Apomorphine
What is apomorphine?
Apomorphine is a strong type of dopamine agonist. Dopamine agonist drugs act like dopamine to stimulate nerve cells. These nerve cells then control movement and other body functions, to help reduce the symptoms of Parkinson’s. Despite its name, apomorphine does not contain morphine.
Apomorphine is given by injection or continuous infusion, using a pump. Continuous infusion is when medication is delivered, via a small pump, non-stop into your body. This uses a fine tubing with a small needle at the end, which is inserted under the skin.
When is apomorphine prescribed?
Every person with Parkinson’s has a different experience of the condition. Apomorphine is usually used for more advanced Parkinson’s, when a person’s symptoms no longer respond well to oral drug treatments. Apomorphine doesn’t help everyone manage their Parkinson’s symptoms, and it may not replace oral medication entirely. But your movement disorders specialist may suggest trying it if you:
If patient have sudden and unpredictable changes in symptoms
If patient have severe ‘off’ periods that aren’t controlled by other Parkinson’s medications
If patient have severe swallowing difficulties that mean you cannot take medication orally.
'On/off' refers to movement fluctuations, usually caused by levodopa medication 'wearing off' before the next dose is due. 'On' is when your symptoms are controlled and when you feel at your most capable. Being 'off' is when your Parkinson's symptoms recur and affect you the most. .
How is apomorphine taken?
Apomorphine can be taken in three different ways:
A pre-filled disposable pen you can use to give injections as needed (APO-go PEN).
Infusion over a period of several hours (usually during the day) via a portable, battery-driven pump (a syringe driver) using a pre-filled syringe (APO-go PFS).
Infusion over a period of several hours (as above) using a portable, battery-driven pump (a syringe driver) and a syringe (APO-go), using apomorphine stored in glass vials called ampoules.
For each option, the dose can be adjusted to suit you. All methods give the drug through a fine needle inserted into the fatty layer under the skin (a subcutaneous injection). It is not an injection given into a vein (intravenously)
Is injection or infusion right for me?
No one method is right for everyone. The choice will depend on how often you need to take apomorphine, how well you can use your hands, your lifestyle and whether you have anyone to help you if you need it. Talk to your movement Disorders specialist about what may be best for you.