Apomorphine Hydrochloride Solution for 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.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

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

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

• asthma or other breathing problems

• heart disease

• history of alcohol or drug abuse

• kidney or liver disease

• low blood pressure

• mental illness

• sleep disorder

• stroke

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

• pregnant or trying to get pregnant

• breast-feeding

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 to prevent nausea and vomiting for at least the first two months of therapy. Use exactly as directed. Do not take your medicine more often than directed. Do not stop taking except on the advice of your doctor or health care professional.

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.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

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.

What may interact with this medicine?

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

• certain antibiotics like grepafloxacin and sparfloxacin

• cisapride

• medicines for irregular heart beat like amiodarone, disopyramide, dofetilide, flecainide, ibutilide, procainamide, quinidine, sotalol

• droperidol

• halofantrine

• levomethadyl

• pimozide

• some medicines for nausea like alosetron, dolasetron, dronabinol, droperidol, granisetron, ondansetron, palonosetron

• ziprasidone

This medicine may also interact with the following medications:

• alfuzosin

• certain antibiotics like clarithromycin, erythromycin, gatifloxacin, gemifloxacin, levofloxacin, moxifloxacin, troleandomycin

• medicines for high blood pressure or chest pain (angina)

• medicines to treat or prevent malaria like chloroquine or mefloquine

• metoclopramide

• phenothiazines like chlorpromazine, mesoridazine, prochlorperazine, thioridazine

• some medicines for depression like amitriptyline, amoxapine, maprotiline, mirtazapine, nefazodone, nortriptyline

• some medicines for mental disturbances like clozapine, haloperidol, molindone, olanzapine, pimozide, quetiapine, risperidone, ziprasidone

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress.

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. You may experience flushing, nausea, vomiting, pale skin, or sweating before dizziness or fainting occurs. Do not get up too quickly from a lying or sitting position. Report any dizziness or related symptoms to your health care provider as soon as possible. Alcohol may increase dizziness and drowsiness. Avoid alcoholic drinks. Do not take any medications that cause drowsiness without first checking with your health care provider.

If you find that you have sudden feelings of wanting to sleep during normal activities, like cooking, watching television, or while driving or riding in a car, you should contact your health care professional.

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.

There have been reports of increased sexual urges or other strong urges such as gambling while taking some medicines for Parkinson's disease. If you experience any of these urges while taking this medicine, you should report it to your health care provider as soon as possible.

You should check your skin often for changes to moles and new growths while taking this medicine. Call your doctor if you notice any of these changes.

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:

• abnormal or unusual body movements

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

• blood pressure changes

• confusion, hallucinations (seeing or hearing things that are not really there)

• depression or depressed mood

• difficulty breathing or swallowing

• dizziness or lightheadedness

• excess sweating

• fainting spells

• falling asleep during normal activities like driving

• irregular or fast, pounding heartbeat, palpitations

• swelling in arms, hands, legs, or feet

• unusually weak or tired

• 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

• yawning

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

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.