Movement Control Medication - Apokyn

Apokyn, also called apomorphine, is a medication for Parkinson's disease. Apokyn is in the dopamine agonist class of medication, similar to ropinirole (Requip) and pramipexole (Mirapex). Apokyn differs in that the medication is injected under the skin using very tiny insulin-size needles.

When is it used?

Apokyn is used as a rescue medication when the symptoms of Parkinson's come back abruptly before the next dose of oral medication is due, or when there is a predictable time of day that the oral medications are not working well. Patients can use Apokyn up to five times a day.

Why do I need a special clinic appointment?

We have a special clinic appointment for patients wanting to try Apokyn for the first time to help establish the correct dose. We see the person off their usual PD medications first thing in the morning and give a test dose to see if Apokyn is beneficial. We also monitor for side effects. The appointment usually takes up to 3 hours to complete, and we encourage you to bring someone with you.

What happens during the Apokyn clinic appointment?

The patient must be taking a prescribed anti-nausea medication for at least 3 days before the appointment. The patient arrives at 8 a.m., having been off their usual PD medications overnight. We quickly examine the patient and then administer a low dose of Apokyn. Apokyn usually starts to work after about 10 minutes and wears off after about 90 minutes. We check blood pressure often and repeat examinations. If symptoms do not improve, we give a higher dose and repeat the blood pressure and examinations. During the waiting time, we go over how to use the injection pen and other safety information. You and your care partner will have time to practice using the injector pen and may be able to inject yourself before leaving the clinic.

Do I have to pay for the kit before trying Apokyn?

Authorization is obtained through your insurance prior to your first appointment. The manufacturer also offers financial assistance to obtain this medication.

What are the side effects?

Nausea, vomiting, blood pressure changes, yawning, confusion, hallucinations and it can cause dyskinesia.

What does the Apokyn kit include?

Medication vials, injection pen, needles, disposal container, practice sponge, alcohol swabs, towel, instructions, carrying case. Apokyn can cause green stains so a green towel is included.

Does Apokyn replace my PD medications?

No. Apokyn is used when the oral medications are not lasting long enough or wear off suddenly.

How do I schedule an appointment for Apokyn?

Call our appointment desk at 425.899.3123 and tell them you want to set up an appointment for Apokyn. If you are not a patient at the Booth Gardner Parkinson's Care Center, you will need to let the scheduler know ahead of time. You will return to your treating neurologist for your care.

What are the steps to obtain Apokyn if helpful?

There are two pharmacies that supply Apokyn. Your doctor will fax in the order.

Who cannot or should not use Apokyn?

Patients who are allergic to sulfa-containing medications should not use Apokyn. Patients with very low blood pressure, hallucinations, confusion or severe dyskinesia may not tolerate Apokyn,  but that is determined during the first visit.