Medication Pearl of the Day: Apomorphine (Kynmobi)
Indication: Apomorphine (Kynmobi) is a non-ergoline dopamine agonist indicated for the acute, intermittent treatment of “off” episodes in patients with Parkinson disease.
- Dosing: The dose range for apomorphine is 10 mg to 30 mg per dose, administered sublingually, as needed.
- Dosage forms: Apomorphine sublingual film: 10 mg, 15 mg, 20 mg, 25 mg, and 30 mg of apomorphine hydrochloride
- Adverse events: Most common adverse reactions (incidence at least 10% in patients treated with apomorphine and with an incidence greater than placebo) were nausea, oral/pharyngeal soft tissue swelling, oral/pharyngeal soft tissue pain and paranesthesia, dizziness, and somnolence.
- Mechanism of action: Apomorphine is a non-ergoline dopamine agonist with high in vitro binding affinity for the dopamine D4 receptor, and moderate affinity for the dopamine D2, D3, and D5, and adrenergic α1D, α2B, α2C receptors. The precise mechanism of action of apomorphine as a treatment for “off” episodes associated with Parkinson disease is unknown, although it is believed to be due to stimulation of post-synaptic dopamine D2-type receptors within the caudate-putamen in the brain.