Apokyn (apomorphine hydrochloride) is a brand-name drug that’s prescribed to treat “off” episodes of advanced Parkinson’s disease in adults. Apokyn comes in a subcutaneous injection that’s given as needed.

Apokyn is approved by the Food and Drug Administration (FDA) to treat “off” episodes in adults with advanced Parkinson’s disease. An off episode is a temporary, recurrent episode of worsening symptoms. These episodes tend to occur when medications start to wear off between doses. However, they can also occur unexpectedly.

Apokyn belongs to a drug class called dopamine agonists. It is not available in a generic version.

Keep reading for specific information about the dosage of Apokyn, including its strength and how to take the medication. For a comprehensive look at Apokyn, see this article.

Note: This article describes typical dosages for Apokyn provided by the drug’s manufacturer. When taking Apokyn, always follow the dosage prescribed by your doctor.

The information below describes Apokyn’s typical dosage and other details about the drug.

Apokyn form

Apokyn comes as a liquid solution in a prefilled cartridge. It’s given as a subcutaneous injection using the Apokyn injector pen and needles.

Apokyn strength

Apokyn comes in one strength of 30 milligrams per 3 milliliters of solution (10 mg/mL).

Typical dosages

Typically, your doctor will start by prescribing you a low dosage. Then, they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended in adults. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Dosage for off episodes related to Parkinson’s disease

Doctors prescribe Apokyn to treat off episodes associated with advanced Parkinson’s disease. Apokyn is prescribed alongside other medications for Parkinson’s disease, such as Sinemet (carbidopa/levodopa).

Your doctor may also prescribe an anti-nausea medication called trimethobenzamide to help prevent side effects of Apokyn. You’ll typically start taking this medication 3 days before your first dose of Apokyn.

You’ll receive your first dose of Apokyn from a healthcare professional at their office. This is because some people experience dizziness or low blood pressure after receiving this medication. For your safety, a healthcare professional will monitor you afterward and check your blood pressure.

The typical starting dose is 0.1 or 0.2 mL. Depending on how your body responds and how well Apokyn works to treat your episode, your doctor may increase your dose. If your doctor adjusts your dose, they will likely want to give your first new dose in their office. This is so they can monitor your condition for signs of low blood pressure.

Depending on your response to the drug, your doctor may continue to increase your dose every few days. The maximum recommended dose is 0.6 mL.

Apokyn can be used as necessary for off episodes, up to five times per day. However, you should not receive another Apokyn dose within 2 hours of the previous one. It’s important that you only use one dose for each off episode that occurs.

For more information about your specific dosage, talk with your doctor.

Long-term treatment

Apokyn is meant to be used as a long-term treatment. If you and your doctor determine that Apokyn is safe and effective for you, you’ll likely use it long term on an as-needed basis for off episodes.

Before you start taking Apokyn, your doctor will discuss your treatment plan with you.

The Apokyn dosage your doctor prescribes will depend on several factors. These include:

  • how your body responds to Apokyn
  • the severity of the episode you’re using Apokyn to treat
  • side effects you may have with Apokyn
  • your kidney function

Other medical conditions you have can also affect your Apokyn dosage.

Dosage adjustments

Your doctor may need to adjust your dosage if you have kidney disease.

Be sure to tell your doctor about all medications you take and any health conditions you may have.

Apokyn comes as a solution in a prefilled cartridge, which you’ll load into an injector pen. The pen is used with a needle to administer the drug as a subcutaneous injection.

Your doctor will administer your first dose. Then, they may show you or your caregiver how to do it at home. Make sure to inject Apokyn according to your prescribed instructions.

Apokyn may be injected into your abdomen, upper leg, or upper arm. Be sure to choose a different location each time you inject Apokyn. And avoid areas where your skin is sore, hard, or irritated. This will reduce your risk of injection-related side effects, such as bleeding or pain at the injection site.

You’ll store Apokyn cartridges at room temperature.

Note that the Apokyn injector pen and needles come separately. The Apokyn pen is reusable and comes with a storage case. However, you’ll use a new needle for each dose. Talk with your pharmacist for more details about this.

If you have questions about how to use Apokyn, talk with your doctor or pharmacist. There are also step-by-step instructions on the manufacturer’s website.

ACCESSIBLE DRUG LABELS

Some pharmacies offer labels with large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist might be able to recommend a pharmacy that does.

It’s important that you don’t use more Apokyn than your doctor prescribes. For some medications, taking more than the recommended amount may lead to harmful effects or overdose.

Symptoms of an overdose

Overdose symptoms of Apokyn may include nausea and loss of consciousness.

If you take more than the recommended amount of Apokyn

Call your doctor right away if you believe you’ve taken too much Apokyn. Another option is to call America’s Poison Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.

Below are some frequently asked questions about Apokyn.

How long does it take for Apokyn to start working?

Apokyn starts to work as quickly as 10 minutes after being injected. In clinical trials, most people responded to the drug within 20 minutes. This means the drug worked to end the off episode within that time.

Talk with your doctor if you have questions about what to expect with Apokyn treatment.

What is the recommended maximum dosage of Apokyn?

You’ll use a maximum of one dose of Apokyn per episode. You should not have a second dose for the same episode, even if the first dose doesn’t seem to be working. And doses of Apokyn should always be given at least 2 hours apart.

The recommended maximum dose of Apokyn is 0.6 mL. However, doctors typically start with a low dose of 0.1 or 0.2 mL. Then, depending on how your body responds, your doctor may increase your dose.

There are no reported benefits of doses larger than 0.6 mL.

For more details about the dosage of Apokyn, see the “Apokyn dosage” section above.

If you have questions or concerns about your dosage of Apokyn, talk with your doctor or pharmacist. If it seems like you need a higher dosage, ask your doctor whether a dosage increase is right for you. Do not increase your dosage unless your doctor recommends doing so.

The dosages in this article are typical dosages provided by the drug’s manufacturer. If your doctor recommends Apokyn for you, they will prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes.

As with any drug, never change your dosage of Apokyn without your doctor’s recommendation. If you have questions about the dosage of Apokyn that’s best for you, talk with your doctor.

Besides learning about dosage, you may want other information about Apokyn. These additional articles might be helpful:

  • More about Apokyn: For information about other aspects of Apokyn, refer to this article.
  • Details about Parkinson’s disease: For details about advanced Parkinson’s disease and off episodes, see our Parkinson’s disease hub.

Disclaimer: Medical News Today 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.