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FAQs


Find the answers to the most frequently asked questions about APOKYN here.

1. How do I use APOKYN?
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.

2. What are off episodes and what causes them?
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.

See Off Episodes and Are Off Episodes common? for more information.

3. How quickly does APOKYN work?
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.

4. What is it like to start APOKYN?
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.

5. Will I develop resistance to APOKYN over time?
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
6. How is my APOKYN prescription filled, and what is a Specialty Pharmacy?
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.

7. What is Tigan® and how do I get it?
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.

8. What happens if I forget to take Tigan?
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.
9. What if I can’t afford my APOKYN or need financial assistance?
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.

10. Can I store the APOKYN pen with a needle attached and ready to inject?
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.

11. Is it OK to board an airplane with an APOKYN pen?
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.

12. Is APOKYN similar to morphine?
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.

All trademarks are the property of their respective owners.

References
  1. Swope DM. Rapid treatment of "wearing off" in Parkinson's disease. Neurology. 2004;62(Suppl 4):S27–S31.
  2. Stacy M, Silver D. Apomorphine for the acute treatment of "off" episodes in Parkinson's disease. Parkinsonism Relat Disord. 2008; 14(2):85–92.
  3. Obeso JA, Rodriguez-Oroz MC, Chana P, Lera G, Rodriguez M, Olanow CW. The evolution and origin of motor complications in Parkinson's disease. Neurology. 2000;55(Suppl 4):S13–S20; discussion S21–S23.
  4. Chen JJ, Obering C. A review of intermittent subcutaneous apomorphine injections for the rescue management of motor fluctuations associated with advanced Parkinson's disease. Clin Ther. 2005;27(11):1710–1724.
  5. Pfeiffer RF, Gutmann L, Hull KL Jr, Bottini PB, Sherry JH, The APO302 Investigators. Continued efficacy and safety of subcutaneous apomorphine in patients with advancved Parkinson's disease. Parkinsonism Relat Disord. 2007;13(2):93–100.
  6. APOKYN® (apomorphine hydrochloride, USP) [Prescribing Information]. Louisville, KY: US WorldMeds, LLC; 2014.

Important Safety Information and Indication

Important Safety Information

Do not take APOKYN if you are being treated with certain drugs called 5HT3 antagonists (including Anzemet®, Kytril®, Zofran®, Lotronex®, and Aloxi®) that are used for nausea and vomiting or irritable bowel syndrome. People taking these types of drugs with apomorphine experienced severely low blood pressure and lost consciousness or "blacked out."

Do not take APOKYN if you are allergic to APOKYN or its ingredients, notably sodium metabisulfite. Sulfites can cause severe, life-threatening allergic reactions in some people, especially in people with asthma.

Before taking APOKYN, tell your healthcare provider about all your medical conditions, including if you have dizziness, fainting spells, low blood pressure, asthma, liver problems, kidney problems, heart problems, a mental disorder called major psychotic disorder, have had a stroke or other brain problems, or drink alcohol.

Tell your healthcare provider about all medicines that you take because APOKYN may interact with other medicines causing serious side effects.

APOKYN must be injected just under the skin and not into a vein. Injecting APOKYN into a vein could cause a blood clot.

Your healthcare provider may prescribe a medicine called Tigan® (trimethobenzamide hydrochloride) to help prevent the severe nausea and vomiting that may occur when taking APOKYN. If Tigan is prescribed, your healthcare provider will determine how long you should remain on this medicine.

Some patients taking APOKYN may get sleepy during the day or fall asleep without warning doing everyday activities. Do not take medicines that make you sleepy while you are taking APOKYN. Until it is known how APOKYN affects your ability to stay alert, you should not drive a car or operate heavy machinery.

APOKYN may lower blood pressure and cause dizziness and fainting, especially when starting treatment or if the dose is increased. Alcohol, antihypertensives, and nitrates may increase this risk. Patients should not get up too fast from sitting or after lying down to minimize these problems.

