Kynmobi (apomorphine) is a medication used for Parkinson's disease (PD). It helps treat the movement problems that happen between doses of your other Parkinson's medications as they start to wear off ("off" episodes). This medication is an oral film that dissolves under your tongue, but it can cause a lot of nausea and vomiting.
"Off" episodes in people with Parkinson's disease (PD)
Kynmobi (apomorphine) is a dopamine agonist. It's not exactly known how the medication helps with movement problems caused by Parkinson's disease, but it's thought to work by activating (turning on) dopamine receptors in the part of your brain involved with movement.
Source:Â DailyMed
Is a sublingual (under the tongue) tablet; can be a good option for people who have trouble swallowing pills or people who don't like injections
Available in multiple strengths so you only have to take 1 tablet per dose
Can be used in people with mild-to-moderate kidney or liver disease
Manufacturer copay savings card available for financial assistance, if eligible
Can cause mouth irritation, sores, swelling, or pain, or a tingling sensation in the mouth
Usually needs to be taken with an anti-nausea medication
Not a good option for someone with a sulfite allergy
Brand name only, which can be expensive
You'll need to take your first dose of Kynmobi (apomorphine) at your provider's office, so they can monitor your blood pressure and heart rate.
Kynmobi (apomorphine) is a film that easily dissolves when water or moisture touches it. Don't open the pouch and remove the film until you're ready to take your dose. Make sure anyone touching the film has dry hands and holds it by the edges.
Before taking each Kynmobi (apomorphine) film, it's best to drink some water to get your mouth wet. This will help the medication dissolve more easily.
Take the whole film for each dose. Don't cut, chew, or swallow the film.
Place the entire Kynmobi (apomorphine) film under your tongue as far back as possible. Close your mouth and keep the film in place until it has completely dissolved (about 3 minutes). Don't swallow your saliva or talk while the film is in your mouth, since this can affect how well the medication gets absorbed into your body. Once the film dissolves, you can swallow. You don't need to drink any liquid with Kynmobi (apomorphine) to take the medication.
Don't stop taking Kynmobi (apomorphine) or lower your dose suddenly without talking to your provider first. Doing so can cause dangerous symptoms like high fever, muscle stiffness, confusion, and unstable movement.
Kynmobi (apomorphine) can cause mouth irritation, sores, swelling, or pain, or a tingling sensation in the mouth. Try sucking on ice chips to help with the pain and swelling. If this doesn't help or if it becomes too bothersome, contact your provider. You might need to stop Kynmobi (apomorphine) and switch to a different medication.
Your provider might recommend taking an anti-nausea medication like trimethobenzamide (Tigan) 3 days before you start Kynmobi (apomorphine). This can help with nausea and vomiting, which are common side effects. If you already have an anti-nausea medication at home, check with your provider or pharmacist to make sure it's safe to use with Kynmobi (apomorphine).
There are several medications that interact with Kynmobi (apomorphine). Don't start any new medications while taking Kynmobi (apomorphine) without telling your provider or pharmacist first. Some medications will need to have their dose adjusted, while others might need to be stopped altogether.
Kynmobi (apomorphine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Nausea and vomiting is a very common side effect of Kynmobi (apomorphine). To prevent this, your provider might prescribe an anti-nausea medication, such as trimethobenzamide (Tigan) (taken as 300 mg by mouth three times per day). To get the most benefit out of the anti-nausea medication, it should be taken 3 days before your first dose of Kynmobi (apomorphine). You can continue to take the anti-nausea medication while you take Kynmobi (apomorphine) to manage any nausea or vomiting, but it shouldn't be taken for longer than 2 months after you start Kynmobi (apomorphine). There are other medications that can help with nausea and vomiting, but don't take anything else without talking to your provider first because they might interact with Kynmobi (apomorphine) or might make your PD symptoms worse.
Risk factors: History of sleep problems | Taking other medications that cause sleepiness
Kynmobi (apomorphine) can cause you to suddenly fall asleep, even if you don't feel sleepy. Don't drive or do activities that require you to focus until you know how this medication affects you and your ability to pay attention, think, or react. Take extra care if you have a sleep disorder or take other medications that cause sleepiness (like opioids, benzodiazepines, or sleep medications). Let your provider know if you feel very sleepy during the daytime or if you fall asleep during activities where you need to concentrate. You might need to stop Kynmobi (apomorphine).
Risk factors: Allergy to sulfite
Allergic reactions to Kynmobi (apomorphine) are possible, including mouth or facial swelling and hives. Kynmobi (apomorphine) has sulfite in it and can cause severe allergic reactions (e.g., swelling of the face, lips, throat; shock) in people who are allergic to sulfites. Let you're provider know if you're allergic to sulfite, as this medication might not be safe for you. If you notice hives, rash, red skin, swelling of the lips or tongue, or difficulty breathing after using Kynmobi (apomorphine), get medical attention right away.
