APO-go Pen / APO-go PFS

  • Apomorphine is used for "off" episodes in Parkinson's disease.
  • Treatment with apomorphine will be started in hospital or a specialist clinic.
  • The main side-effects are feeling sick, drowsiness, sleepiness, and injection site reactions.
  • Do not drive if you are affected by drowsiness or sleepiness.

About apomorphine

Type of medicine Dopamine receptor agonist
Used for Parkinson's disease
Also called APO-go® Pen
Available as Injection, pen injector, or prefilled syringe

In Parkinson's disease, for reasons that are not fully understood, nerve cells in the brain which produce a chemical called dopamine begin to decrease in number. The overall effect is a large loss of dopamine in the brain causing a chemical imbalance. The effect of the chemical imbalance is a lack of co-ordination with tremors, stiff muscles, stiff joints, and difficulty moving. Currently, there is no way to stop the loss of these dopamine-producing nerve cells or to restore the cells that have already been lost.

As Parkinson's disease progresses, some people develop a condition where one minute they can move freely and the next minute they find it difficult. This is called an "on-off effect". If this happens, apomorphine can be used to treat this problem.

Before using apomorphine

Before using apomorphine make sure your doctor or pharmacist knows:

  • If you have dystonia (you are unable to move) or dyskinesia (you have involuntary movements) despite taking levodopa.
  • If you have breathing problems.
  • If you have heart or blood vessel disease.
  • If you have ever had postural hypotension (low blood pressure particularly when you stand up).
  • If you have kidney or liver problems.
  • If you have had mental health problems such as depression, psychosis or dementia.
  • If you are pregnant or breast-feeding.
  • If you are taking other medicines, including those available to buy without a prescription, herbal and complementary medicines.
  • If you have ever had an allergic reaction to this or any other medicine.

How to use apomorphine

  • Always use apomorphine exactly as your doctor has told you. It is only available as an injection.
  • Treatment with apomorphine will be started while you are in hospital or a specialist clinic. This is because you will need to be supervised closely at first. Your doctor or nurse will administer apomorphine for you to begin with.
  • If the treatment is successful you will be taught how to inject apomorphine into an area under your skin.
  • Do not use apomorphine injection if the solution is cloudy, contains particles or has turned green.

Getting the most from your treatment

  • Before starting this treatment, read the printed information leaflet you will be given and follow the instructions carefully.
  • Before you are given apomorphine injection, you will be given at least two days' treatment with an anti-sickness medicine. You should continue to take this during the first few weeks of treatment. It will then be reduced or slowly withdrawn.
  • Keep your regular appointments with your doctor so your progress can be monitored. You may require regular blood tests while you are using apomorphine.
  • If you are having any treatment like an operation or dental treatment, tell the person carrying out the treatment that you are using apomorphine.

Can apomorphine cause problems?

Along with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Common side-effects - these affect less than 1 in 10 people who take this medicine What can I do if I experience this
Feeling or being sick Make sure you take the anti-sickness medicine your doctor has prescribed for you. Speak with your doctor if this continues
Small lumps and redness at the injection site Use a different site of injection each time you use apomorphine. Ask your doctor or nurse for further advice
Drowsiness, sleepiness This may occur at the start of your treatment but usually resolves after a few weeks. If you are affected, do not drive or operate machinery or do any other tasks which would be dangerous when you are not fully alert. Speak with your doctor if this continues to be a problem
Dizziness or light-headedness Stand up slowly and get your balance before starting to walk
Yawning, confusion, imagining things that are not real If any of these become troublesome, speak with your doctor

Important: speak with your doctor if you notice the following:

  • Changes in your behaviour, such as a desire to gamble or an increased sex drive.
  • Falling asleep suddenly. (It is important that you do not drive if this affects you.)

How to store apomorphine

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.