Before using apomorphine

Before using apomorphine make sure your doctor or pharmacist knows:

• If you have dystonia (you are unable to move) or dyskinesia (you have involuntary movements) despite taking levodopa.
• If you have breathing problems.
• If you have heart or blood vessel disease.
• If you have ever had postural hypotension (low blood pressure particularly when you stand up).
• If you have kidney or liver problems.
• If you have had mental health problems such as depression, psychosis or dementia.
• If you are pregnant or breast-feeding.
• If you are taking other medicines, including those available to buy without a prescription, herbal and complementary medicines.
• If you have ever had an allergic reaction to this or any other medicine.

How to use apomorphine

• Always use apomorphine exactly as your doctor has told you. It is only available as an injection.
• Treatment with apomorphine will be started while you are in hospital or a specialist clinic. This is because you will need to be supervised closely at first. Your doctor or nurse will administer apomorphine for you to begin with.
• If the treatment is successful you will be taught how to inject apomorphine into an area under your skin.
• Do not use apomorphine injection if the solution is cloudy, contains particles or has turned green.

Getting the most from your treatment

• Before starting this treatment, read the printed information leaflet you will be given and follow the instructions carefully.
• Before you are given apomorphine injection, you will be given at least two days' treatment with an anti-sickness medicine. You should continue to take this during the first few weeks of treatment. It will then be reduced or slowly withdrawn.
• Keep your regular appointments with your doctor so your progress can be monitored. You may require regular blood tests while you are using apomorphine.
• If you are having any treatment like an operation or dental treatment, tell the person carrying out the treatment that you are using apomorphine.

Can apomorphine cause problems?

Along with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

• Changes in your behaviour, such as a desire to gamble or an increased sex drive.
• Falling asleep suddenly. (It is important that you do not drive if this affects you.)

How to store apomorphine

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

References

• Manufacturer's PIL, APO-go® Pen 10mg/ml Solution for Injection, Genus Pharmaceuticals, electronic Medicines Compendium. Dated February 2010, accessed November 2010.
• Manufacturer's PIL, APO-go® PFS 5mg/ml Solution for Infusion in Pre-filled Syringe, Genus Pharmaceuticals, electronic Medicines Compendium. Dated May 2010, accessed November 2010.
• British National Formulary; 60th Edition (September 2010) British Medical Association and Royal Pharmaceutical Society of Great Britain, London (link to current BNF)