apomorphine hydrochloride at a glance
Class
Direct dopamine-receptor agonist
Usual role
Reduces Parkinson’s OFF periods not adequately controlled by oral treatment
What is apomorphine hydrochloride used for?
The selected products are licensed for adults with Parkinson’s disease whose motor fluctuations or OFF episodes are not sufficiently controlled by oral anti-Parkinson treatment.
Intermittent treatment of OFF episodes using a subcutaneous injection pen.
Continuous subcutaneous infusion for persistent motor fluctuations.
Intermittent treatment of OFF episodes using a sublingual film.
How does apomorphine hydrochloride work?
Apomorphine directly stimulates dopamine receptors, including D1- and D2-type receptors. This temporarily restores dopamine signalling involved in movement and can help a person move from an OFF state towards an ON state; unlike levodopa, it does not need conversion into dopamine.
apomorphine hydrochloride preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 5 mg/mL
Injection
Route: Parenteral
Strengths: 10 mg/mL
How to take apomorphine hydrochloride
Treatment should be started and demonstrated by a specialist Parkinson’s team. Follow product-specific training and do not change or stop treatment without discussing it with that team.
Injectable products are given into tissue under the skin, never into a vein. Rotate sites and use only clear, colourless, particle-free solution; do not use solution that has turned green.
The pre-filled syringe is used undiluted with the prescribed infusion device and is not intended for intermittent injection.
For sublingual film, moisten the mouth with water, place the whole film under the tongue and leave it there until dissolved. Do not cut, chew or swallow the film, and do not talk or swallow saliva while it dissolves.
apomorphine hydrochloride side effects
Common or expected effects
- Nausea or vomiting
- Sleepiness, dizziness or light-headedness
- Yawning
- Hallucinations or mild confusion
- Involuntary movements
- Low blood pressure, especially on standing
- Injection-site pain, redness, bruising or nodules with subcutaneous products
- Mouth irritation, soreness, swelling or ulceration with sublingual film
Get urgent medical advice
- Severe allergic reaction or bronchospasm
- Fainting, palpitations or severe hypotension
- Sudden sleep onset
- Severe or worsening hallucinations, psychosis, agitation or harmful impulsive behaviour
- High fever, rigidity and altered consciousness after rapid reduction or withdrawal
- Unusual bruising, bleeding or symptoms of anaemia
- Injection-site ulceration or tissue damage
- Prolonged painful erection
apomorphine hydrochloride in pregnancy
Human pregnancy data are very limited. Injectable APO-go products should be used only when clearly necessary, while the Kynmobi SmPC does not recommend use during pregnancy. Anyone pregnant, planning pregnancy or who could become pregnant should have product-specific advice from the Parkinson’s specialist and obstetric team.
apomorphine hydrochloride while breastfeeding
It is not known whether apomorphine or its metabolites pass into human milk, and risk to a breastfed infant cannot be excluded. The specialist and prescriber should weigh the benefits of breastfeeding against the benefits of treatment and agree whether breastfeeding or apomorphine should be stopped.
apomorphine hydrochloride interactions
A full medication review is essential before treatment and whenever other medicines change.
Ondansetron and other 5-HT3 antagonists
Contraindicated because profound hypotension and loss of consciousness may occur.
Domperidone
Combined treatment can increase cardiac rhythm risk, so individual risk assessment and ECG monitoring may be required.
Common questions about apomorphine hydrochloride
Answers are fully visible for fast scanning and source review.
Is apomorphine hydrochloride the same as morphine?
No. Despite its name, apomorphine is a dopamine agonist rather than morphine or an opioid. Excessive, addiction-like use can nevertheless occur as dopamine dysregulation syndrome and should be reported.
What is an OFF episode?
It is a period when Parkinson’s movement symptoms noticeably worsen because existing oral treatment is not providing adequate control.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.