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.

MDD US Operations, LLC, a subsidiary of Supernus Pharmaceuticals, Inc., is the exclusive
licensee and distributor of APOKYN in the United States and Its territories. © 2022. APOKYN is
a registered trademark of BRITUSWIP. APO.2022-0025 03/22