Apomorphine (Apokyn) - Uses, Side Effects, and More

What are the most common side effects of apomorphine?

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

• Yawning
• Sleepiness (see below)
• Uncontrollable, involuntary movements (see below)
• Dizziness and low blood pressure upon standing (see below)
• Runny nose
• Nausea and vomiting (see below)
• Hallucinations (see below)
• Confusion
• Fluid retention and swelling in your limbs

There may be other side effects of apomorphine 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 apomorphine?

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

Severe Allergic Reactions. Apomorphine may cause allergic reactions, which can be serious. Stop using apomorphine 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. Apomorphine 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 apomorphine. Tell your healthcare provider if you have bothersome or persistent nausea or vomiting.

Sleepiness. Apomorphine 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 apomorphine affects you. Tell your healthcare provider if you feel sleepy or drowsy while using apomorphine.

Low Blood Pressure Upon Standing (Orthostatic Hypotension), Fainting, and Falls. Apomorphine may cause a sudden drop in blood pressure when standing up from a seated or lying position. Apomorphine may also cause fainting, which can be due to the drop in blood pressure or changes in your heart rate. You may also have a higher risk of falls with apomorphine. 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, especially upon standing
• Blurred vision
• Confusion
• Feeling weak

Hallucinations or Psychotic-like Behaviors. Apomorphine may cause hallucinations or psychotic-like behaviors. Talk to your healthcare provider right away if you or someone you know notices that you have any of the following symptoms.

• Seeing or hearing things that others do not see or hear, also called hallucinations
• 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 (Dyskinesia). Apomorphine 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. Apomorphine 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. Apomorphine 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, Heart Attack, or Stroke. Apomorphine may increase your risk of heart problems, including chest pain, heart attack, or stroke that can lead to death. This risk is higher in people who have heart disease or blood flow problems in their brain. Get emergency help if you have any of the following signs or symptoms of a heart attack or stroke.

• Chest pain or pressure
• Fast or abnormal heartbeat
• Trouble breathing
• Pain in your back, jaw, throat, or arm
• Sweating, upset stomach, vomiting, or dizziness
• Sudden weakness on one side of your body
• Sudden and severe headache
• Slurred speech or trouble understanding speech

Heart Rhythm Changes. Apomorphine 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 some medicines for other heart rhythm problems. 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). Apomorphine 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 apomorphine and get emergency help right away if you have any of the following symptoms of priapism. 

• Erection lasting for more than 4 hours 
• Erection that is unrelated to sexual stimulation
• Painful or tender penis

Swelling of Ankles or Legs. Apomorphine may cause fluid retention and swelling, especially in your ankles or legs. Tell your healthcare provider if you notice swelling in your ankles, legs, or any other limbs.

Injection Site Problems. Apomorphine may cause bruising, swelling, or itching where you inject the medicine. Tell your healthcare provider if you have any injection site problems that are bothersome or concerning.