The changes that occur with PD and the effects of some PD medicines can increase the risk of falling. APOKYN can also increase this risk.

APOKYN can cause or worsen psychotic-like behavior including hallucinations (seeing or hearing things that are not real), confusion, excessive suspicion, aggressive behavior, agitation, delusional beliefs (believing things that are not real), and disorganized thinking. Call your healthcare provider right away if you experience any of these symptoms.

Some people with PD may get sudden, uncontrolled movements after treatment with some PD medicines. APOKYN can cause or worsen this effect.

Some people with PD have reported new or increased gambling urges, increased sexual urges, and other intense urges, while taking PD medicines, including APOKYN. If you experience new or increased urges, tell your healthcare provider.

If you experience shortness of breath, fast heartbeat, chest pain, or if you have a change in your heartbeat, or faint while taking APOKYN, you should call your healthcare provider right away.

Some people with PD may have an increased chance of getting a skin cancer called melanoma. People with PD should have a healthcare provider check their skin for skin cancer regularly.

The most common side effects seen in clinical studies with APOKYN were: yawning; sleepiness; sudden uncontrolled movements; dizziness; runny nose; nausea and/or vomiting; seeing and hearing things that are not real; swelling of hands, arms, legs, and feet.

Some patients may notice soreness, redness, bruising, or itching at the injection site. Change the site with each injection.

Some people may develop depression while taking APOKYN. Call your healthcare provider right away if you become depressed with APOKYN.

Tell your healthcare provider if you are pregnant or plan to become pregnant or if you are breast-feeding or planning to breast-feed. It is not known if APOKYN can harm your unborn baby or if APOKYN passes into breast milk.

To report SUSPECTED ADVERSE REACTIONS or product complaints, contact US WorldMeds at 1-877-727-6596 (1-877-7APOKYN). You may also report SUSPECTED ADVERSE REACTIONS to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Indication

APOKYN (apomorphine hydrochloride injection) is used by injection, as needed, to treat loss of control of body movements in people with advanced Parkinson's disease (PD). This condition is also called hypomobility or off episodes. An off episode may include symptoms such as muscle stiffness, slow movements, and difficulty starting movements. APOKYN may improve your ability to control your movements when it is used during an off episode. This may help you walk, talk, or move around easier. APOKYN is not used to prevent off episodes. APOKYN does not take the place of your other medicines for PD.

Patients and care partners must receive complete instructions on the proper use of APOKYN. Please see full Prescribing Information and Pen Instructions for Use/Patient Information.

All trademarks are property of their respective owners.

US WorldMeds, LLC is the exclusive licensee and distributor of APOKYN in the United States and Its territories.

© 2017. APOKYN is a registered trademark of BRITUSWIP.

Terms of Use | Privacy Policy

Important Safety Information and Indication

Important Safety Information

Do not take APOKYN if you are being treated with certain drugs called 5HT3 antagonists (including Anzemet®, Kytril®, Zofran®, Lotronex®, and Aloxi®) that are used for nausea and vomiting or irritable bowel syndrome. People taking these types of drugs with apomorphine experienced severely low blood pressure and lost consciousness or "blacked out."

Do not take APOKYN if you are allergic to APOKYN or its ingredients, notably sodium metabisulfite. Sulfites can cause severe, life-threatening allergic reactions in some people, especially in people with asthma.

Before taking APOKYN, tell your healthcare provider about all your medical conditions, including if you have dizziness, fainting spells, low blood pressure, asthma, liver problems, kidney problems, heart problems, a mental disorder called major psychotic disorder, have had a stroke or other brain problems, or drink alcohol.

Tell your healthcare provider about all medicines that you take because APOKYN may interact with other medicines causing serious side effects.

APOKYN must be injected just under the skin and not into a vein. Injecting APOKYN into a vein could cause a blood clot.

Your healthcare provider may prescribe a medicine called Tigan® (trimethobenzamide hydrochloride) to help prevent the severe nausea and vomiting that may occur when taking APOKYN. If Tigan is prescribed, your healthcare provider will determine how long you should remain on this medicine.

