‘On-off’ fluctuations can happen quickly and with little warning. During an ‘on’ period, you will be mobile and independent. When experiencing an ‘off’ period you may become immobile and have great difficulty initiating movements such as picking up a cup, undoing buttons, or writing. Normal speech may be restricted and facial stiffness more noticeable.

The signs of an approaching ‘off’ period can vary for each individual, your Parkinson’s Disease Nurse will help you to recognise them. Some examples are:

• Cramping of the toes
• Painful feet and calves
• Stiffness or pain in the neck
• Stiffness in the jaw
• Speech becomes quieter
• Inability to hold objects
• A general feeling of being uncomfortable

The purpose of APO-go is to prevent or reverse ‘off’ periods as quickly as possible. The key to success is to inject as soon as you feel your own individual warning signs of an approaching ‘off’ period.

The dosage of each injection, and the number of injections required each day will be determined by your personal needs. Your doctor will tell you how much APO-go you should inject and how often.

Intermittent injections of APO-go apomorphine solution are available in the form of a pre-filled multiple dose pen device. The pen removes the need to prepare syringes and may be more discrete for use in public places.