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Latest comment: 9 days ago by D6194c-1cc in topic Medical uses

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[edit]
Latest comment: 15 years ago1 comment1 person in discussion

I think that the chemical structure image is an optical isomer of apomorphine. Not a chemist though, could do with being looked at maybe. Apomorphine as opposed to 4H-dibenzo[de,g]quinoline-10,1​1-diol, 5,6,6a,7-tetrahydro-6-​methyl-, (6aS)- —Preceding unsigned comment added by 130.88.99.232 (talk) 14:02, 7 January 2011 (UTC)Reply

[edit]
Latest comment: 9 years ago1 comment1 person in discussion

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Medical Uses update

[edit]
Latest comment: 2 months ago8 comments3 people in discussion

Hi editors, I'm Lexi and I'm a physician with Supernus Pharmaceuticals, which manufactures apomorphine.

I believe that the Medical uses section is inconsistent with rules for medical content sourcing and the Pharmacology style guide. Its focus on the historical is also likely to be confusing for modern patients researching the drug. To resolve this, I propose updating the section to stay focused on current uses and best practice guidelines for apomorphine. Here's what I propose:

Apomorphine is used for the management of motor fluctuations in Parkinson's disease, particularly for the treatment of "off" episodes.[1]: 13 [2]: 1261  "Off" episodes are periods during which motor symptoms such as rigidity, bradykinesia, or reduced mobility reemerge as the effects of dopaminergic medications wear off.[3]: 1711  Apomorphine can provide rapid improvement in motor symptoms.[3]: 1722 [4]: 136 

Apomorphine is administered in multiple pharmaceutical formulations. Intermittent subcutaneous injection is used as an acute treatment and has been shown to terminate "off" episodes in individuals with motor fluctuations not adequately controlled with oral therapy.[5]: 1025  Sublingual formulations have also been shown to be effective as acute treatments of "off" episodes.[6]: 703–706 

Continuous subcutaneous infusion of apomorphine using a wearable infusion device is also prescribed for individuals with motor fluctuations.[7][1]: 12–13  Continuous infusion treatment is used in patients whose symptoms are not adequately controlled with oral or transdermal therapies and has been shown to reduce daily "off" time.[5]: 1024–1025 [8]: 755–756  Apomorphine is generally used as an adjunct to levodopa-based therapy in patients with Parkinson's disease and motor fluctuations.[6]: 694 

