Apomorphine Stats & Data

Apomorphine is a fast-acting non‑ergoline dopamine agonist used as a rescue for 'off' episodes in advanced Parkinson’s disease; it has no opioid effects despite its name. 5‑HT3 antiemetics such as ondansetron or granisetron are contraindicated with apomorphine because the combination has produced profound hypotension and loss of consciousness; do not use these for nausea prophylaxis with apomorphine. In regions where available, domperidone (peripheral D2 antagonist) is often used for 72 hours before initiating apomorphine to reduce nausea and hypotension; in the US, trimethobenzamide has historically been used instead—avoid 5‑HT3 agents for this purpose. Initial test dosing and titration should occur under medical supervision because orthostatic hypotension, syncope, or severe emesis can occur during early titration. Sublingual and subcutaneous routes have rapid onsets (about 10–20 minutes) and short durations; sublingual film half‑life is longer than IV, which can extend effects. Daytime somnolence and sudden sleep attacks have been reported with dopamine agonists; avoid driving/operating machinery until you know your response. Alcohol and other CNS depressants can increase dizziness, sedation, and fall risk, especially during dose escalation. Antipsychotics that block D2 receptors can blunt apomorphine’s benefit and exacerbate parkinsonism; coordinate care if such agents are necessary. Injection-site rotation and proper subcutaneous technique reduce local reactions when using pens or pumps; infusion is reserved for frequent, prolonged 'off' periods under specialist care. Kynmobi sublingual film (10–30 mg) was marketed 2020–2023 in the US and then discontinued for commercial reasons; subcutaneous products and infusion systems remain available in many regions. Always verify cardiovascular status (including orthostatic blood pressures) during initiation and when adjusting doses.