-nausea medicine throughout your treatment with apomorphine.

If you stop using apomorphine for 7 days or longer, ask your doctor before restarting the medication. You may need to restart with a lower dose.

Do not stop using apomorphine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using apomorphine.

Store at room temperature, away from heat, moisture, and light.

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