References

  1. 1 2 Poewe W, Seppi K, Tanner CM, Halliday GM, Brundin P, Volkmann J, Schrag AE, Lang AE (March 2017). "Parkinson disease". Review. Nature Reviews. Disease Primers. 3 (1) 17013. doi:10.1038/nrdp.2017.13. PMID 28332488.
  2. ↑ Fox SH, Katzenschlager R, Lim SY, Barton B, de Bie RM, Seppi K, Coelho M, Sampaio C (August 2018). "International Parkinson and movement disorder society evidence-based medicine review: Update on treatments for the motor symptoms of Parkinson's disease". Review. Movement Disorders. 33 (8): 1248–1266. doi:10.1002/mds.27372. PMID 29570866.
  3. 1 2 Chen JJ, Obering C (November 2005). "A review of intermittent subcutaneous apomorphine injections for the rescue management of motor fluctuations associated with advanced Parkinson's disease". Review. Clinical Therapeutics. 27 (11): 1710–1724. doi:10.1016/j.clinthera.2005.11.016. PMID 16368444.
  4. ↑ Olanow CW, Factor SA, Espay AJ, Hauser RA, Shill HA, Isaacson S, Pahwa R, Leinonen M, Bhargava P, Sciarappa K, Navia B, Blum D (February 2020). "Apomorphine sublingual film for off episodes in Parkinson's disease: a randomised, double-blind, placebo-controlled phase 3 study". primary. The Lancet. Neurology. 19 (2): 135–144. doi:10.1016/S1474-4422(19)30396-5. PMID 31818699.
  5. 1 2 Trenkwalder C, Chaudhuri KR, García Ruiz PJ, LeWitt P, Katzenschlager R, Sixel-Döring F, Henriksen T, Sesar Á, Poewe W (September 2015). "Expert Consensus Group report on the use of apomorphine in the treatment of Parkinson's disease--Clinical practice recommendations". Review. Parkinsonism & Related Disorders. 21 (9): 1023–1030. doi:10.1016/j.parkreldis.2015.06.012. hdl:20.500.11940/8387. PMID 26189414.
  6. 1 2 Agbo F, Isaacson SH, Gil R, Chiu YY, Brantley SJ, Bhargava P, Navia B (December 2021). "Pharmacokinetics and Comparative Bioavailability of Apomorphine Sublingual Film and Subcutaneous Apomorphine Formulations in Patients with Parkinson's Disease and "OFF" Episodes: Results of a Randomized, Three-Way Crossover, Open-Label Study". Primary. Neurology and Therapy. 10 (2): 693–709. doi:10.1007/s40120-021-00251-6. PMC 8571442. PMID 33991326.
  7. ↑ "ONAPGO- apomorphine hydrochloride injection, solution". United States Food & Drug Administration. Retrieved 1 April 2026.
  8. ↑ Katzenschlager R, Poewe W, Rascol O, Trenkwalder C, Deuschl G, Chaudhuri KR, Henriksen T, van Laar T, Spivey K, Vel S, Staines H, Lees A (September 2018). "Apomorphine subcutaneous infusion in patients with Parkinson's disease with persistent motor fluctuations (TOLEDO): a multicentre, double-blind, randomised, placebo-controlled trial". The Lancet. Neurology. 17 (9): 749–759. doi:10.1016/S1474-4422(18)30239-4. PMID 30055903.

Please let me know what you think! Happy to answer any questions. Lexi at Supernus (talk) 20:50, 29 April 2026 (UTC)Reply

I added a section Modern medical usage using your text, please let me know, if it's in the right place. Victoria (talk) 11:54, 18 May 2026 (UTC)Reply
Your edit summary doesn't have any attribution (a link to the talk page: special:diff/1351737559). You had to specify a link and the information on whether the content was modified. Take a look at Wikipedia:Copying within Wikipedia, Wikipedia:Copyrights and Wikipedia:Plagiarism. D6194c-1cc (talk) 15:44, 18 May 2026 (UTC)Reply
@Victoria: Thanks for doing that! I was thinking that this would replace the Apomorphine#Medical_uses section at the top, since this information is the most up to date and the current Medical uses section might cause confusion for patients. What do you think about moving the content to that top section? Lexi at Supernus (talk) 13:46, 19 May 2026 (UTC)Reply
Done. Victoria (talk) 08:54, 21 May 2026 (UTC)Reply
Lexi at Supernus, would you be so kind to declare here that you license the provided text under the CC0 license? Currently, the text is provided via the CC BY-SA 4.0 license. Such a way there would be no inconsistency between Victoria's edit, the license, and the rules of the English Wikipedia. D6194c-1cc (talk) 21:17, 19 May 2026 (UTC)Reply
@D6194c-1cc: Sure, I declare it is CC0 licensed. I am not entirely sure how the licensing works. Lexi at Supernus (talk) 22:38, 21 May 2026 (UTC)Reply
Thanks! Under the CC0 license, mentioning the original author is not necessary. So if you'd want to backup up the editor who will copy some new content to an article in the future, you can simply add a note that you license the content under the CC0 license. For a company, authorship is not important, as I understand. D6194c-1cc (talk) 05:38, 22 May 2026 (UTC)Reply
@Victoria: I think there may be some confusion about the placement of the content, so I will try to reframe:
I propose removing the content currently in Apomorphine#Medical_uses, which is as follows:
=== Parkinson's disease ===

