The Medical Letter on Drugs and Therapeutics
Apomorphine (Apokyn) for Parkinson's Disease
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Apomorphine (Apokyn – Mylan/Bertek), an injected non-ergot dopamine agonist, was recently approved by the FDA for intermittent subcutaneous (SC) treatment of hypomobility (“off” episodes) in patients with advanced Parkinson’s disease. It has been available in Europe for many years.

ADVANCED PARKINSON’S DISEASE — Levodopa combined with carbidopa (Sinemet, and others) is effective for most patients with Parkinson’s disease during the first 2 to 5 years of treatment. As the disease progresses, however, some patients develop sudden, unpredictable fluctuations between mobility and immobility (the “on-off” effect).1

PHARMACOLOGY — Apomorphine is a potent lipophilic dopamine agonist that crosses the blood-brain barrier unchanged. It is rapidly absorbed after SC administration. The onset of action is usually within 10 to 20 minutes; the duration of ... more      

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