Uprima



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Generic Name: apomorphine
(a poe MOR feen)

What is Uprima?

Uprima has some of the same effects as a chemical called dopamine, which occurs naturally in your body. Low levels of dopamine in the brain are associated with Parkinson's disease.

Uprima is used to treat "wearing-off" episodes (muscle stiffness, loss of muscle control) in people with advanced Parkinson's disease.

Uprima may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Uprima?

Some people using Uprima have fallen asleep during normal daytime activities such as working, talking, eating, or driving. You may fall asleep suddenly, even after feeling alert. Tell your doctor if you have any problems with daytime sleepiness or drowsiness.

You may have increased sexual urges, unusual urges to gamble, or other intense urges while using this medication.

Do not drink alcohol or use narcotic pain medications, sedatives, tranquilizers, muscle relaxers, or other medicines that can make you sleepy or lower your blood pressure. Dangerous side effects may result.

Uprima can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Some people using medicines for Parkinson's disease have developed skin cancer (melanoma). However, people with Parkinson's disease may have a higher risk than most people for developing melanoma. Talk to your doctor about your specific risk and what skin symptoms to watch for. You may need to have regular skin exams.

What should I discuss with my healthcare provider before using Uprima?

You should not use this medication if you are allergic to Uprima, or if you are using any of the following medications:

  • alosetron (Lotronex)
  • dolasetron (Anzemet)
  • granisetron (Kytril)
  • ondansetron (Zofran); or
  • palonosetron (Aloxi).

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use Uprima:

  • an electrolyte imbalance (such as low levels of potassium or magnesium in your blood)
  • a slow heart rate
  • a personal or family history of "Long QT syndrome"
  • a history of stroke or heart attack
  • asthma
  • liver disease
  • kidney disease
  • a psychiatric disorder such as schizophrenia; or
  • low blood pressure.

Some people using Uprima have fallen asleep during normal daytime activities such as working, talking, eating, or driving. You may fall asleep suddenly, even after feeling alert. Tell your doctor if you have any problems with daytime sleepiness or drowsiness. If you are unsure of how this medicine will affect you, be careful if you drive or do anything that requires you to be awake and alert.

You may have increased sexual urges, unusual urges to gamble, or other intense urges while using this medication. Talk with your doctor if you believe you have any intense or unusual urges while using Uprima.

FDA pregnancy category C. It is not known whether Uprima is harmful to an unborn baby. Before using this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment.

Uprima can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Some people using medicines for Parkinson's disease have developed skin cancer (melanoma). However, people with Parkinson's disease may have a higher risk than most people for developing melanoma. Talk to your doctor about your specific risk and what skin symptoms to watch for. You may need to have regular skin exams.

How should I use Uprima?

Uprima is given as an injection under the skin of your stomach, upper arm, or upper thigh. Your doctor, nurse, or other healthcare provider will give you this injection. You may be shown how to inject your medicine at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Do not inject Uprima into a vein.

Measuring your Uprima dose correctly is extremely important. If you use an injector pen with your apomorphine, the medication is measured in milliliters (mL) marked on the pen. However, your prescribed dose may be in milligrams (mg). One milligram, or 1 mg, of apomorphine is equal to 0.1 mL marked on the dosing pen.

Use a different place on your stomach, arm, or thigh each time you give yourself an injection. Do not inject Uprima into the same place two times in a row.

Use each disposable needle only one time. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

Uprima can cause severe nausea and vomiting. For this reason, your doctor may prescribe an anti-nausea medication for you to start taking a few days before you begin using apomorphine. You may also need to keep using the anti-nausea medicine throughout your treatment with apomorphine.

You may have withdrawal symptoms such as fever, muscle stiffness, and feeling light-headed or fainting, when you stop using this medication after using it over a long period of time. Do not stop using Uprima suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely.

If you stop using Uprima for a week or longer, ask your doctor before restarting the medication. You may need to restart with a lower dose.

Store this medication at room temperature, away from heat, moisture, and light.

What happens if I miss a dose?

Use the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include nausea, extreme drowsiness, or fainting.

What should I avoid while using Uprima?

Avoid drinking alcohol. It can increase some of the side effects of Uprima.

Uprima can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What are the possible side effects of Uprima?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • nausea or vomiting that continues after taking an anti-nausea medication
  • feeling light-headed (especially when you stand up), falling or passing out
  • chest pain or heavy feeling, pain spreading to the arm or shoulder, sweating, general ill feeling
  • confusion, hallucinations
  • restless muscle movements in your eyes, tongue, jaw, or neck
  • tremor (uncontrolled shaking); or
  • penis erection that is painful or lasts 4 hours or longer.

Less serious side effects may include:

  • bruising, itching, or hardening of your skin where the injection was given
  • increased sexual desire
  • depressed mood, headache
  • pale skin, increased sweating
  • warmth, redness, or tingling under your skin
  • dizziness, drowsiness, yawning
  • runny nose
  • swelling in your hands or feet
  • sleep problems (insomnia)
  • joint pain; or
  • constipation or diarrhea.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Uprima?

Before using Uprima, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by apomorphine.

Before using Uprima, tell your doctor if you are using any of the following drugs:

  • arsenic trioxide (Trisenox)
  • bepridil (Vascor)
  • blood pressure medications
  • cisapride (Propulsid)
  • chloroquine (Arelan) or halofantrine (Halfan)
  • metoclopramide (Reglan)
  • niacin (nicotinic acid, Niacor, Niaspan, and others)
  • sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra)
  • narcotic medication such as fentanyl (Actiq, Duragesic), hydrocodone (Vicodin), morphine (Kadian, MS Contin), oxycodone (OxyContin, Percocet), and others
  • antibiotics such as azithromycin (Zithromax), clarithromycin (Biaxin), dirithromycin (Dynabac), erythromycin (E-Mycin, E.E.S., Erythrocin, Ery-Tab), pentamidine (NebuPent, Pentam), sparfloxacin (Zagam), telithromycin (Ketek)
  • medicines to treat psychiatric disorders, such as haloperidol (Haldol), chlorpromazine (Thorazine), prochlorperazine (Compazine), thioridazine (Mellaril), and others; or
  • heart rhythm medicine such as amiodarone (Cordarone, Pacerone), dofetilide (Tikosyn), disopyramide (Norpace), procainamide (Procan, Pronestyl), quinidine (Cardioquin, Quinaglute), or sotalol (Betapace).

This list is not complete and there may be other drugs that can interact with Uprima. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about Uprima.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.