The use of apomorphine to treat "the shakes" was first suggested by Weil in France in 1884,[1] although seemingly not pursued until 1951.[2] Its clinical use was first reported in 1970 by Cotzias et al.,[3] although its emetic properties and short half-life made oral use impractical. A later study found that combining the drug with the antiemetic domperidone improved results significantly.[4] The commercialization of apomorphine for Parkinson's disease followed its successful use in patients with refractory motor fluctuations using intermittent rescue injections and continuous infusions.[5] Apomorphine is used in advanced Parkinson's disease intermittent hypomobility ("off" episodes), where a decreased response to an anti-Parkinson drug such as L-DOPA causes muscle stiffness and loss of muscle control.[6][7] While apomorphine can be used in combination with L-DOPA, the intention is usually to reduce the L-DOPA dosing, as by this stage the patient often has many of dyskinesias caused by L-DOPA and hypermobility periods.[8][9] When an episode sets in, the apomorphine is injected subcutaneously or applied sublingually,[10] and signs subside. It is used an average of three times a day.[8] Some people use portable mini-pumps that continuously infuse them with apomorphine, allowing them to stay in the "on" state and using apomorphine as an effective monotherapy.[9][11]

References

  1. ↑ Weil E (1884). "De l'apomorphine dans certain troubles nerveux" [On apomorphine in certain nervous shakes]. Lyon Med (in French). 48: 411–419.
  2. ↑ Schwab RS, Amador LV, Lettvin JY (1951). "Apomorphine in Parkinson's disease". Transactions of the American Neurological Association. 56: 251–253. PMID 14913646.
  3. ↑ Cotzias GC, Papavasiliou PS, Fehling C, Kaufman B, Mena I (January 1970). "Similarities between neurologic effects of L-dopa and of apomorphine". The New England Journal of Medicine. 282 (1): 31–33. doi:10.1056/NEJM197001012820107. PMID 4901383.
  4. ↑ Corsini GU, Del Zompo M, Gessa GL, Mangoni A (May 1979). "Therapeutic efficacy of apomorphine combined with an extracerebral inhibitor of dopamine receptors in Parkinson's disease". Lancet. 1 (8123): 954–956. doi:10.1016/S0140-6736(79)91725-2. PMID 87620. S2CID 43526111.
  5. ↑ Stibe CM, Lees AJ, Kempster PA, Stern GM (February 1988). "Subcutaneous apomorphine in parkinsonian on-off oscillations". Lancet. 1 (8582): 403–406. doi:10.1016/S0140-6736(88)91193-2. PMID 2893200. S2CID 35208453.
  6. ↑ "Apomorphine Uses, Side Effects & Warnings". Drugs.com. Retrieved 27 February 2018.
  7. ↑ Clayton BD, Willihnganz M (2016). Basic Pharmacology for Nurses – E-Book. Elsevier Health Sciences. pp. 210–211. ISBN 978-0-323-37697-6.
  8. 1 2 "Apomorphine Hydrochloride Monograph for Professionals". Drugs.com. Retrieved 26 February 2018.
  9. 1 2 Chaudhuri KR, Clough C (February 1998). "Subcutaneous apomorphine in Parkinson's disease". BMJ. 316 (7132): 641. doi:10.1136/bmj.316.7132.641. PMC 1112674. PMID 9522772.
  10. ↑ Paton DM (January 2021). "Apomorphine hydrochloride: a sublingual tablet for the OFF episodes in Parkinson's disease". Drugs of Today. 57 (1): 5–16. doi:10.1358/dot.2021.57.1.3211618. PMID 33594386. S2CID 231945531.
  11. ↑ Schapira AH, Olanow CW (2005). Principles of Treatment in Parkinson's Disease (illustrated ed.). Elsevier Health Sciences. p. 35. ISBN 978-0-7506-5428-9.
I propose removing the heading Modern medical uses from the article, and placing the content under that heading under the Medical uses heading at the top of the article. That content would be as follows:

