Apomorphine 50mg/5ml solution for injection ampoules

10mg

Apomorphine 15mg sublingual films sugar free

15mg

Apomorphine 20mg sublingual films sugar free

20mg

Apomorphine 25mg sublingual films sugar free

25mg

Apomorphine 30mg sublingual films sugar free

30mg

Drug monograph — bnf.nice.org.uk

Similarity based on WHO Anatomical Therapeutic Chemical (ATC) classification and NHS BNF section grouping. Source data: NHS dm+d via TRUD (OGL v3.0), WHO ATC/DDD Index.

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Clinical guidelines and formulary information

British National Formulary

Apomorphine

BNF

Source: British National Formulary, NICE. Joint Formulary Committee. Contains public sector information licensed under the Open Government Licence v3.0.

NICE clinical guidance(2)

Parkinson's disease in adults (NG71)

NG71

NICE guideline

Updated Jul 2017

Foslevodopa–foscarbidopa for treating advanced Parkinson's with motor symptoms (TA934)

TA934

Technology appraisal

Updated Nov 2023

Source: National Institute for Health and Care Excellence (NICE). Contains public sector information licensed under the Open Government Licence v3.0.

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Discontinuations & alternatives for Apomorphine

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Codes for healthcare professionals and prescribing systems

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These codes are used by healthcare IT systems and prescribers to identify this medicine.

NHS UK identifiers

SNOMED CT

35902611000001104

dm+d ID

35902611000001104

VTM (Virtual Therapeutic Moiety)

774625001

VMP (Virtual Medicinal Product)

35902611000001104

BNF code

04090100

International identifiers

ATC code — Anatomical Therapeutic Chemical (WHO)

N04BC07

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SNOMED CT and dm+d codes from NHS TRUD (Technology Reference data Update Distribution), licensed under the Open Government Licence v3.0. BNF codes from NHS Business Services Authority (NHSBSA). ATC codes from the WHO Collaborating Centre for Drug Statistics Methodology (whocc.no).

Active and completed clinical studies from ClinicalTrials.gov

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Source: ClinicalTrials.gov, a database of the U.S. National Library of Medicine (NLM), National Institutes of Health (NIH). Data accessed via ClinicalTrials.gov API v2. Trial information is provided for research purposes and does not constitute medical advice.

Pharmacology and chemical data from DrugBank

go.drugbank.com

Key facts

Drug status

Approved

Major interactions

49 found

Half-life

1.7h

Mechanism

Apomorphine is a non-ergoline dopamine agonist with high binding affinity to dopamine D2, D3, and D5 receptors.

Food interactions

1 warning

Human targets

14 targets

Data: DrugBank · CC BY-NC 4.0

Pharmacokinetics at a glance

Absorption

10-20 minutes

Apomorphine has a plasma T_max of 10-20 minutes and a cerebrospinal fluid T_max.
[A203549]…

Half-life

15mg

The terminal elimination half life of a 15mg sublingual dose of apomorphine is 1.7h,[L13919]…

Protein binding

99.9%

Apomorphine is expected to be 99.9% bound to human serum albumin, as no unbound apomorphine is detected.
[A177817][A203405]

Volume of distribution

123-404L

The apparent volume of distribution of subcutaneous apomorphine is 123-404L with an average of 218L.
[L13919]…

Metabolism

60%

Apomorphine is N-demethylated by CYP2B6, 2C8, 3A4, and 3A5.
[L13919]
It can be glucuronidated by various UGTs,[L13919] or sulfated by SULTs 1A1, 1A2, 1A3, 1E1, and 1B1.
[A203447]…

Elimination

Data regarding apomorphine's route of elimination is not readily available.
[L13919][L13922]…

Clearance

15mg

The clearance of a 15mg sublingual dose of apomorphine is 1440L/h,[L13919] while the clearance of an intravenous dose is 223L/h.
[L13922]

Pharmacokinetic data: DrugBank · CC BY-NC 4.0

Status:

Approved

Investigational

Small molecule

About this compound

Apomorphine is a non-ergoline dopamine D2 agonist indicated to treat hypomobility associated with Parkinson's. It was first synthesized in 1845 and first used in Parkinson's disease in 1884.[A203618] Apomorphine has also been investigated as an emetic, a sedative, a treatment for alcoholism, and a treatment of other movement disorders.[A203597][A203618]

