Who should not take APOKYN?

Do not take APOKYN if you are:

• taking certain medicines to treat
nausea called 5HT₃ antagonists
including Anzemet^® (dolasetron),
Kytril^® (granisetron), Zofran^®
(ondansetron), Lotronex^®
(alosetron), and Aloxi^®
(palonosetron). People taking
Zofran^® (ondansetron) together
with apomorphine, the active
ingredient in APOKYN, have had
very low blood pressure and lost
consciousness or “blacked out.”

• allergic to APOKYN or its
ingredients and experience
hives, itching, rash, or swelling
(e.g., eyes, tongue, etc.).
APOKYN also contains a sulfite
called sodium metabisulfite.
Sulfites can cause severe, life-
threatening allergic reactions in
some people, especially people
with asthma.

What should I tell my healthcare
provider before taking APOKYN?

Before you start using APOKYN,
tell your healthcare provider if
you:

•have difficulty staying awake
during the daytime • have
dizziness, fainting spells or low
blood pressure • have asthma
• are allergic to any medicines
containing sulfites • have liver,
kidney or heart problems • have
had a stroke or other brain
problems • have a mental
problem called a major
psychotic disorder • drink
alcohol • are pregnant or plan to
become pregnant, or if you are
breastfeeding or plan to
breastfeed. It is not known if
APOKYN will harm your unborn
baby or if APOKYN passes into
your breast milk.

Tell your healthcare provider
about all the medicines you
take, including prescription and
non-prescription medicines,
vitamins, and herbal supplements.
Using APOKYN with certain other
medicines may affect each other
and can cause serious side effects.

•If you take nitroglycerin under
your tongue while using
APOKYN, your blood pressure
may decrease and cause
dizziness. After taking
nitroglycerin, lie down for
at least 45 minutes.

What should I avoid while using
APOKYN?

•Do not drink alcohol while using
APOKYN. It can increase your
chance of developing serious
side effects.

•Do not take medicines that
make you sleepy while you are
using APOKYN.

•Do not drive, operate machinery,
or do other dangerous activities
until you know how APOKYN
affects you.

•Do not change your body
position too fast. Get up slowly
from sitting or lying. APOKYN
can lower your blood pressure
and cause dizziness or fainting.

What are the possible side
effects of APOKYN?

Tell your healthcare provider if
you experience the following
serious side effects:

•blood clots. Injecting APOKYN
into a vein (intravenous) can
cause blood clots. Do not inject
APOKYN in your vein.

•nausea and vomiting. Severe
nausea and vomiting can
happen with APOKYN. Your
healthcare provider may
prescribe medicine called an
antiemetic, such as
trimethobenzamide (Tigan^®), to
help prevent it. If Tigan is
prescribed, talk to your
healthcare provider about how
long you should remain on this
medicine.

•sleepiness or falling asleep
during the day. Some people
treated with APOKYN may get
sleepy during the day or fall
asleep without warning while
doing everyday activities such as
talking, eating, or driving a car.

•dizziness. APOKYN can lower
your blood pressure and cause
dizziness. Dizziness can happen
when APOKYN treatment is
started or when the dose is
increased. Do not get up too fast
from sitting or lying down,
especially if you have been
sitting or lying down for a long
period of time.

•falls. The changes that can
happen with PD, and the effects
of some PD medicines, can
increase the risk of falling.
APOKYN may also increase your
risk of falling.

•hallucinations or psychotic-
like behavior. APOKYN can
cause or worsen psychotic-like
behavior including hallucinations
(seeing or hearing things that
are not real), confusion,
excessive suspicion, aggressive
behavior, agitation, delusional
beliefs (believing things that are
not real), and disorganized
thinking.

•sudden uncontrolled
movements (dyskinesias).
Some people with PD may get
sudden, uncontrolled
movements after treatment with
some PD medicines. APOKYN
can cause or make dyskinesias
worse.

•intense urges. Some people
with PD have reported new or
increased gambling urges,
increased sexual urges, and
other intense urges, while taking
PD medicines, including
APOKYN.

•heart problems. If you have
shortness of breath, fast
heartbeat, or chest pain while
taking APOKYN, call your
healthcare provider or get
emergency help right away.

•serious heart rhythm changes
(QT prolongation). Tell your
healthcare provider right away if
you have a change in your
heartbeat (a fast or irregular
heartbeat), or if you faint.

•injection site problems.
Bruising, swelling, and itching
can happen at the injection site.

•prolonged painful erections
(priaprism). APOKYN may cause
prolonged, painful erections in
some people. If you have an
erection that lasts more than 4
hours you should call your
healthcare provider or go to the
nearest hospital emergency
room right away.

Other common side effects of
APOKYN include:

•yawning • runny nose

•confusion • swelling of
ankles/legs

You are encouraged to report
negative side effects of
prescription drugs to the FDA.
Visit www.fda.gov/medwatch, or
call 1-800-FDA-1088.

What is APOKYN?

APOKYN is a prescription medicine
used to treat acute, intermittent
“off” episodes (end-of-dose
wearing “off” or unpredictable
“on-off” episodes) in people with
advanced Parkinson’s disease (PD).

It is not known if APOKYN is safe
and effective in children.

Patients and care partners must
receive complete instructions on
the proper use of APOKYN.
Please see full Prescribing
Information and Pen Instructions
for Use/Patient Information.