Comprehensive medication guide to Apomorphine including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$50–$500+ specialty tier copay per month depending on plan; prior authorization required by most commercial and Medicare plans; manufacturer copay assistance available for eligible commercially insured patients.
Estimated Cash Pricing
$315–$1,794 per 3 mL cartridge for generic with GoodRx or SingleCare coupons; brand Apokyn 15 mL retails over $7,000; Onapgo continuous infusion $8,500–$9,500/month cash.
Medfinder Findability Score
42/100
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Apomorphine is a non-ergoline dopamine agonist used to treat acute "off" episodes in adults with advanced Parkinson's disease. Despite the word "morphine" in its name, it is not an opioid and does not bind to opioid receptors. It was first approved by the FDA in 2004 as Apokyn (subcutaneous injection) and received a second approval in February 2025 as Onapgo, the first wearable continuous subcutaneous infusion device for Parkinson's disease in the United States.
"Off" episodes are periods when Parkinson's symptoms—tremor, rigidity, and slow movement—return as levodopa or other medications wear off or become less predictable. Apomorphine acts as a rapid rescue agent, typically restoring motor control within 10–20 minutes and providing relief for 45–90 minutes per dose.
A generic version of apomorphine hydrochloride injection (10 mg/mL) is available from TruPharma, offering a more affordable alternative to brand-name Apokyn. Apomorphine is exclusively available through specialty pharmacies and requires prior authorization from most insurance plans.
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Apomorphine works by directly activating dopamine receptors in the brain—primarily D2, D3, D4, and D5 receptors, with meaningful D1 engagement as well. This makes it a non-selective dopamine agonist with a broader receptor profile than most oral Parkinson's dopamine agonists. The primary therapeutic target is the post-synaptic dopamine D2-type receptors within the caudate-putamen in the brain.
Unlike levodopa—which must be converted into dopamine by surviving neurons before it can work—apomorphine bypasses this conversion entirely by mimicking dopamine directly. This is why it works even in advanced Parkinson's disease when levodopa becomes unreliable, and why it produces effects much faster than oral medications.
Apomorphine cannot be taken orally because the liver destroys it before it can reach the brain (first-pass metabolism). It must be given subcutaneously (under the skin), where it is absorbed directly into the bloodstream and crosses the blood-brain barrier within minutes. Apomorphine also antagonizes 5-HT2 and alpha-adrenergic receptors, contributing to its broader pharmacological profile.
2 mg (0.2 mL) — Subcutaneous injection (Apokyn pen)
Starting dose; first dose administered under medical supervision
Up to 6 mg (0.6 mL) — Subcutaneous injection (Apokyn pen)
Maximum single dose; doses separated by at least 2 hours; max ~5 doses/day
1 mg/hr starting — Continuous SC infusion (Onapgo device)
Initial continuous infusion rate; titrated in 0.5–1 mg/hr increments; mean clinical dose ~4 mg/hr; max 98 mg/day over 16 waking hours
Apomorphine is a specialty medication, meaning it can only be dispensed through licensed specialty pharmacies—not standard retail pharmacies. This significantly limits the number of locations where patients can fill their prescription. The FDA has not issued a formal shortage declaration for apomorphine in the US as of 2026, but inventory limitations at the specialty pharmacy level mean individual patients may still encounter difficulty filling their prescription.
Access challenges are compounded by mandatory prior authorization from most insurance plans, which can take 5–10 business days for approval. The February 2025 FDA approval and subsequent launch of Onapgo increased demand and created some localized supply pressure in the Onapgo-specific distribution network. The UK discontinued APO-go prefilled syringes in September 2025, but this did not directly affect US supply.
If you are having trouble locating apomorphine, medfinder calls specialty pharmacies near you to check which ones have it in stock, texting results directly to your phone. You can also contact Supernus Support at 877-727-6596 for assistance locating stocked pharmacies and financial assistance.
Apomorphine is not a controlled substance, so it does not require DEA scheduling clearance. However, because it is a specialty medication requiring supervised first-dose administration, antiemetic coordination, and blood pressure monitoring, it is almost always initiated by neurologists or movement disorder specialists. Any licensed prescriber with appropriate neurology expertise may prescribe apomorphine.
Movement disorder specialists (preferred for initiation of Onapgo and complex cases)
General neurologists
Geriatricians (in coordination with a neurologist)
Nurse practitioners and physician assistants (for ongoing management after physician initiation)
Telehealth is generally not appropriate for apomorphine initiation because the first dose must be given under direct medical supervision with blood pressure monitoring. However, established patients may be able to manage follow-up and refill visits via telehealth depending on their neurologist's practice. Use the Parkinson's Foundation Find a Care tool (parkinson.org/find-care) to locate movement disorder specialists near you.
