Apomorphine

Introduction

Written by Sarah Lewis, PharmD
Medically reviewed by Patricia Weiser, PharmD
Updated on October 3, 2023

Apomorphine (a poe MOR feen) is a generic medication prescribed for “off” episodes in people with advanced Parkinson’s disease. “Off” episodes are periods between medication doses when symptoms return. Apomorphine belongs to a group of drugs called dopamine agonists.

Common questions about apomorphine

Below you’ll find answers to a few commonly asked questions about apomorphine.

Is it safe to use apomorphine for dogs?

Possibly. Veterinarians (vets) sometimes use apomorphine to make dogs vomit when they’ve eaten something harmful. But it isn’t approved for this use, and other options are available.

Talk with your vet to learn more. Do not administer apomorphine or any other medications to a pet without talking with your vet.

Can apomorphine be used for erectile dysfunction (ED)?

Possibly, but apomorphine isn’t approved for treating erectile dysfunction (ED). Doctors may prescribe it for this purpose as an off-label use. It’s an off-label use when doctors prescribe a drug for a condition other than its approved uses.

You can learn more about using apomorphine for ED by talking with your doctor.

How does apomorphine work? And how long does it take to start working?

Apomorphine works by acting like dopamine. Dopamine is a natural chemical your body makes. It plays a role in movement and mood. People with Parkinson’s disease have low levels of dopamine. Apomorphine can take the place of dopamine when dopamine levels are low.

Apomorphine should start working within 10–20 minutes after injecting a dose. 

If you’d like to know more about this, talk with your doctor or pharmacist.

Side effects of apomorphine

Apomorphine may cause mild or serious side effects. More common mild side effects of apomorphine and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about apomorphine’s side effects, ask your doctor or pharmacist. You can also refer to the prescribing information for apomorphine listed in the “Resources” section.

Mild side effects

More common mild side effects reported with apomorphine are listed below.

This article doesn’t include all possible mild side effects of the drug. To learn more about apomorphine’s side effects, refer to the prescribing information for apomorphine listed in the “Resources” section.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Apomorphine injection’s* mild side effects may include:

• dizziness
• drowsiness
• injection site reactions
• yawning
• mild allergic reaction†

* This is given as an injection under your skin.
† For details about this side effect, see the “Interactions and warnings for apomorphine” section.

Serious side effects

Serious side effects of apomorphine are listed below.

This article doesn’t include all possible serious side effects of the drug. To learn more about apomorphine’s side effects, refer to the prescribing information for apomorphine listed in the “Resources” section.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, apomorphine’s serious side effects include:

• chest pain or pressure
• confusion
• edema (swelling due to fluid retention)
• extreme sleepiness
• hallucinations (seeing or hearing things that aren’t really there)
• heart attack
• impulsive behaviors*
• priapism (a painful erection lasting more than 4 hours that needs immediate medical treatment)
• prolonged QT interval (changes in the heart’s electrical signals, which can lead to serious and life threatening heart rhythm problems)*
• severe nausea or vomiting
• sudden low blood pressure upon standing or sitting up, which can lead to fainting and falls
• thickening or scarring of connective tissue in the belly, lungs, or heart valves*
• worsened uncontrollable movements
• withdrawal symptoms (side effects that can occur when you stop taking a drug that your body has become used to)
• severe allergic reaction†

* This side effect wasn’t reported in studies of the drug. But it has occurred in people after the drug was approved for use.
† For details about this side effect, see the “Interactions and warnings for apomorphine” section.

Interactions and warnings for apomorphine

Below, you’ll find information about apomorphine’s possible interactions and warnings.

Interactions of apomorphine

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you use apomorphine, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription or over-the-counter drugs
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for apomorphine” section below.

Warnings for apomorphine

Some people should not use apomorphine, and others should use it cautiously.

Apomorphine could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether apomorphine is a safe option for you.

Ask your doctor about specific warnings for apomorphine, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Apomorphine can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to apomorphine or any of its ingredients, your doctor will likely not prescribe apomorphine. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to apomorphine, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Overdose of apomorphine

If you use apomorphine, you should not use more apomorphine than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.

If you think you’ve used too much apomorphine, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Pregnancy or breastfeeding and apomorphine

Information about apomorphine and pregnancy and breastfeeding is described below.

Apomorphine and pregnancy

It’s not known whether apomorphine should be used during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before using this medication.

Apomorphine and breastfeeding

It’s not known whether apomorphine should be used while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before using this medication.

Uses of apomorphine

The Food and Drug Administration (FDA) approves prescription drugs such as apomorphine for certain conditions. Approved uses for apomorphine are described below.

Use for “off” episodes in people with Parkinson’s disease

Doctors may prescribe apomorphine injection* for treating “off” episodes in people with advanced Parkinson’s disease. It’s used for this purpose in adults. It’s usually prescribed as a long-term treatment.

With “off” episodes, some people with Parkinson’s disease have periods between medication doses when symptoms return. These episodes often happen in the morning before the first dose of medication. They can also occur during the day between doses. They’re more common in people who have been taking the drug levodopa for a long time.

Symptoms of “off” episodes vary and may include:

• fatigue (low energy)
• mood changes
• muscle cramping
• stiffness
• tremor
• trouble thinking
• trouble walking, moving, or speaking

Apomorphine is prescribed together with other medications for Parkinson’s disease. It should also be prescribed together with a drug to manage nausea and vomiting when you first start treatment. These are common side effects of apomorphine.

* This is given as an injection under your skin.

What to ask your doctor

Let your doctor know if you have questions about apomorphine or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• How should I use apomorphine?
• How should I store apomorphine?
• Do any of my other medications interact with apomorphine?
• What should I avoid while using apomorphine?
• What’s the most important information I should know about apomorphine?

Resources

• Apomorphine hydrochloride injection, for subcutaneous use. (2022). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/aedf70e4-1949-44bc-bf1b-0f282c4f0705/spl-doc
• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.