Risk factors: History of low blood pressure or heart disease | Taking medications that lower blood pressure (e.g., blood pressure medications, serotonin antagonists, nitroglycerin (Nitrostat) | Alcohol | When your Kynmobi (apomorphine) dose is raised
Kynmobi (apomorphine) can lower your blood pressure, which can lead to fainting, falls, and accidental injuries. Your risk is higher if you have a history of low blood pressure or heart disease, are take other medications that lower blood pressure, drink alcohol after using Kynmobi (apomorphine), or when your dose of Kynmobi (apomorphine) is raised. Don't take medications like ondansetron (Zofran) with Kynmobi (apomorphine) because this combination has been known to cause a dangerous drop in your blood pressure and can also make you pass out. If you take nitroglycerin (Nitrostat) for chest pain, lie down before and after taking it.
Make sure to hold onto something and stand up slowly after sitting or lying down. Always stay well hydrated. If you feel dizzy, lightheaded, feel like you're going to faint, tired, or confused after taking Kynmobi (apomorphine), sit or lie down right away to prevent falling and contact your provider right away. Your dose might have to be lowered or you might have to stop taking the medication.
Risk factors: History of certain mental health conditions
Kynmobi (apomorphine) can cause hallucinations (seeing or hearing things that aren't real) and changes in behavior and thinking. Some people also had delusions and confusion. Other similar PD medications can also cause paranoia, aggressive behavior, uneasiness, and less awareness of your surroundings. If you have a history of mental health conditions, Kynmobi (apomorphine) might not be right for you, since this medication can worsen your condition. If you or your loved ones notice any of these symptoms while taking Kynmobi (apomorphine), contact your provider right away.
Some people had lower impulse control while taking PD medications, such as Kynmobi (apomorphine). This can include strong sexual or gambling urges, urges to spend a lot of money, and binge eating. Talk to your provider if these urges start to have a negative impact on your life. Lowering your dose or stopping the medication can help.
Risk factors: Low heart rate | Low potassium and magnesium blood levels | Taking other medications that cause heart rhythm problems | Genetic heart rhythm problem | History of abnormal heart rhythms (arrhythmias)
Some people taking injectable apomorphine experienced QT prolongation, where there's a time delay from when the heart squeezes and then relaxes. This can raise the risk of life-threatening abnormal heart rhythms. Though heart rhythm problems weren't seen in clinical trials with Kynmobi (apomorphine) at recommended doses, the risk is still possible. Your risk is higher if you have a low heart rate, low potassium and magnesium blood levels, or use other medications that can cause heart rhythm problems. Make sure to tell your provider about your full medical history and all the medications you're taking or plan to take. People who were born with heart rhythm problems or who have a history of arrhythmias should avoid taking Kynmobi (apomorphine). If you experience a pounding heart, chest pain, shortness of breath, faintness, or lightheadedness after taking Kynmobi (apomorphine), call 911 right away. Let your provider know if you ever feel an irregular heartbeat.
Although rare, some men taking Kynmobi (apomorphine) experienced prolonged and painful erections (priapism). Get medical attention right away if you have an erection that lasts longer than 4 hours.
Dosage | Quantity | Price as low as | Price per unit |
---|---|---|---|
30 pouches of 1 sublingual film of 10mg | 1 carton | $836.32 | $836.32 |
30 pouches of 1 sublingual film of 15mg | 1 carton | $931.34 | $931.34 |
30 pouches of 1 sublingual film of 20mg | 1 carton | $836.32 | $836.32 |
30 pouches of 1 sublingual film of 25mg | 1 carton | $836.32 | $836.32 |
30 pouches of 1 sublingual film of 30mg | 1 carton | $836.32 | $836.32 |
Dosage | Quantity | Price as low as | Price per unit |
---|---|---|---|
10mg/15mg/20mg/25mg/30mg | 1 titration pack | $2.50 | $2.50 |
The typical starting dose is 10 mg dissolved under the tongue on an as-needed basis, up to 5 times per day. Don't take more than 30 mg in a single dose. You can take another dose after at least 2 hours, but don't take more than 1 dose for the same "off" episode.
Your provider will adjust the dose based on how you respond to the medication. Your dose might differ if you have kidney or liver problems.
Take serotonin antagonists (e.g., ondansetron (Zofran), alosetron (Lotronex)) with Kynmobi (apomorphine)
"Off" episodes in people with Parkinson's disease (PD)
By signing up, I agree to GoodRx's Terms and Privacy Policy, and to receive marketing messages from GoodRx.
Research prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.