No. Apomorphine is not a controlled substance under the federal Controlled Substances Act (CSA). Despite containing "morphine" in its name, apomorphine is specifically excluded from Schedule II opioid classification in the CSA. It does not bind to opioid receptors, does not produce opioid-type euphoria or respiratory depression, and has no recognized abuse potential.
Apomorphine is, however, a prescription-only specialty medication. It requires a valid prescription from a licensed prescriber, prior authorization from most insurance plans, and dispensing through a specialty pharmacy. The first dose must be administered under medical supervision in a clinical setting. Standard retail pharmacies cannot dispense apomorphine.
The following side effects are common and often improve over time:
Nausea and vomiting (very common; antiemetic pre-treatment required)
Orthostatic hypotension (dizziness when standing)
Somnolence and sleep attacks
Dyskinesia (involuntary movements)
Injection site reactions (bruising, nodules, swelling)
Sweating and yawning
Hallucinations and psychosis — contact your neurologist immediately
Impulse control disorders (gambling, hypersexuality, compulsive eating/spending)
QTc prolongation and cardiac arrhythmias
Severe allergic reactions (hives, swelling, difficulty breathing)
CONTRAINDICATED with 5-HT3 antagonists (ondansetron, granisetron, dolasetron, palonosetron, alosetron) — risk of profound hypotension and loss of consciousness
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Carbidopa/Levodopa (Sinemet, Rytary)
The cornerstone of Parkinson's therapy; oral or intestinal gel delivery (Duopa); slower onset than apomorphine but widely available and affordable; generic exists.
Pramipexole (Mirapex)
Oral non-ergoline D2/D3 dopamine agonist; reduces off-time frequency; generic available; higher impulse control disorder risk than apomorphine.
Ropinirole (Requip)
Oral non-ergoline D2/D3 dopamine agonist; immediate-release and extended-release; generic available; comparable profile to pramipexole.
Rotigotine (Neupro)
Transdermal patch delivering once-daily continuous dopaminergic stimulation; D1-D5 receptor activity; no generic; applied to skin, bypasses GI variability.
VYALEV (Foscarbidopa/Foslevodopa)
FDA-approved October 2024; 24-hour subcutaneous infusion of levodopa prodrug; non-invasive alternative to Duopa intestinal gel; for advanced Parkinson's with motor fluctuations.
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Ondansetron (Zofran) / 5-HT3 Antagonists
majorABSOLUTELY CONTRAINDICATED. Profound hypotension and loss of consciousness reported. All 5-HT3 antagonists (ondansetron, granisetron, dolasetron, palonosetron, alosetron) are contraindicated with apomorphine.
Antihypertensives and vasodilators
majorAdditive blood pressure reduction; risk of symptomatic hypotension and fainting. Dose adjustment of antihypertensives may be needed.
Antipsychotics and dopamine antagonists
majorReduce apomorphine efficacy by blocking dopamine receptors; may worsen Parkinson's symptoms. Most antipsychotics should be avoided in Parkinson's patients.
QTc-prolonging drugs (antibiotics, antidepressants, antiarrhythmics)
moderateAdditive QTc prolongation increases risk of torsades de pointes arrhythmia. Review for any QTc-prolonging drugs before initiating apomorphine.
Alcohol and CNS depressants
moderateAdditive sedation, hypotension, and fall risk. Alcohol is absolutely contraindicated during apomorphine therapy.
Apomorphine is a uniquely powerful option for Parkinson's patients who are experiencing significant off episodes despite optimized oral therapy. Its rapid onset, parenteral delivery, and broad dopamine receptor profile make it one of the most effective rescue treatments available for advanced Parkinson's disease. The 2025 FDA approval of Onapgo—the first wearable continuous infusion device—has further expanded how apomorphine can be used, bringing the 30-year European experience with continuous subcutaneous apomorphine infusion to US patients for the first time.
The challenges are real: apomorphine is expensive, requires specialty pharmacy dispensing, mandates supervised first-dose administration, has serious drug interactions (especially with 5-HT3 antagonists), and is only available where specialty pharmacy infrastructure exists. But for patients who can access it, the quality-of-life benefit can be transformative.
If access to apomorphine is a challenge for you, medfinder calls specialty pharmacies near you to find which ones have it in stock—so you spend less time on hold and more time focused on what matters. Enter your medication and zip code to get started.
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