Apokyn (apomorphine) is used by injection to treat loss of body movement control in patients with advanced Parkinson’s disease between doses of levodopa treatment. It has the same effect as dopamine, a naturally occurring chemical messenger found in the brain. Low levels of dopamine are associated with Parkinson’s disease.
How Apokyn works
Apokyn works by imitating the activity of dopamine in the brain to carry signals between brain cells, helping with mobility.
Apokyn does not prevent “off” episodes, but it does help to improve symptoms when an “off” episode has already begun.
“Off” episodes happen when oral levodopa is not working or its effects wear off, causing or worsening Parkinson’s symptoms. They can happen at any time of the day, with patients experiencing more than one “off” episode every day.
A 2016 Apokyn study showed that morning “off” episodes seemed common in people that had been diagnosed with Parkinson’s for less than five to 10 years. An Apokyn injection had significantly fewer dose failures compared to the usual levodopa dosing and people with morning “off” episodes had rapid and reliable turning “on” after the injection.
A Phase 3 study (NCT02864004) is currently recruiting participants with early stage Parkinson’s to assess the impact of an Apokyn infusion on quality of life before the appearance of severe disabling motor complications. The study expects to enroll 192 participants and is estimated to be completed by September 2021.
Another Phase 3 study (NCT02339064) is also currently recruiting participants to assess the safety and tolerability of a continuous infusion of Apokyn in people with advanced Parkinson’s, whose “off” episodes remain uncontrolled with levodopa and at least one other class of drugs. The primary objective of the study is to measure the percentage of daily “off” time while the patients are awake. The study aims to enroll 100 participants and is estimated to be completed by January 2019.
Apokyn may be used up to five times a day as a small injection under the skin, using a device similar to the one used for insulin injection in people with diabetes. Apokyn starts working as early as 10 minutes after the injection, with most people feeling relief from the “off” episode within 20 minutes. It usually lasts for up to 90 minutes, so it’s important patients not stop taking their other Parkinson’s medications.
Apokyn should not be taken with medicines for nausea, vomiting, or irritable bowel syndrome, as serious side effects may occur, such as severely low blood pressure and loss of consciousness.
Common side effects caused by Apokyn include nausea, vomiting, drowsiness and dizziness, involuntary muscle movement, chest pain, pale skin, increased sweating, flushing, swelling of the upper and lower limbs, yawning, runny nose or itching, and bruising or hardening of the skin at the injection site.
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