Apomorphine Injection
Apomorphine injection is used to treat ”off” episodes (times of difficulty moving, walking, and speaking that may happen as medication wears off or at random) in people with advanced Parkinson’s disease (PD; a disorder of the nervous system that causes difficulties with movement, muscle control, and balance) who are taking other medications for their condition. Apomorphine injection is in a class of medications called dopamine agonists. It works by acting in place of dopamine, a natural substance produced in the brain that is needed to control movement.
🔔 How should this medicine be used?
Apomorphine comes as a solution to inject subcutaneously (just under the skin). Apomorphine is usually injected when needed, according to your doctor’s directions. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use apomorphine injection exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
Do not use a second dose of apomorphine injection for treatment of the same “off” episode. Wait at least 2 hours between doses.
Your doctor will give you another medication called trimethobenzamide (Tigan) to take when you begin to use apomorphine injection. This medication will help decrease your chance of developing nausea and vomiting while you are using apomorphine injection, especially during the beginning of treatment. Your doctor will probably tell you to begin taking trimethobenzamide a few days before you begin to use apomorphine injection, and to continue taking it for up to 2 months. You should know that taking trimethobenzamide along with apomorphine injection may increase your risk of drowsiness, dizziness, and falls. However, do not stop taking trimethobenzamide without first talking to your doctor.
Your doctor will probably start you on a low dose of apomorphine injection and gradually increase your dose, not more than once every few days. Ask your doctor what to do if you do not use apomorphine injection for longer than 1 week. Your doctor will probably tell you to restart this medication using a low dose and gradually increase your dose.
Apomorphine solution comes in a glass cartridge to use with an injector pen. Some needles are provided with your pen and additional needles are sold separately. Ask your doctor or pharmacist if you have questions about the type of needle you need. Always use a new, sterile needle for each injection. Never reuse needles, and never let a needle touch any surface except the place where you will inject the medicine. Never store or carry the injector pen with a needle attached. Discard used needles in a puncture-resistant container kept out of reach of children. Talk to your doctor or pharmacist about how to discard the puncture-resistant container.
Administrative spending is particularly problematic in United States hospitals, where it makes up about 25% of total hospital spending and accounts for hundreds of billions of dollars in healthcare spending annually, The Commonwealth Fund The percentage of total hospital spending devoted to administration is highest in for-profit hospitals, followed by nonprofit hospitals, teaching hospitals, and finally public hospitals. Outdated reimbursement and reporting methods are a big part of the administrative cost, says Salvo-Wendt. “Reimbursing in bundled payments instead of itemizing each service or component would produce instant savings of administrative costs.”
You will receive your first dose of apomorphine injection in a medical office where your doctor can closely monitor your condition. After that, your doctor may tell you that you can inject apomorphine yourself or have a friend or relative perform the injections. Before you use apomorphine injection yourself the first time, read the written instructions that come with it. Ask your doctor or pharmacist to show you or the person who will be injecting the medication how to inject it.
Be sure you know what numbers on the injector pen show your dose. Your doctor may have told you how many milligrams you need to use, but the pen is marked with milliliters. Ask your doctor or pharmacist if you are not sure how to find your dose on the injector pen.
The apomorphine injector pen is only for use by one person. Do not share your pen with anyone.
Be careful not to get apomorphine injection on your skin or in your eyes. If apomorphine injection does get on your skin or in your eyes, immediately wash your skin or flush your eyes with cold water.
You can inject apomorphine in your stomach area, upper arm, or upper leg. Do not inject into a vein or in an area where the skin is sore, red, bruised, scarred, infected, or abnormal in any way. Use a different spot for each injection, choosing from among the spots you have been told to use. Keep a record of the date and spot of each injection. Do not use the same spot two times in a row.
Always look at your apomorphine solution before you inject it. It should be clear, colorless, and free of particles. Do not use apomorphine if it is cloudy, green, contains particles, or if the expiration date on the carton has passed.
Keep a record of how much apomorphine injection you use each time you receive an injection so that you will know when to replace the medication cartridge.
You may clean your apomorphine injector pen with a damp cloth as needed. Never use strong disinfectants or wash your pen under running water.
