Onapgo (apomorphine) - Uses, Side Effects, and More

What are the most common side effects of Onapgo?

The most common side effects of Onapgo are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

• Infusion site problems, such as a bump, lump, or redness at the infusion site (see below)
• Nausea and vomiting (see below)
• Sleepiness (see below)
• Uncontrollable, involuntary movements (see below)
• Headache
• Trouble sleeping
• Dizziness

There may be other side effects of Onapgo that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Onapgo?

While less common, the most serious side effects of Onapgo are described below, along with what to do if they happen.

Severe Allergic Reactions. Onapgo may cause allergic reactions, which can be serious. Stop using Onapgo and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching, skin rash, or pale red bumps on the skin called hives
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain

Nausea and Vomiting. Onapgo may cause nausea and vomiting, which can be severe. Your healthcare provider may advise you to use another medicine to prevent or limit nausea when you start Onapgo. Your dose may also need to be adjusted based on how you tolerate the medicine. Tell your healthcare provider if you have bothersome or persistent nausea or vomiting.

Sleepiness. Onapgo can make you sleepy, sometimes very suddenly and without warning signs (also called a "sleep attack"). Do not drive or do other activities that require alertness or coordination until you know how Onapgo affects you. Tell your healthcare provider if you feel sleepy, drowsy, or fall asleep while doing your usual activities while using Onapgo.

Low Blood Pressure Upon Standing (Orthostatic Hypotension), Fainting, and Falls. Onapgo may cause low blood pressure or fainting, especially when standing up from a seated or lying position. This risk may be higher when starting Onapgo or when the dose is increased. You may also be at a higher risk of falling while using Onapgo. To help prevent these problems, be careful not to get up too quickly. If you feel dizzy, sit or lie down right away until the dizziness stops, then take your time getting up again. Tell your healthcare provider right away if you have any of the following symptoms. 

• Dizziness, feeling lightheaded, or fainting upon standing
• Blurred vision
• Confusion
• Feeling weak or sweating

Infusion Site Problems. You may notice itching, a rash, bruising, or a lump or bump where Onapgo is infused. Do not infuse into a site that is bruised, lumpy or bumpy, or seems irritated. Infections are also possible. To reduce this risk, follow the product instructions, including washing your hands and changing your infusion set and site every day. Tell your healthcare provider if you think your infusion site is infected or you have any of the following symptoms.

• Fever
• Pain, redness, warmth, or swelling at the infusion site

Hallucinations or Psychotic-like Behaviors. Onapgo may cause hallucinations or psychotic-like behaviors. Tell your healthcare provider right away if you have any of the following symptoms, or if you have been told by others you have these symptoms.

• Hearing, seeing, smelling, tasting, or otherwise perceiving things that others do not
• Delusional thoughts, such as false beliefs that you are being controlled
• Disorganized thoughts, such as jumping between topics or having a hard time focusing
• Sudden decline in self-care, such as personal hygiene or academic/work performance
• Aggressive behavior

Uncontrollable, Involuntary Movements (Dyskinesias). Onapgo may cause or worsen involuntary movement problems, including shakiness, stiffness, or jerkiness. Call your healthcare provider right away if you develop any unusual or uncontrolled movements or if they get worse.

Blood Disorders. Onapgo may cause hemolytic anemia, which is when red blood cells are destroyed. This may be severe enough to require hospitalization. Tell your healthcare provider if you have any of the following symptoms of hemolytic anemia.

• Unusual weakness or tiredness
• Cold hands and feet
• Fast or abnormal heartbeat
• Pale or yellowish skin 
• Dizziness, lightheadedness, or feeling like you are about to pass out
• Shortness of breath

Unusual or Compulsive Behaviors. Onapgo can cause some people to have strong unusual and uncontrolled urges (compulsions), including gambling, sex, shopping, or eating. Talk to your healthcare provider right away if you or someone you know notices that you have new or worsening strong urges or behaviors.

Chest Pain or Heart Attack. Onapgo can increase your risk of having chest pain or a heart attack. This may be related to the fact that Onapgo can cause low blood pressure. Get emergency help if you have any of the following symptoms.

• Chest pain or pressure
• Fast or abnormal heartbeat
• Trouble breathing or shortness of breath
• Pain in your back, jaw, throat, or arm
• Sweating, upset stomach, vomiting, or dizziness

Heart Rhythm Changes. Onapgo may cause a rare, dangerous heart rhythm problem called QT prolongation and torsade de pointes. Some people have a higher risk of this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium levels, or who take medicines that can prolong the QT interval. Tell your healthcare provider right away if you faint or have changes in your heart rate or rhythm, such as a fast or skipping heartbeat.

Painful, Prolonged Erection (Priapism). Onapgo may cause an unwanted erection that is persistent, painful, and that may occur without sexual arousal. Permanent damage to the penis may occur if priapism is not treated quickly. Stop using Onapgo and get emergency help if you have any of the following symptoms of priapism. 

• Erection lasting for more than four hours 
• Erection that is unrelated to sexual stimulation
• Painful or tender penis

Tissue Changes. Some people taking medicines like Onapgo may have tissue changes in different parts of their body, including the lungs, heart, and pelvic or hip region. Tell your healthcare provider if you notice any changes.