Some patients taking APOKYN may get sleepy during the day or fall asleep without warning doing everyday activities. Do not take medicines that make you sleepy while you are taking APOKYN. Until it is known how APOKYN affects your ability to stay alert, you should not drive a car or operate heavy machinery.

APOKYN may lower blood pressure and cause dizziness and fainting, especially when starting treatment or if the dose is increased. Alcohol, antihypertensives, and nitrates may increase this risk. Patients should not get up too fast from sitting or after lying down to minimize these problems.

The changes that occur with PD and the effects of some PD medicines can increase the risk of falling. APOKYN can also increase this risk.

APOKYN can cause or worsen psychotic-like behavior including hallucinations (seeing or hearing things that are not real), confusion, excessive suspicion, aggressive behavior, agitation, delusional beliefs (believing things that are not real), and disorganized thinking. Call your healthcare provider right away if you experience any of these symptoms.

Some people with PD may get sudden, uncontrolled movements after treatment with some PD medicines. APOKYN can cause or worsen this effect.

Some people with PD have reported new or increased gambling urges, increased sexual urges, and other intense urges, while taking PD medicines, including APOKYN. If you experience new or increased urges, tell your healthcare provider.

If you experience shortness of breath, fast heartbeat, chest pain, or if you have a change in your heartbeat, or faint while taking APOKYN, you should call your healthcare provider right away.

Some people with PD may have an increased chance of getting a skin cancer called melanoma. People with PD should have a healthcare provider check their skin for skin cancer regularly.

The most common side effects seen in clinical studies with APOKYN were: yawning; sleepiness; sudden uncontrolled movements; dizziness; runny nose; nausea and/or vomiting; seeing and hearing things that are not real; swelling of hands, arms, legs, and feet.

Some patients may notice soreness, redness, bruising, or itching at the injection site. Change the site with each injection.

Some people may develop depression while taking APOKYN. Call your healthcare provider right away if you become depressed with APOKYN.

Tell your healthcare provider if you are pregnant or plan to become pregnant or if you are breast-feeding or planning to breast-feed. It is not known if APOKYN can harm your unborn baby or if APOKYN passes into breast milk.

To report SUSPECTED ADVERSE REACTIONS or product complaints, contact US WorldMeds at 1-877-727-6596 (1-877-7APOKYN). You may also report SUSPECTED ADVERSE REACTIONS to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Indication

APOKYN (apomorphine hydrochloride injection) is used by injection, as needed, to treat loss of control of body movements in people with advanced Parkinson's disease (PD). This condition is also called hypomobility or off episodes. An off episode may include symptoms such as muscle stiffness, slow movements, and difficulty starting movements. APOKYN may improve your ability to control your movements when it is used during an off episode. This may help you walk, talk, or move around easier. APOKYN is not used to prevent off episodes. APOKYN does not take the place of your other medicines for PD.

Patients and care partners must receive complete instructions on the proper use of APOKYN. Please see full Prescribing Information and Pen Instructions for Use/Patient Information.

All trademarks are property of their respective owners.

US WorldMeds, LLC is the exclusive licensee and distributor of APOKYN in the United States and Its territories.

© 2017. APOKYN is a registered trademark of BRITUSWIP.

Terms of Use | Privacy Policy

 

 

Indication: APOKYN (apomorphine hydrochloride injection) is used by injection, as needed, to treat loss of control of body movements in people with advanced Parkinson's disease (PD). This condition is also called hypomobility or off episodes. An off episode may include symptoms such as muscle stiffness, slow movements, and difficulty starting movements. APOKYN may improve your ability to control your movements when it is used during an off episode. This may help you walk, talk, or move around easier. APOKYN is not used to prevent off episodes. APOKYN does not take the place of your other medicines for PD.

