The FDA has approved a new drug called Onapgo (apomorphine hydrochloride) for adults with advanced Parkinson's disease. It is used to treat motor fluctuations, which are times when Parkinson's symptoms return or worsen between doses of oral medication. Onapgo is given as a continuous infusion under the skin, using a pump. This approval offers a new treatment option for people who still have OFF episodes even when their current oral therapy is optimized.
Onapgo is for patients with advanced Parkinson's disease who experience motor fluctuations. It is not meant for people with earlier stages of the disease or for those who do not have OFF episodes. The drug works by stimulating dopamine receptors in the brain, which helps improve movement control. Before starting Onapgo, patients must take a medicine called trimethobenzamide to reduce nausea and vomiting. Onapgo should not be used with certain anti-nausea drugs called 5HT3 antagonists because this combination can cause low blood pressure and loss of consciousness.
This approval means there is now another choice for managing motor complications in advanced Parkinson's disease. However, Onapgo is not interchangeable with other apomorphine products that are given as injections for sudden OFF episodes. The dosing and safety information are provided in the drug label. Patients and caregivers should talk to their doctor to see if Onapgo is right for them and to understand how to use the infusion pump properly.