Medical uses

[edit]
Latest comment: 9 days ago9 comments3 people in discussion

Apomorphine is used for the management of motor fluctuations in Parkinson's disease, particularly for the treatment of "off" episodes.[1]: 13 [2]: 1261  "Off" episodes are periods during which motor symptoms such as rigidity, bradykinesia, or reduced mobility reemerge as the effects of dopaminergic medications wear off.[3]: 1711  Apomorphine can provide rapid improvement in motor symptoms.[3]: 1722 [4]: 136 

Apomorphine is administered in multiple pharmaceutical formulations. Intermittent subcutaneous injection is used as an acute treatment and has been shown to terminate "off" episodes in individuals with motor fluctuations not adequately controlled with oral therapy.[5]: 1025  Sublingual formulations have also been shown to be effective as acute treatments of "off" episodes.[6]: 703–706 

Continuous subcutaneous infusion of apomorphine using a wearable infusion device is also prescribed for individuals with motor fluctuations.[7][1]: 12–13  Continuous infusion treatment is used in patients whose symptoms are not adequately controlled with oral or transdermal therapies and has been shown to reduce daily "off" time.[5]: 1024–1025 [8]: 755–756  Apomorphine is generally used as an adjunct to levodopa-based therapy in patients with Parkinson's disease and motor fluctuations.[6]: 694 

References

  1. 1 2 Poewe W, Seppi K, Tanner CM, Halliday GM, Brundin P, Volkmann J, Schrag AE, Lang AE (March 2017). "Parkinson disease". Nature Reviews. Disease Primers. 3 (1) 17013. doi:10.1038/nrdp.2017.13. PMID 28332488.
  2. ↑ Fox SH, Katzenschlager R, Lim SY, Barton B, de Bie RM, Seppi K, Coelho M, Sampaio C (August 2018). "International Parkinson and movement disorder society evidence-based medicine review: Update on treatments for the motor symptoms of Parkinson's disease". Movement Disorders. 33 (8): 1248–1266. doi:10.1002/mds.27372. PMID 29570866.
  3. 1 2 Chen JJ, Obering C (November 2005). "A review of intermittent subcutaneous apomorphine injections for the rescue management of motor fluctuations associated with advanced Parkinson's disease". Clinical Therapeutics. 27 (11): 1710–1724. doi:10.1016/j.clinthera.2005.11.016. PMID 16368444.
  4. ↑ Olanow CW, Factor SA, Espay AJ, Hauser RA, Shill HA, Isaacson S, Pahwa R, Leinonen M, Bhargava P, Sciarappa K, Navia B, Blum D (February 2020). "Apomorphine sublingual film for off episodes in Parkinson's disease: a randomised, double-blind, placebo-controlled phase 3 study". The Lancet. Neurology. 19 (2): 135–144. doi:10.1016/S1474-4422(19)30396-5. PMID 31818699.
  5. 1 2 Trenkwalder C, Chaudhuri KR, García Ruiz PJ, LeWitt P, Katzenschlager R, Sixel-Döring F, Henriksen T, Sesar Á, Poewe W (September 2015). "Expert Consensus Group report on the use of apomorphine in the treatment of Parkinson's disease--Clinical practice recommendations". Parkinsonism & Related Disorders. 21 (9): 1023–1030. doi:10.1016/j.parkreldis.2015.06.012. hdl:20.500.11940/8387. PMID 26189414.
  6. 1 2 Agbo F, Isaacson SH, Gil R, Chiu YY, Brantley SJ, Bhargava P, Navia B (December 2021). "Pharmacokinetics and Comparative Bioavailability of Apomorphine Sublingual Film and Subcutaneous Apomorphine Formulations in Patients with Parkinson's Disease and "OFF" Episodes: Results of a Randomized, Three-Way Crossover, Open-Label Study". Neurology and Therapy. 10 (2): 693–709. doi:10.1007/s40120-021-00251-6. PMC 8571442. PMID 33991326.
  7. ↑ "ONAPGO- apomorphine hydrochloride injection, solution". United States Food & Drug Administration. Retrieved 1 April 2026.
  8. ↑ Katzenschlager R, Poewe W, Rascol O, Trenkwalder C, Deuschl G, Chaudhuri KR, Henriksen T, van Laar T, Spivey K, Vel S, Staines H, Lees A (September 2018). "Apomorphine subcutaneous infusion in patients with Parkinson's disease with persistent motor fluctuations (TOLEDO): a multicentre, double-blind, randomised, placebo-controlled trial". The Lancet. Neurology. 17 (9): 749–759. doi:10.1016/S1474-4422(18)30239-4. PMID 30055903.

