What is Apomorphine?

Apomorphine is a medication used to manage  Parkinson’s Disease. It is a strong dopamine agonist (Medications which act to stimulate nerve cells to release more dopamine). This leads to improvement of body functions in patients with Parkinson’s disease, who have low dopamine levels. Despite its name, apomorphine does not contain morphine. Unlike other dopamine agonist drugs (like Pramipexole, Ropinirole), which are taken as tablets or patches, apomorphine is given by injection or continuous infusion, using a pump.

Who would be benefited from Apomorphine?

It doesn’t help everyone manage their Parkinson’s symptoms.It may not replace oral medication entirely. It usually suggested for patients who have

Oral medications taking long time to act
Have sudden and unpredictable changes in symptoms
Severe OFF periods
Cannot be considered for surgery for other medical issues / Patient not willing for surgery
Patients who cannot take medications orally

How is Apomorphine medication taken?

It can be taken by various methods and include:

Pre-filled disposable pen you can use to give injections as needed.
Infusion over a period of several hours (usually during the day) via a portable, battery-driven pump (a syringe driver) using a pre-filled syringe

What are its advantages?

  1. Apomorphine Injections using the pen are taken in a similar way to insulin for diabetes. It works within five to 10 minutes. Much faster than oral medications, and can act as a ‘rescue’ treatment. This is very useful to treat a sudden ‘off’ period.
  2. Will have fewer ‘OFF’ periods. : You can significantly reduce the number of ‘off’ periods

What are the its Disadvantages?

  1. Only available as Injection / Pumps for infusion
  2. Can cause severe short term Nausea and Vomiting
  3. Heart pounding/ fainting episodes
  4. May cause Sleepy or experience sudden onset of Sleep
  5. Injection sites can become sore and irritated and Nodules (lumps) at the site of injection can be noticed
  6. Can Cause hallucinations/ Delusions
  7. May lead to Impulsive/ Compulsive behaviors

Is there Indian Experience of Apomorphine Therapy?

It is available in India since 2019 and already medical publications about its experience in Indian patients has been published.