Important Safety Information for Patients

Do not take APOKYN if you are being treated with certain drugs called 5HT3 antagonists (including Anzemet®, Kytril®, Zofran®, Lotronex®, and Aloxi®) that are used for nausea and vomiting or irritable bowel syndrome. People taking these types of drugs with apomorphine experienced severely low blood pressure and lost consciousness or "blacked out."

Do not take APOKYN if you are allergic to APOKYN or its ingredients, notably sodium metabisulfite. Sulfites can cause severe, life-threatening allergic reactions in some people, especially in people with asthma.

Before taking APOKYN, tell your healthcare provider about all your medical conditions, including if you have dizziness, fainting spells, low blood pressure, asthma, liver problems, kidney problems, heart problems, a mental disorder called major psychotic disorder, have had a stroke or other brain problems, or drink alcohol.

Tell your healthcare provider about all medicines that you take because APOKYN may interact with other medicines causing serious side effects.

APOKYN must be injected just under the skin and not into a vein. Injecting APOKYN into a vein could cause a blood clot.

Your healthcare provider may prescribe a medicine called Tigan® (trimethobenzamide hydrochloride) to help prevent the severe nausea and vomiting that may occur when taking APOKYN. If Tigan is prescribed, your healthcare provider will determine how long you should remain on this medicine.

Some patients taking APOKYN may get sleepy during the day or fall asleep without warning doing everyday activities. Do not take medicines that make you sleepy while you are taking APOKYN. Until it is known how APOKYN affects your ability to stay alert, you should not drive a car or operate heavy machinery.

APOKYN may lower blood pressure and cause dizziness and fainting, especially when starting treatment or if the dose is increased. Alcohol, antihypertensives, and nitrates may increase this risk. Patients should not get up too fast from sitting or after lying down to minimize these problems.

The changes that occur with PD and the effects of some PD medicines can increase the risk of falling. APOKYN can also increase this risk.

APOKYN can cause or worsen psychotic-like behavior including hallucinations (seeing or hearing things that are not real), confusion, excessive suspicion, aggressive behavior, agitation, delusional beliefs (believing things that are not real), and disorganized thinking. Call your healthcare provider right away if you experience any of these symptoms.

Some people with PD may get sudden, uncontrolled movements after treatment with some PD medicines. APOKYN can cause or worsen this effect.

Some people with PD have reported new or increased gambling urges, increased sexual urges, and other intense urges, while taking PD medicines, including APOKYN. If you experience new or increased urges, tell your healthcare provider.

If you experience shortness of breath, fast heartbeat, chest pain, or if you have a change in your heartbeat, or faint while taking APOKYN, you should call your healthcare provider right away.

Some people with PD may have an increased chance of getting a skin cancer called melanoma. People with PD should have a healthcare provider check their skin for skin cancer regularly.

The most common side effects seen in clinical studies with APOKYN were: yawning; sleepiness; sudden uncontrolled movements; dizziness; runny nose; nausea and/or vomiting; seeing and hearing things that are not real; swelling of hands, arms, legs, and feet.

Some patients may notice soreness, redness, bruising, or itching at the injection site. Change the site with each injection.

Some people may develop depression while taking APOKYN. Call your healthcare provider right away if you become depressed with APOKYN.

Tell your healthcare provider if you are pregnant or plan to become pregnant or if you are breast-feeding or planning to breast-feed. It is not known if APOKYN can harm your unborn baby or if APOKYN passes into breast milk.

To report SUSPECTED ADVERSE REACTIONS or product complaints, contact US WorldMeds at 1-877-727-6596 (1-877-7APOKYN). You may also report SUSPECTED ADVERSE REACTIONS to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Patients and care partners must receive complete instructions on the proper use of APOKYN. Please see full Prescribing Information and Pen Instructions for Use/Patient Information.

US WorldMeds, LLC is the exclusive licensee and distributor of APOKYN in the United States and Its territories.
© 2017. APOKYN is a registered trademark of BRITUSWIP.

Terms of Use | Privacy Policy