Apomorphine was granted FDA approval on 20 April 2004.[L13919]

Properties:

solid

Avg. mass: 267.32 Da

View FDA drug label

DrugBank indication

Apomorphine is indicated to treat acute, intermittent treatment of hypomobility, off episodes associated with advanced Parkinson's disease.
[L13919][L13922]

Also known as(275)

(−)-10,11-dihydroxyaporphine

(6aR)-6-methyl-5,6,6a,7-tetrahydro-4H-dibenzo[de,g]quinoline-10,11-diol

(R)-5,6,6a,7-tetrahydro-6-methyl-4H-dibenzo[de,g]quinoline-10,11-diol

Apomorfina

Apomorphin

Apomorphine

R-(−)-apomorphine

D(2C) dopamine receptor

Dosage forms(36)

Solution — 10 mg/1ml

Solution (Subcutaneous) — 5 mg/ml

Injection (Subcutaneous) — 5 mg/ml

Injection, solution (Parenteral) — 50 MG/5ML

Injection, solution (Parenteral; Subcutaneous) — 30 MG/3ML

Injection, solution (Subcutaneous) — 20 mg/2ml

Injection, solution (Subcutaneous) — 50 mg/5ml

Injection (Subcutaneous) — 30 mg/3mL

Molecular properties(19)

Drug interactions(1460)

Known interactions with other medications. Always consult a healthcare professional.

Duloxetine

Major

DB00476

The risk or severity of orthostatic hypotension and syncope can be increased when Apomorphine is combined with Duloxetine.

Levodopa

Major

DB01235

The risk or severity of hypotension and orthostatic hypotension can be increased when Apomorphine is combined with Levodopa.

Risperidone

Moderate

DB00734

Apomorphine may increase the hypotensive activities of Risperidone.

Buprenorphine

Moderate

DB00921

Apomorphine may increase the central nervous system depressant (CNS depressant) activities of Buprenorphine.

Doxylamine

Moderate

DB00366

Doxylamine may increase the central nervous system depressant (CNS depressant) activities of Apomorphine.

Dronabinol

Moderate

DB00470

Dronabinol may increase the central nervous system depressant (CNS depressant) activities of Apomorphine.

Droperidol

Moderate

DB00450

Droperidol may increase the central nervous system depressant (CNS depressant) activities of Apomorphine.

Hydrocodone

Moderate

DB00956

Apomorphine may increase the central nervous system depressant (CNS depressant) activities of Hydrocodone.

Magnesium sulfate

Moderate

DB00653

The therapeutic efficacy of Apomorphine can be increased when used in combination with Magnesium sulfate.

Methotrimeprazine

Moderate

DB01403

Apomorphine may increase the central nervous system depressant (CNS depressant) activities of Methotrimeprazine.

Metyrosine

Moderate

DB00765

Apomorphine may increase the sedative activities of Metyrosine.

Minocycline

Moderate

DB01017

Minocycline may increase the central nervous system depressant (CNS depressant) activities of Apomorphine.

Nabilone

Moderate

DB00486

Nabilone may increase the central nervous system depressant (CNS depressant) activities of Apomorphine.

Orphenadrine

Moderate

DB01173

Apomorphine may increase the central nervous system depressant (CNS depressant) activities of Orphenadrine.

Paraldehyde

Moderate

DB09117

Apomorphine may increase the central nervous system depressant (CNS depressant) activities of Paraldehyde.

Perampanel

Moderate

DB08883

Perampanel may increase the central nervous system depressant (CNS depressant) activities of Apomorphine.

Pramipexole

Moderate

DB00413

Apomorphine may increase the sedative activities of Pramipexole.

Ropinirole

Moderate

DB00268

Apomorphine may increase the sedative activities of Ropinirole.

Rotigotine

Moderate

DB05271

Apomorphine may increase the sedative activities of Rotigotine.

Rufinamide

Unknown severity

DB06201

The risk or severity of adverse effects can be increased when Rufinamide is combined with Apomorphine.

