Kynmobi (Apomorphine Hydrochloride Hemihydrate)

Kynmobi acts on the dopaminergic pathway to treat sudden motor fluctuations in Parkinson's disease.

• Parkinson's disease: rapid reversal of OFF episodes, restoring motor function during sudden symptom worsening.

• Apomorphine binds to and activates dopamine D1 and D2 receptors in both peripheral and central nervous systems. This stimulation bypasses the depleted endogenous dopamine in Parkinson's disease, quickly restoring dopaminergic signaling and improving motor control during OFF periods.

Apomorphine may cause a range of adverse reactions, from mild to severe.

Common Side Effects

• Nausea: transient feeling of sickness, often occurring shortly after administration.
• Vomiting: occasional forceful expulsion of stomach contents.
• Dizziness: light‑headed sensation, especially when standing quickly.
• Orthostatic hypotension: drop in blood pressure upon standing, causing faintness.
• Somnolence: mild sleepiness or fatigue.
• Headache: mild to moderate head pain.

Serious or Rare Side Effects

• Severe hypotension: marked blood pressure drop requiring medical attention.
• Syncope: sudden loss of consciousness.
• Neuroleptic malignant syndrome: rare but life‑threatening reaction with fever and muscle rigidity.
• Severe skin reactions: such as Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Pulmonary edema: fluid accumulation in the lungs, presenting with shortness of breath.
• Anaphylaxis: acute allergic response with airway compromise.

When prescribing apomorphine, clinicians should consider several safety measures.

• Cardiovascular monitoring: observe blood pressure and heart rate, especially after the first dose.
• Orthostatic hypotension: advise patients to rise slowly to reduce fainting risk.
• Contraindication in severe heart disease: avoid use in patients with unstable cardiac conditions.
• Hypersensitivity: discontinue if signs of allergic reaction appear.
• Psychiatric disorders: use caution in patients with a history of psychosis or severe depression.
• Store at ambient temperature: keep below 25°C, retain in original packaging, protect from moisture and direct sunlight.

Apomorphine can interact with several drug classes, requiring careful management.

Major Interactions (Avoid)

• Monoamine oxidase inhibitors (MAOIs): risk of hypertensive crisis when combined.
• Antipsychotics (dopamine antagonists): may diminish apomorphine's efficacy.
• Other dopamine agonists: additive dopaminergic effects can increase adverse events.

Moderate Interactions (Monitor Closely)

• Antihypertensive agents: enhanced hypotensive response, monitor blood pressure.
• Alcohol: may potentiate dizziness and sedation.
• Selective serotonin reuptake inhibitors (SSRIs): potential for serotonin syndrome in rare cases.