Generic Name and Formulations:
Apomorphine HCl 10mg/mL; soln for SC inj; contains sulfites; cartridges also contain benzyl alcohol.
US WorldMeds, LLC
Indications for APOKYN:
Acute, intermittent treatment of hypomobility, "off" episodes (end-of-dose wearing off and unpredictable on/off episodes) in advanced Parkinson's disease.
See full labeling. Prescribe by specifying volume, not mg. Premedicate with trimethobenzamide (300mg 3 times daily) starting 3 days prior to Apokyn initiation. Give by SC inj only. Supervise 1st dose (monitor BP); prescribe for outpatient use at a dose at least 0.1mL less than tolerated test dose; usual range 0.2mL to 0.6mL; max 0.6mL/episode and one dose/episode; usual max 5 doses/day (2mL/day). Restart at 0.2mL/dose and re-titrate if therapy interrupted for >1 week. Mild-moderate renal dysfunction: reduce test and start doses to 0.1mL.
Concomitant 5HT3 receptor antagonists (eg, alosetron, dolasetron, granisetron, ondansetron, palonosetron).
Nausea and vomiting: pretreat with trimethobenzamide for up to 2 months (see Adult dosing). Sleep disorders (discontinue if significant daytime sleepiness occurs). Cardio- or cerebrovascular disease. Hepatic or renal impairment. Proarrhythmic conditions (eg, hypokalemia, congenital QT prolongation). Monitor BP. Reevaluate if coronary or cerebral ischemia occurs. Asthma. Pregnancy. Nursing mothers.
See Contraindications. Hypotension potentiated with alcohol, antihypertensives, vasodilators (esp. nitrates). Sedation potentiated by CNS depressants. Antagonized by dopamine antagonists (eg, antipsychotics, metoclopramide). Caution with others that cause QT prolongation.
Dopamine agonist (non-ergot).
Yawning, dyskinesias, GI upset (may be severe), somnolence, dizziness, rhinorrhea, hallucinations, edema, chest pain, flushing, pallor, inj site reactions, falling, arthralgia, insomnia, headache, depression, anxiety, pain, CHF, pneumonia, dyspnea, fatigue, ecchymosis, dehydration, orthostatic hypotension, syncope, priapism, QTc prolongation, psychosexual stimulation.
Cartridges (w. injector pen) (3mL)—5
Psychiatry Advisor Articles
- ACOG Update: Marijuana Use Discouraged During Pregnancy, Breastfeeding
- Continuing Research, Emerging Treatments Hold Promise for Treating Anorexia Nervosa
- Asenapine Prevents Recurrence of Mood Events in Bipolar Disorder
- Depression Profiles in Patients With Type 1 Diabetes vs Type 2 Diabetes
- Purpose, Questions of Social Interaction Lead Physicians to Delay Retirement
- CBT, Acceptance Commitment Therapy Helpful for Those With Chronic Pain
- Suicidal Behavior, Thoughts Associated With Perfectionist Tendencies
- Depression Reduced by Social Belonging, Feelings of Inclusion
- Sleep Disturbance May Be Causal Factor in Psychotic Experiences
- Is Antidepressant Use in Pregnancy Tied to Psychiatric Disorders in Offspring?
- Cardiovascular Risk Management May Slow Neurocognitive Decline in HIV
- Maintenance rTMS for Treatment-Resistant Depression
- New Study Compares Opioid Dependence Relapse Treatments
- Increase Use of Nursing Home for Patients With Cognitive Impairment Category
- Venlafaxine XR Safe, Effective in Treating Generalized Anxiety Disorder