Sodium oxybate

Unknown severity

DB09072

The risk or severity of CNS depression can be increased when Apomorphine is combined with Sodium oxybate.

Suvorexant

Moderate

DB09034

Apomorphine may increase the central nervous system depressant (CNS depressant) activities of Suvorexant.

Tapentadol

Moderate

DB06204

Tapentadol may increase the central nervous system depressant (CNS depressant) activities of Apomorphine.

Thalidomide

Moderate

DB01041

Apomorphine may increase the central nervous system depressant (CNS depressant) activities of Thalidomide.

Zolpidem

Moderate

DB00425

Apomorphine may increase the central nervous system depressant (CNS depressant) activities of Zolpidem.

Cabergoline

Unknown severity

DB00248

The risk or severity of adverse effects can be decreased when Cabergoline is combined with Apomorphine.

Dihydroergotamine

Unknown severity

DB00320

The risk or severity of adverse effects can be decreased when Dihydroergotamine is combined with Apomorphine.

Lisuride

Unknown severity

DB00589

The risk or severity of adverse effects can be decreased when Lisuride is combined with Apomorphine.

Fenoldopam

Unknown severity

DB00800

The risk or severity of adverse effects can be decreased when Apomorphine is combined with Fenoldopam.

Ergoloid mesylate

Unknown severity

DB01049

The risk or severity of adverse effects can be decreased when Apomorphine is combined with Ergoloid mesylate.

Pergolide

Unknown severity

DB01186

The risk or severity of adverse effects can be decreased when Apomorphine is combined with Pergolide.

Bromocriptine

Unknown severity

DB01200

The risk or severity of adverse effects can be decreased when Apomorphine is combined with Bromocriptine.

Aripiprazole

Unknown severity

DB01238

The risk or severity of adverse effects can be decreased when Apomorphine is combined with Aripiprazole.

Quinagolide

Unknown severity

DB09097

The risk or severity of adverse effects can be decreased when Apomorphine is combined with Quinagolide.

Brexpiprazole

Unknown severity

DB09128

The risk or severity of adverse effects can be decreased when Apomorphine is combined with Brexpiprazole.

Dihydroergocornine

Unknown severity

DB11273

The risk or severity of adverse effects can be decreased when Apomorphine is combined with Dihydroergocornine.

Dopexamine

Unknown severity

DB12313

The risk or severity of adverse effects can be decreased when Apomorphine is combined with Dopexamine.

Piribedil

Unknown severity

DB12478

The risk or severity of adverse effects can be decreased when Apomorphine is combined with Piribedil.

Dihydrexidine

Unknown severity

DB12890

The risk or severity of adverse effects can be decreased when Apomorphine is combined with Dihydrexidine.

Dihydroergocryptine

Unknown severity

DB13385

The risk or severity of adverse effects can be decreased when Apomorphine is combined with Dihydroergocryptine.

Metergoline

Unknown severity

DB13520

The risk or severity of adverse effects can be decreased when Apomorphine is combined with Metergoline.

Methylphenidate

Unknown severity

DB00422

The risk or severity of adverse effects can be increased when Methylphenidate is combined with Apomorphine.

Dexmethylphenidate

Unknown severity

DB06701

The risk or severity of adverse effects can be increased when Dexmethylphenidate is combined with Apomorphine.

Methadone

Unknown severity

DB00333

The risk or severity of adverse effects can be increased when Methadone is combined with Apomorphine.

Ondansetron

Unknown severity

DB00904

The risk or severity of adverse effects can be increased when Ondansetron is combined with Apomorphine.

Mifepristone

Unknown severity

DB00834

The serum concentration of Apomorphine can be increased when it is combined with Mifepristone.

Linezolid

Major

DB00601

The risk or severity of serotonin syndrome can be increased when Linezolid is combined with Apomorphine.

Dicoumarol

Unknown severity

DB00266

The risk or severity of adverse effects can be increased when Apomorphine is combined with Dicoumarol.

Phenindione

Unknown severity

DB00498

The risk or severity of adverse effects can be increased when Apomorphine is combined with Phenindione.

Acenocoumarol

Unknown severity

DB01418

The risk or severity of adverse effects can be increased when Apomorphine is combined with Acenocoumarol.