Apomorphine is used to treat intermittent hypomobility in Patients with advanced Parkinson's
disease. In this condition, the individual sees a decreased response to an anti-Parkinson
drug such as L-DOPA causing muscle stiffness and loss of muscle control. Apomorphine is
given in combination L-DOPA with the intention to reduce the L-DOPA dosing, because
those at the advanced stages often have many of dyskinesias associcated with L-DOPA and
periods of hypermobility. The apomorphine is injected subcutaneously, when an episode
sets in, and signs subside. Patients can use portable mini-pumps to continuously infuse
apomorphine, an average of three times a day, allowing them to stay in the "on" state.
Apomorphine is called dopamine agonists. They works by acting like dopamine, which our
minds need to motor control. In patients with advanced stage of Parkinsons, the ''off''
episodes, when they have difficulty moving, walking, and speaking, occur as medication
wears off or at random who have been taking other therapies for a long and are taking other
medications for their condition.
Apomorphine is available under the brand name Apokyn among others.
Apomorphine was first synthesised by Arppe in 1845 from morphine and sulfuric acid..
Earlier, in 1869, Matthiesen and Wright has used hydrochloric acid instead of sulfuric acid in
the process, naming the resulting compound apomorphine.
Dosage and administration
Apomorphine solution is available as a glass cartridge and it comes with an injector pen. You
will be given some needs with the pen, however, the patient is also recommended to buy a
few more, any questions about administration must be cleared with the doctor, including the
needle to be used.
Patients must always use a new, sterile needle for every injection. These needles once used
must be immediately destroyed, and never used again. They can also not touch any surface
except the exact spot of the injection. Injector pen must be never be carried or stored with
the needle attached. Use puncture-resistant container and learn from the pharmacist about
how to discard the puncture-resistant container.
It can be injected in stomach, upper arm, or upper leg areas. You will also be given other
medication to help decrease your chance of developing nausea and vomiting while you are
using apomorphine injection, more so during the beginning of treatment.
Patients are usually started off on a low dose. The dose is gradually increased, not more
than once every few days. If you want to stop using the medication, do not do it without
consulting your doctor.
The Cost of Apomorphine
In the USA, the consumers have to pay and average retail price of $42 for 3 mL pen. In the
USA, the Average Daily Drug Cost of using this medicine is USD 4.30 to 21.48. this
medicine also relatively economical to buy in the developing world. In India, the injections
are available in 2 ml and 5 ml ampoules cost USD4 and USD9, respectively. With daily cost
between USD7 and USD15.
How does Apomorphine Work?
As a non-ergoline dopamine agonist, Apomorphine has high binding affinity to dopamine D2,
D3, and D5 receptors. Caudate-putamen, a region of the brain responsible for locomotor
control is achieved through stimulation of D2 receptors in the brain. The eventual result is
that relaxation of the stiffness and better motor control in individuals.
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