APO-go (apomorphine hydrochloride) is a highly effective1, 2 anti-Parkinsonian drug, that is a direct stimulant of dopamine receptors. APO-go possesses both D1 and D2 receptor agonist properties, but does not share transport or metabolic pathways with levodopa.3
APO-go is a potent, rapid acting dopamine agonist that gives a reliable motor response4 and will restore mobility or prevent ‘off’ periods,within 4 to 12 minutes of treatment.3
APO-go efficacy is comparable to levodopa
The potency of APO-go therapy is comparable to levodopa.5 APO-go has an identical quality of response on Pd symptoms, but with faster onset2, 6 than that of oral or liquid levodopa. 7
Treatment with APO-go CDS has been shown to be successful in managing ‘off’ period disabilities,2, 5, 8 as well as notably reducing interdose dyskinesias without loss of motor control. 5
APO-go and levodopa are the only therapies with good levels of affinity for D1 and D2 receptors, giving additional clinical efficacy6
D1 |
D2 |
D3 |
5-HT |
α1 |
α2 |
|
| Apomorphine | ||||||
| Apomorphine | ++ |
+++ |
++ |
0/+ |
0/+ |
++ |
| Ergot derivatives | ||||||
| Bromocriptine | - |
+++ |
++ |
++ |
++ |
++ |
| Cabergoline | + |
+++ |
+ |
+ |
+ |
+ |
| Lisuride | - |
+++ |
+++ |
++ |
+ |
+ |
| Pergolide | + |
+++ |
+++ |
0/+ |
+ |
++ |
| Nonergoline derivatives | ||||||
| Piribedil | + |
+++ |
+ |
0 |
NA |
NA |
| Pramipexole | 0/+ |
+++ |
+++ |
0/+ |
0/+ |
+ |
| Ropinirole | 0 |
+++ |
+++ |
0 |
0 |
0 |
Table adapted from Deleu.6
α = α-adrenoceptors;NA = information not available; – indicates antagonist activity; 0 indicates no affinity; + indicates low affinity; ++ indicates moderate affinity; +++ indicates high affinity.
APO-go is believed to be more potent than any currently available orally active dopamine agonist.2
Therapeutic Indications
Treatment of motor fluctuations ('on-off' phenomena) in patients with Parkinson's disease which are not sufficiently controlled by oral anti-Parkinson medication.
APO-go Package of Care
The APO-go Package of Care (PoC) offered by Britannia to all patients and all Healthcare Professionals (HCPs) has been developed over the last 20 years, is of the highest quality and is one of the most comprehensive in the industry. Britannia ensures that all aspects of support and care are addressed whilst patients are in both Secondary and Primary care settings.
1. Pietz K, Hagell P, Odin P, 1998. Subcutaneous apomorphine in late stage Parkinson’s disease: A long term
follow up. Journal of Neurology Neurosurgery and Psychiatry, 65:709–716.
2. Lees A, Turner K, 2002. Apomorphine for Parkinson’s Disease. Practical Neurology, 2:280-287.
3. APO-go SmPC 2008.
5. Colzi A, Turner K and Lees AJ, 1998. Continuous subcutaneous waking day apomorphine in the long term
treatment of levodopa induced dyskinesias in Parkinson’s disease. Journal of Neurology, Neurosurgery and
Psychiatry, 64(5):573-576.
6. Deleu D, Hanssens Y et al 2004. Subcutaneous apomorphine: An evidence-based review of its use in
Parkinson’s disease. Drugs and Aging, 21(11):687-709.
7. Menon R, Stacy M 2007. Apomorphine in the treatment of Parkinson’s disease. Expert Opinion
Pharmacotherapy, 8(12):1941-1950.
8. Cotzias GC, Papavasiliou PS, et al 1970. Similarities between neurologic effects of L-dopa and of
Apomorphine. New England Journal of Medicine, 282(1):31-33.

