Apomorphine injection

What is this medicine?

APOMORPHINE (a poe MOR feen) is used to treat 'off' episodes in advanced Parkinson's disease. These episodes affect your ability to move or perform tasks.

How should I use this medicine?

This medicine is for injection under the skin. You will be taught how to prepare and give this medicine. You will also need to take a medicine prescribed by your doctor to prevent nausea and vomiting when you first start treatment. Use exactly as directed. Do not take your medicine more often than directed. Do not stop taking except on your doctor's advice. Stopping this medicine too quickly may cause serious side effects or your condition may worsen.

It is important that you put your used needles and syringes in a special sharps container. Do not put them in a trash can. If you do not have a sharps container, call your pharmacist or healthcare provider to get one.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

• breathing problems

• changes in emotions or moods

• chest pain

• confusion

• falling asleep during normal activities like driving

• hallucinations

• increased sweating

• males: prolonged or painful erection

• new or increased gambling urges, sexual urges, uncontrolled spending, binge or compulsive eating, or other urges

• signs and symptoms of a dangerous change in heartbeat or heart rhythm like chest pain; dizziness; fast or irregular heartbeat; palpitations; feeling faint or lightheaded, falls; breathing problems

• signs and symptoms of low blood pressure like dizziness; feeling faint or lightheaded, falls; unusually weak or tired

• swelling in arms, hands, legs, or feet

• uncontrollable movements of the arms, face, head, mouth, neck, or upper body

• vomiting

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome)

• drowsiness

• headache

• nausea

• pain, redness, or irritation at site where injected

• runny nose

• yawning

What may interact with this medicine?

Do not take this medicine with any of the following medications:

• cisapride

• dronedarone

• pimozide

• thioridazine

• some medicines for nausea/vomiting like dolasetron, granisetron, ondansetron, palonosetron

This medicine may also interact with the following medications:

• alcohol

• certain medicines for anxiety or sleep

• certain medicines for blood pressure, heart disease, irregular heartbeat

• dofetilide

• haloperidol

• metoclopramide

• narcotic medicines for pain

• phenothiazines like chlorpromazine, prochlorperazine

• nitroglycerin

• other medicines that prolong the QT interval (an abnormal heart rhythm)

• thiothixene

What if I miss a dose?

This does not apply. This medicine is only given as needed to treat 'off' episodes in Parkinson's disease. Contact your health care provider if your symptoms do not respond to the first dose for a particular 'off' episode. Do not use a second dose for that episode. Do not use double or extra doses.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees). Throw away any unused medicine after the expiration date.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• have trouble controlling your muscles

• heart disease

• history of irregular heartbeat

• history of stroke

• if you often drink alcohol

• kidney disease

• liver disease

• low blood pressure

• lung or breathing disease, like asthma

• mental illness

• narcolepsy

• sleep apnea

• an unusual or allergic reaction to apomorphine, sulfites, other medicines foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. Tell your health care professional if your symptoms do not start to get better or if they get worse.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. This medicine may cause a sudden drop in blood pressure with or without symptoms such as nausea, dizziness, feeling faint, or sweating, especially when you first start treatment or after an increase in dose. Do not get up too quickly from a lying or sitting position. A drop in blood pressure may increase the risk for falling. Report any dizziness or related symptoms to your health care provider as soon as possible. Avoid alcoholic drinks. Alcohol may increase the risk of dizziness, drowsiness, or low blood pressure while taking this medicine. Do not take any medications that cause drowsiness without first checking with your health care provider.

When taking this medicine, you may fall asleep without notice. You may be doing activities like driving a car, talking, or eating. You may not feel drowsy before it happens. Contact your health care provider right away if this happens to you.

There are have been reports of increased sexual urges or other strong urges such as gambling while taking this medicine. If you experience any of these while taking this medicine, you should report this to your health care professional as soon as possible.

This medicine may cause severe nausea and vomiting. Your doctor may prescribe a medication to prevent these symptoms. Do not treat yourself. Not all medicines for nausea and vomiting can be used with this medicine. Talk to your doctor about which one may be right for you.

Using nitroglycerin while taking apomorphine may increase the risk of low blood pressure or a sudden drop in blood pressure. If you are going to take nitroglycerin under the tongue, it is important to lie down first and stay lying down for at least 45 minutes after taking it to reduce the risk of effects from low blood pressure, such as dizziness and falls.