Quote:
Originally Posted by johnt
APL-130277 (Sunovion) is a sublingual version of apomorphine, a dopamine agonist. As such, it offers a more convenient delivery than present versions of apomorphine, which need to be injected (e.g. Apokyn).
Its purpose is supposed to be dealing with "off" periods. It is suitable for this because it reaches maximum concentration in about 20 minutes, as compared to the 60 minutes of levodopa/carbidopa.
Apomorphine's weakness is that it has a short half-life, 30 minutes as compared to the 90 minutes of L/C. So unless you take other medication you will go "off" quickly.
I think most people will benefit more by having their present drug regimen optimised; making use of the longer half-life of other drugs to give a smoother control of the symptoms.
There is a role for this drug in the case of unexpected "offs", but one has to be careful. Suppose you take a dose of L/C, which has its impact delayed by something in the diet. You go "off" and take the apomorphine, just before the L/C dose kicks in.
John
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i have a different opinion, i think there is a need for a "rescue" drug to get you back on in 20minutes or so. there are some people that can't tolerate longer lasting agonists and can't afford rytary so have to struggle with C/L and C/L extenders like entacapone and have to deal with the results of eating too much protein if they loose their self control and overindulge in protein. if i do that, i have to wait up to 2hrs before taking C/L. i will take an extra 100mg if C/L when i know i've eaten too much protein but i risk having my BP going too low. if this form of apomorphine lets you splurge on protein once in awhile - assuming it isn't greatly affected by protein - then for me it fills a valuable need. i recently added MIRAPEX, didn't like it but toughed it out to reach 3mg/day and had to stop, started seeing / hearing things that weren't there. couldn't tolerate amantadine, entacapone added maybe 45minutes at the best, i have high blood pressure so can't take a mao-b inhibitor so not that easy to adjust my drug regime, especially since i am taking enough C/L that i risk my BP going too low. so a convienent quick acting apomorphine would be a godsend for me if it significantly reduces the inevitable OFF time if i happen to eat more than 4 grams of protein which i do once a day.