}}

This should ensure readers do not confuse old usages with how it is currently used and makes it more consistent with the rules for medical content sourcing and the Pharmacology style guideline. Hopefully that makes sense! Lexi at Supernus (talk) 22:38, 21 May 2026 (UTC)Reply
Lexi at Supernus Per WP:MEDRS The sentence “Apomorphine can provide rapid improvement in motor symptoms” cites the Olanow phase 3 trial (a primary source). I suggest replacing this source with the Chen (review) and Trenkwalder (expert consensus). The sentence “Sublingual formulations have also been shown to be effective…” cites Agbo PK/bioavailability RCT (primary). I suggest replacing with Fox (MDS evidence‑based review). Boghog (talk) 15:25, 16 June 2026 (UTC)Reply
After replacing primary with secondary source, the content that you propose reads as neutral and encyclopedic and does not show obvious signs of being slanted toward Supernus. Hence I would support replacing the current "Medical uses" section with the one that you are proposing. Boghog (talk) 15:53, 16 June 2026 (UTC)Reply
@Boghog: thank you for the close eye! I have replaced the Olanow study as you suggested but I couldn't see in Fox where it mentioned the sublingual formulations. I was able to find another review that does state the same claim, so I replaced it with that. What do you think?
In think the PMID 38743091 citation is appropriate to include. The citation I was referring to was PMID 40055961 which does mention "sublingual film". The two review come to somewhat different conclusions however which could be summarized as follows:
Sublingual apomorphine film has been reported ins a recent narrative review to produce rapid OFF‑to‑ON conversion and clinically meaningful short‑term improvements in motor scores when used as an on‑demand treatment for OFF episodes in Parkinson’s disease PMID 38743091, but an MDS evidence‑based review judged the randomized‑trial data insufficient to conclude that intermittent apomorphine formulations (including sublingual film) provide sustained benefits in disability or quality of life over 12‑week treatment periods.PMID 40055961 Boghog (talk) 04:59, 19 June 2026 (UTC)Reply
Apomorphine is used for the management of motor fluctuations in Parkinson's disease, particularly for the treatment of "off" episodes.[1]: 13 [2]: 1261  "Off" episodes are periods during which motor symptoms such as rigidity, bradykinesia, or reduced mobility reemerge as the effects of dopaminergic medications wear off.[3]: 1711  Apomorphine can provide rapid improvement in motor symptoms.[3]: 1722 [4]: 1024 

Apomorphine is administered in multiple pharmaceutical formulations. Intermittent subcutaneous injection is used as an acute treatment and has been shown to terminate "off" episodes in individuals with motor fluctuations not adequately controlled with oral therapy.[4]: 1025  Sublingual formulations have also been shown to be effective as acute treatments of "off" episodes.[5]: 1214 

Continuous subcutaneous infusion of apomorphine using a wearable infusion device is also prescribed for individuals with motor fluctuations.[6][1]: 12–13  Continuous infusion treatment is used in patients whose symptoms are not adequately controlled with oral or transdermal therapies and has been shown to reduce daily "off" time.[4]: 1024–1025 [7]: 755–756  Apomorphine is generally used as an adjunct to levodopa-based therapy in patients with Parkinson's disease and motor fluctuations.[8]: 694 

