Find the answers to the most frequently asked questions about APOKYN here.
APOKYN can be used up to 5 times a day by injection under the skin (not into a vein), using a thin needle similar to what is used to give insulin injections for diabetes patients. Once trained by a member of your healthcare team, either you or your care partner can give the injections.*
APOKYN is used with your other PD medications. Unlike your scheduled oral PD medications, you can take APOKYN when you need it to treat your off episodes, up to 5 times a day. APOKYN is not used to prevent off episodes.
*Your healthcare provider will advise you on what dose of APOKYN to use ond how often you should use it.
Oral medications containing levodopa are the most commonly prescribed treatment for PD and usually work quite well when first given. After some time you may start experiencing decreased "on" time (when you are feeling your best), and may be having what are known as "off episodes." These off episodes such as tremor, rigidity, slowness and difficulty moving happen when your PD symptoms are at their worst. Off episodes can interfere with your everyday work, recreation, or even routine daily activities for a few minutes up to a few hours.
Off episodes are fairly common in PD and can happen at any time.1,2 They can occur as your levodopa medications start to wear-off. This can happen first thing in the morning prior to your first dose of levodopa medications or before it’s time to take your next dose. Off episodes may also occur less predictably – perhaps because your levodopa medications are taking a while to start working (also known as 'delayed-on' ) or they may fail to work at all (also known as 'dose failure' ) . Sometimes off episodes can appear to have no real or obvious trigger.
Regardless of their cause, off episodes are more common the longer a patient has been on levodopa.3 Some people experience multiple off episodes every day.2,4 APOKYN can help people with PD manage and treat off episodes, returning them to an on state.
APOKYN can rapidly stop off episodes after they start. APOKYN starts working as early as 10 minutes after injection, and most people feel relief from their off symptoms within 20 minutes.5,6
Since APOKYN bypasses the stomach, you do not need to worry about your meal times; APOKYN will work just as effectively at any time of the day.
See Rapid and Reliable for more information.
Prior to starting APOKYN, you will be instructed on its use and have all of your questions answered. It is helpful to have your care partner with you, if available, during this time. You’ll be asked to briefly interrupt your normal schedule of oral Parkinson’s medications in order to trigger an off episode. This is done to test for the right dose of APOKYN. You will take a low dose of APOKYN by a small injection just under your skin. Your blood pressure will be checked several times.
See Starting APOKYN for more information.
APOKYN was approved for use in the United States in 2004. There has been no evidence that patients develop resistance to APOKYN, and patients in clinical trials required few changes to their dose even after using APOKYN for over one year.4,5
Your APOKYN prescription is "filled" by a Specialty Pharmacy and sent to your home. Certain insurance plans may instruct their patients to pick up their prescription at the insurer’s local and/or approved pharmacy.
Specialty Pharmacies are distinct from traditional pharmacies because they dispense and distribute specialized FDA-approved medications including APOKYN. Your Specialty Pharmacy will ship APOKYN to your home, both the initial prescription and refills. You should expect phone calls from them to arrange your APOKYN delivery.
If you have any questions or need assistance regarding APOKYN, please contact your CoC coordinator at 1-877-7APOKYN (1-877-727-6596), Option 3.
See Circle of Care Program for more information.
Your physician may prescribe Tigan (trimethobenzamide hydrochloride) to help prevent nausea and vomiting, which are known to be side effects of APOKYN.
You will be advised when to start taking Tigan, usually 3 days before you begin APOKYN therapy. You should continue to take this medicine until you are advised to stop by your healthcare provider.
If your physician has handed you a prescription for Tigan, you will need to fill it at your local pharmacy. This is usually where you go to pick up your oral PD medications. Your physician may send the prescription directly to your local pharmacy or may have Tigan come from a specialty pharmacy.
Tigan is a medicine prescribed to help prevent nausea and vomiting, and you may experience nausea and vomiting if you forget to take it. Take your missed dose as soon as you remember, unless it is almost time for your next dose, then you should skip your missed dose and take your next scheduled dose as normal. Do not use extra medicine to make up the missed dose.
The Circle of Care coordinator can help you by identifying programs that may be able to assist you with out-of-pocket costs for APOKYN.
To learn more, call a Circle of Care coordinator at 1-877-7APOKYN (1-877-727-6596), Option 3.
Never store the APOKYN pen with a needle attached. Storing and carrying the pen this way can leave an open passage for air to enter the cartridge and for medicine to leak out. Either of these can affect the accuracy of the injection.
See the APOKYN Pen Instructions for Use for more information.
According to current security guidelines you may take an APOKYN pen on airplanes in carry-on luggage.
More details about traveling with medicines are available from the Transportation Security Administration.
APOKYN works by mimicking the activity of dopamine in the brain. Dopamine is reduced or absent in people with PD and is thought to cause many of the symptoms of the disease. APOKYN is not morphine. APOKYN is not addictive.