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Apokyn Generic Name & Formulations
Legal Class
Rx
General Description
Apomorphine HCl 10mg/mL; soln for SC inj; contains sulfites; cartridges also contain benzyl alcohol.
Pharmacological Class
Dopamine agonist (non-ergot).
How Supplied
Cartridges (w. injector pen) (3mL)—5
Manufacturer
Generic Availability
YES
Apokyn Indications
Indications
Acute, intermittent treatment of hypomobility, "off" episodes (end-of-dose wearing off and unpredictable on/off episodes) in advanced Parkinson's disease.
Apokyn Dosage and Administration
Adult
See full labeling. Prescribe by specifying volume, not mg. Premedicate with trimethobenzamide (300mg 3 times daily) starting 3 days prior to Apokyn initiation; alternatively, consider starting Apokyn at 0.1mL (1mg) and titrate based on response. 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 0.1mL 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 or moderate renal impairment: reduce test and start doses to 0.1mL.
Children
Not established.
Apokyn Contraindications
Contraindications
Concomitant 5HT3 receptor antagonists (eg, alosetron, dolasetron, granisetron, ondansetron, palonosetron). Sulfite allergy.
Apokyn Boxed Warnings
Not Applicable
Apokyn Warnings/Precautions
Warnings/Precautions
Nausea and vomiting: pretreat with trimethobenzamide for up to 2 months (see Adult dosing). Sleep disorders (discontinue if significant daytime sleepiness occurs). Psychosis. Impulse control/compulsive behaviors; consider dose reduction or discontinue if urges develop. Consider discontinuing if hemolytic anemia occurs. Cardio- or cerebrovascular disease. Hepatic or renal impairment. Proarrhythmic conditions (eg, hypokalemia, congenital QT prolongation). Monitor blood pressure. Reevaluate if coronary or cerebral ischemia occurs. Asthma. Elderly. Pregnancy. Nursing mothers.
Apokyn Pharmacokinetics
See Literature
Apokyn Interactions
Interactions
See Contraindications. Avoid alcohol. Hypotension potentiated with antihypertensives, vasodilators (esp. nitrates). Sedation potentiated by CNS depressants. Antagonized by dopamine antagonists (eg, antipsychotics, metoclopramide). Caution with concomitant drugs that prolong the QT interval.
Apokyn Adverse Reactions
Adverse Reactions
Yawning, dyskinesias, drowsiness, somnolence, nausea, vomiting, dizziness, postural hypotension, rhinorrhea, chest pain/pressure/angina, hallucinations, edema, swelling of extremities, inj site reactions, falling, arthralgia, insomnia, headache, depression, UTIs, anxiety, CHF, limb pain, back pain, Parkinson's disease aggravated, pneumonia, sweating increased, dyspnea, fatigue, ecchymosis, constipation, diarrhea, weakness, dehydration; syncope, priapism, QTc prolongation, hypersensitivity reactions, withdrawal-emergent hyperpyrexia/confusion, fibrotic complications.
Apokyn Clinical Trials
See Literature
Apokyn Note
Not Applicable
Apokyn Patient Counseling
See Literature