References

  1. 1 2 Poewe, Werner; Seppi, Klaus; Tanner, Caroline M.; Halliday, Glenda M.; et al. (23 March 2017). "Parkinson disease". Nature Reviews Disease Primers. 3 (1): 17013. doi:10.1038/nrdp.2017.13. ISSN 2056-676X. Retrieved 1 April 2026.
  2. ↑ Fox, Susan H.; Katzenschlager, Regina; Lim, Shen‐Yang; Barton, Brandon; et al. (August 2018). "International Parkinson and movement disorder society evidence‐based medicine review: Update on treatments for the motor symptoms of Parkinson's disease". Movement Disorders. 33 (8): 1248–1266. doi:10.1002/mds.27372. ISSN 0885-3185. Retrieved 1 April 2026.
  3. 1 2 Chen, Jack J.; Obering, Crystal (November 2005). "A review of intermittent subcutaneous apomorphine injections for the rescue management of motor fluctuations associated with advanced Parkinson's disease". Clinical Therapeutics. 27 (11): 1710–1724. doi:10.1016/j.clinthera.2005.11.016. Retrieved 1 April 2026.
  4. 1 2 3 Trenkwalder, Claudia; Chaudhuri, K. Ray; García Ruiz, Pedro J.; LeWitt, Peter; et al. (September 2015). "Expert Consensus Group report on the use of apomorphine in the treatment of Parkinson's disease – Clinical practice recommendations". Parkinsonism & Related Disorders. 21 (9): 1023–1030. doi:10.1016/j.parkreldis.2015.06.012. Retrieved 1 April 2026.
  5. ↑ Kassubek, Jan; Jost, Wolfgang H.; Schwarz, Johannes (October 2024). "Sublingual apomorphine in the treatment of Parkinson's disease". Journal of Neural Transmission. 131 (10): 1209–1216. doi:10.1007/s00702-024-02777-z. Retrieved 17 June 2026.
  6. ↑ "ONAPGO- apomorphine hydrochloride injection, solution". United States Food & Drug Administration. Retrieved 1 April 2026.
  7. ↑ Katzenschlager, Regina; Poewe, Werner; Rascol, Olivier; Trenkwalder, Claudia; et al. (September 2018). "Apomorphine subcutaneous infusion in patients with Parkinson's disease with persistent motor fluctuations (TOLEDO): a multicentre, double-blind, randomised, placebo-controlled trial". The Lancet Neurology. 17 (9): 749–759. doi:10.1016/S1474-4422(18)30239-4. Retrieved 1 April 2026.
  8. ↑ Agbo, Felix; Isaacson, Stuart H.; Gil, Ramon; Chiu, Yu-Yuan; Brantley, Scott J.; Bhargava, Parul; Navia, Bradford (1 December 2021). "Pharmacokinetics and Comparative Bioavailability of Apomorphine Sublingual Film and Subcutaneous Apomorphine Formulations in Patients with Parkinson's Disease and "OFF" Episodes: Results of a Randomized, Three-Way Crossover, Open-Label Study". Neurology and Therapy. 10 (2): 693–709. doi:10.1007/s40120-021-00251-6. ISSN 2193-6536. Retrieved 2 April 2026.
Thanks again for looking! Lexi at Supernus (talk) 12:49, 18 June 2026 (UTC)Reply
@Boghog: That works for me if it works for you! I have put it together all in one block of markup:
Apomorphine is used for the management of motor fluctuations in Parkinson's disease, particularly for the treatment of "off" episodes.[1]: 13 [2]: 1261  "Off" episodes are periods during which motor symptoms such as rigidity, bradykinesia, or reduced mobility reemerge as the effects of dopaminergic medications wear off.[3]: 1711  Apomorphine can provide rapid improvement in motor symptoms.[3]: 1722 [4]: 1024 

