Exercise no. 320 Apomorphine sublingual film (KYNMOBI°) in "off" episodes in Parkinson's disease

In patients with Parkinson's disease who have very troublesome motor fluctuations (the "on-off phenomenon", in which patients alternate between "off" periods, when movements and speech are markedly impaired, and "on" periods, when they improve), the non-ergot dopamine agonist apomorphine is an option when modifications to oral treatment have failed. Apomorphine is available for use by subcutaneous (SC) injection via a pen injector, during off episodes; or by SC infusion via a pump, which is better suited to very frequent off episodes. After SC injection, the clinical effect of apomorphine is of rapid onset (about 20 minutes on average), but of brief duration (45 to 90 minutes).