What is apomorphine? 

Apomorphine has some of the same effects as a chemical called dopamine, which occurs naturally in your body. Low levels of dopamine in the brain are associated with Parkinson's disease. 

Apomorphine is used to treat "wearing-off" episodes (muscle stiffness, loss  of muscle control)  in people with advanced Parkinson's disease. 

Apomorphine may also be used for  other purposes  not listed  in this medication guide. 

What is the most important information I  should know about apomorphine? 

Some people using apomorphine have fallen asleep during normal daytime activities such  as working, talking, eating, or driving. You may fall asleep suddenly, even after feeling alert. Tell  your doctor if you have any problems with daytime sleepiness  or drowsiness. If  you are unsure of how this medicine will affect you, be careful if you drive or  do anything that requires you to be awake and alert.  Do not drink alcohol or  use narcotic pain medications, sedatives, tranquilizers, muscle relaxes,  or other medicines that can make you sleepy  or lower  your blood pressure. Dangerous side effects may result. Apomorphine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. 

What should I discuss with my healthcare provider before using apomorphine? 

You should not use this  medication if  you are allergic to apomorphine, or if  you are using any  of the following medications: 

• alosetron (Lotronex); 
• dolasetron (Anzemet); 
• granisetron (Kytril); 
• ondansetron (Zofran); or 
• palonosetron (Aloxi). 

Before using  apomorphine, tell  your doctor if you are allergic  to any drugs, or if you have: 

• an electrolyte imbalance (such as  low levels of potassium or magnesium in your blood); 
• a slow heart rate; 
• a personal or family history of "Long QT syndrome"; 
• a history of stroke or heart attack; 
• asthma; 
• liver disease; 
• kidney disease; 
• a psychiatric disorder such as schizophrenia;  or
• low blood pressure. 

If  you have any  of these conditions,  you may need  a dose adjustment  or special tests  to safely use apomorphine. 

Some people using apomorphine have fallen asleep during normal daytime activities such as working, talking, eating, or driving.  You may fall asleep suddenly, even after feeling alert. Tell  your doctor if  you have any problems with daytime sleepiness  or drowsiness. If you are unsure of how this medicine  will affect you,  be careful if you drive or do anything that requires you  to be awake  and alert. FDA pregnancy category C. This medication may  be harmful to an unborn baby. Tell  your doctor if  you are pregnant or plan  to become pregnant during treatment. Apomorphine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling  your doctor if you are breast-feeding a baby. 

How should I  use apomorphine? 

Apomorphine is given as an injection under the  skin of  your stomach, upper arm,  or upper thigh. Your doctor, nurse,  or other healthcare provider will give you this injection.  You may be shown how to  inject your medicine at home.  Do not self-inject this medicine if  you do not fully understand how  to give  the injection and properly dispose  of used needles and syringes. 

This  medication comes with patient instructions for safe  and effective use. Follow these directions carefully. Ask  your doctor or pharmacist if  you have any questions. 

Do not inject  apomorphine into a vein. Measuring your  apomorphine dose correctly  is extremely important. If you  use an injector pen with  your apomorphine,  the medication is measured  in milliliters (mL) marked  on the pen. However, your prescribed dose may be in milligrams (mg). One milligram, or 1 mg,  of apomorphine  is equal  to 0.1 mL marked  on the dosing  pen.

Use  a different place on your stomach, arm, or thigh each time you give yourself an injection.  Do not inject apomorphine into  the same place two times in a row. 

Use each disposable  needle only one time. Throw away used needles in  a puncture-proof container (ask your pharmacist where you  can get one  and how to dispose  of it). Keep this container  out of the reach of children and pets. 

Apomorphine can cause severe nausea and vomiting. For  this reason, your doctor may prescribe an anti-nausea medication for  you to start taking  a few days before  you begin using apomorphine. You may also need  to keep using  the anti-nausea medicine throughout  your treatment with apomorphine. You may have withdrawal symptoms such  as fever, muscle stiffness,  and feeling light-headed or fainting, when  you stop using this medication after using it over a long period of time. Do  not stop using apomorphine suddenly without first talking  to your doctor. You may need  to use less and less before you stop  the medication completely. 

If you stop using apomorphine for a week or longer, ask  your doctor before restarting  the medication. You may need  to restart with a lower  dose.

Store this medication at room temperature, away from heat, moisture,  and light. 

What happens if I miss a dose? 

Use  the missed  dose as soon as  you remember.  If it is almost time for  the next dose, skip  the missed dose  and wait until your next regularly scheduled dose. Do not use extra medicine  to make up  the missed dose. 

What happens if I overdose? 

Seek emergency medical attention if  you think  you have used too much  of this medicine. Overdose symptoms  may include nausea, extreme drowsiness,  or fainting. 

What should I avoid while using apomorphine? 

Avoid drinking alcohol. It can increase some of  the side effects  of apomorphine. Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers,  and medicine for seizures, depression  or anxiety can add to sleepiness caused by apomorphine. Tell your doctor if you regularly use  any of these other medicines. Apomorphine can cause side effects  that may impair your thinking  or reactions. Be careful if you drive or do anything that requires you  to be awake and alert. 

Apomorphine side effects 

Get emergency medical help if you have any of these signs  of an allergic reaction: hives; difficulty breathing; swelling of  your face, lips, tongue,  or throat. Call your doctor  at once if you have any of these serious side effects: 

• nausea or vomiting that continues after taking an anti-nausea medication; 
• feeling light-headed (especially when you stand up); 
• falling or passing out; 
• chest pain  or heavy feeling, pain spreading to the arm or shoulder, sweating, general ill feeling; 
• confusion, hallucinations; 
• restless muscle  movements in your eyes, tongue, jaw, or neck; 
• tremor (uncontrolled shaking); or 
• penis erection that is painful or lasts 4 hours or longer. 

Less serious side effects may include: 

• bruising, itching, or hardening of your skin where the injection was given; 
• increased sexual desire; 
• depressed mood, headache; 
• pale skin, increased sweating; 
• warmth, redness, or tingling under  your skin;
• dizziness, drowsiness, yawning; 
• runny nose; 
• swelling in  your hands or feet; 
• sleep problems (insomnia); 
• joint pain;  or
• Constipation  or diarrhea.