Apomorphine is administered in multiple pharmaceutical formulations. Intermittent subcutaneous injection is used as an acute treatment and has been shown to terminate "off" episodes in individuals with motor fluctuations not adequately controlled with oral therapy.[4]: 1025  Sublingual apomorphine film has been reported in a recent narrative review to produce rapid off‑to‑on conversion and clinically meaningful short‑term improvements in motor scores when used as an on‑demand treatment for off episodes in Parkinson's disease,[5] but an MDS evidence‑based review judged the randomized‑trial data insufficient to conclude that intermittent apomorphine formulations (including sublingual film) provide sustained benefits in disability or quality of life over 12‑week treatment periods.[6]

Continuous subcutaneous infusion of apomorphine using a wearable infusion device is also prescribed for individuals with motor fluctuations.[7][1]: 12–13  Continuous infusion treatment is used in patients whose symptoms are not adequately controlled with oral or transdermal therapies and has been shown to reduce daily "off" time.[4]: 1024–1025 [8]: 755–756  Apomorphine is generally used as an adjunct to levodopa-based therapy in patients with Parkinson's disease and motor fluctuations.[9]: 694 

References

  1. 1 2 Poewe, Werner; Seppi, Klaus; Tanner, Caroline M.; Halliday, Glenda M.; et al. (23 March 2017). "Parkinson disease". Nature Reviews Disease Primers. 3 (1): 17013. doi:10.1038/nrdp.2017.13. ISSN 2056-676X. Retrieved 1 April 2026.
  2. ↑ Fox, Susan H.; Katzenschlager, Regina; Lim, Shen‐Yang; Barton, Brandon; et al. (August 2018). "International Parkinson and movement disorder society evidence‐based medicine review: Update on treatments for the motor symptoms of Parkinson's disease". Movement Disorders. 33 (8): 1248–1266. doi:10.1002/mds.27372. ISSN 0885-3185. Retrieved 1 April 2026.
  3. 1 2 Chen, Jack J.; Obering, Crystal (November 2005). "A review of intermittent subcutaneous apomorphine injections for the rescue management of motor fluctuations associated with advanced Parkinson's disease". Clinical Therapeutics. 27 (11): 1710–1724. doi:10.1016/j.clinthera.2005.11.016. Retrieved 1 April 2026.
  4. 1 2 3 Trenkwalder, Claudia; Chaudhuri, K. Ray; García Ruiz, Pedro J.; LeWitt, Peter; et al. (September 2015). "Expert Consensus Group report on the use of apomorphine in the treatment of Parkinson's disease – Clinical practice recommendations". Parkinsonism & Related Disorders. 21 (9): 1023–1030. doi:10.1016/j.parkreldis.2015.06.012. Retrieved 1 April 2026.
  5. ↑ Kassubek, Jan; Jost, Wolfgang H.; Schwarz, Johannes (October 2024). "Sublingual apomorphine in the treatment of Parkinson's disease". Journal of Neural Transmission. 131 (10): 1209–1216. doi:10.1007/s00702-024-02777-z. Retrieved 17 June 2026.
  6. ↑ de Bie, Rob M.A.; Katzenschlager, Regina; Swinnen, Bart E.K.S.; Peball, Marina; et al. (May 2025). "Update on Treatments for Parkinson's Disease Motor Fluctuations – An International Parkinson and Movement Disorder Society Evidence‐Based Medicine Review". Movement Disorders. 40 (5): 776–794. doi:10.1002/mds.30162. Retrieved 22 June 2026.
  7. ↑ "ONAPGO- apomorphine hydrochloride injection, solution". United States Food & Drug Administration. Retrieved 1 April 2026.
  8. ↑ Katzenschlager, Regina; Poewe, Werner; Rascol, Olivier; Trenkwalder, Claudia; et al. (September 2018). "Apomorphine subcutaneous infusion in patients with Parkinson's disease with persistent motor fluctuations (TOLEDO): a multicentre, double-blind, randomised, placebo-controlled trial". The Lancet Neurology. 17 (9): 749–759. doi:10.1016/S1474-4422(18)30239-4. Retrieved 1 April 2026.
  9. ↑ Agbo, Felix; Isaacson, Stuart H.; Gil, Ramon; Chiu, Yu-Yuan; Brantley, Scott J.; Bhargava, Parul; Navia, Bradford (1 December 2021). "Pharmacokinetics and Comparative Bioavailability of Apomorphine Sublingual Film and Subcutaneous Apomorphine Formulations in Patients with Parkinson's Disease and "OFF" Episodes: Results of a Randomized, Three-Way Crossover, Open-Label Study". Neurology and Therapy. 10 (2): 693–709. doi:10.1007/s40120-021-00251-6. ISSN 2193-6536. Retrieved 2 April 2026.

