What is Apomorphine?

Apomorphine is a medication used to manage the symptoms of Parkinson’s Disease. It is a strong dopamine agonist (Medications which act to stimulate nerve cells to release more dopamine). This leads to improvement of body functions in patients with Parkinson’s disease, who have low dopamine levels. Despite its name, apomorphine does not contain morphine. Unlike other dopamine agonist drugs (like Pramipexole, Ropinirole), which are taken as tablets or patches, apomorphine is given by injection or continuous infusion, using a pump.

Who would be benefited from Apomorphine?

Apomorphine doesn’t help everyone manage their Parkinson’s symptoms, and it may not replace oral medication entirely. It usually suggested for patients who have

Oral medications taking long time to act
Have sudden and unpredictable changes in symptoms
Severe OFF periods
Cannot be considered for surgery for other medical issues / Patient not willing for surgery
Patients who cannot take medications orally

How is Apomorphine medication taken?

Apomorphine can be taken by various methods and include:

Pre-filled disposable pen you can use to give injections as needed.
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
Syringe, using apomorphine stored in glass vials called ampoules

What are the advantages of Apomorphine?
  1. Apomorphine Injections using the pen are taken in a similar way to insulin for diabetes. Apomorphine works within five to 10 minutes, much faster than oral medications, and can act as a ‘rescue’ treatment if your tablets or capsules don’t take effect. This is very useful to treat a sudden ‘off’ period.
  2. Will have fewer ‘OFF’ periods.

Use a continuous infusion of apomorphine over several months, you can significantly reduce the number of ‘off’ periods

What are the Disadvantage of Apomorphine?
  1. Only available as Injection / Pumps for infusion
  2. Can cause severe short term Nausea and Vomiting
  3. Heart pounding/ fainting episodes
  4. May cause Sleepy or experience sudden onset of Sleep
  5. Injection sites can become sore and irritated and Nodules (lumps) at the site of injection can be noticed
  6. Can Cause hallucinations/ Delusions
  7. May lead to Impulsive/ Compulsive behaviors