What do you think? Lexi at Supernus (talk) 18:43, 24 June 2026 (UTC)Reply

@Lexi at Supernus: Looks good. Implemented in this edit. I hope this is OK. Cheers. Boghog (talk) 10:44, 25 June 2026 (UTC)Reply
@Boghog: looks great! Thanks for your time reviewing! Lexi at Supernus (talk) 19:56, 25 June 2026 (UTC)Reply
Your edit misses the sufficient attribution, see special:PermanentLink/1355499736#Medical_Uses_update for details. D6194c-1cc (talk) 09:00, 19 July 2026 (UTC)Reply

Side effects update

[edit]
Latest comment: 17 days ago2 comments2 people in discussion

Hi editors, Lexi with Supernus Pharmaceuticals again with a request to update the side effects section. The current section uses some, from what I understand, questionable sources (drugs.com), and it is missing some potential side effects, so I propose the following which uses peer-reviewed literature and the FDA label to list out the side effects.

Common side effects of apomorphine include nausea and vomiting, particularly when starting treatment; injection site reactions, including bruising, subcutaneous nodules, and rarely necrosis or abscesses; somnolence, dizziness, and falls.[1]: 4–7 [2]: 912  Clinical reviews note that while nausea is frequently reported early during apomorphine therapy, tolerability may improve with a lower starting dose and continued use, and routine antiemetic pretreatment is not universally required.[3]

Less common side effects include dyskinesia, orthostatic hypotension, hallucinations or psychotic-like behavior, syncope, hemolytic anemia, impulse control disorders, dose-dependent QT interval prolongation, peripheral edema, and priapism.[1]: 4–7 [4]

References

  1. 1 2 "Apokyn (apomorphine hydrochloride injection), for subcutaneous use" (PDF). United States Food and Drug Administration. January 2025. Retrieved 21 April 2026.
  2. ↑ Carbone, Federico; Djamshidian, Atbin; Seppi, Klaus; Poewe, Werner (September 2019). "Apomorphine for Parkinson's Disease: Efficacy and Safety of Current and New Formulations". CNS Drugs. 33 (9): 905–918. doi:10.1007/s40263-019-00661-z. Retrieved 22 April 2026.
  3. ↑ Isaacson, Stuart H.; Dewey Jr., Richard B; Pahwa, Rajesh; Kremens, Daniel E. (2023). "How to manage the initiation of apomorphine therapy without antiemetic pretreatment: A review of the literature". Clinical parkinsonism & related disorders. 8. doi:10.1016/j.prdoa.2022.100174. PMID 36691604. Retrieved 22 April 2026.
  4. ↑ Nakanishi, Etsuro; Takahashi, Ryosuke (2022). "Side Effects, Contraindications, and Drug-Drug Interactions in the Use of Antiparkinsonian Drugs". NeuroPsychopharmacotherapy. Springer, Cham. p. 3000. ISBN 978-3-030-62059-2. Retrieved 22 April 2026.

Please let me know what you think! Lexi at Supernus (talk) 20:01, 25 June 2026 (UTC)Reply

"not universally required" is peacock language. So is " shown to reduce" without numbers (prev. edit) . RememberOrwell (talk) 08:58, 11 July 2026 (UTC)Reply
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