Apo-go-Pen: I'm new here, was diagnosed... - Parkinson's Movement

Parkinson's Movement
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I'm new here, was diagnosed with PD in 2010 after Dat-scan. As the Oral medications wear out and dyskinesia takes control of me most of the day, my Neuro suggests to switch to The apo-go-morphine pen. For that I reduced by half my Levodopa dosage which is not without difficulty and 2 days before the switch my Neuro asked me to take Domperidone which is an anti-vomiting drug.

I would be grateful for information from someone else undergoing the same treatment change. Catherine

13 Replies

idk what the app go morphine pen is...

Is it the injection rescue ?

I take Amantadine to help wth the dyskinesia caused by the l-dopa

I'll look into that pen & get back to u

Best regards


Ugghhh I should've realized you were talking about Apokyn

U threw me off with the morphine !

I wrote my dr about it ... this was his reply: ( sry its lengthy)

"We offer Apokyn injections at the clinic and the Apokyn pumps should be available “soon” (they are in use in Europe). It is going to be another very promising treatment in the management of advanced Parkinson’s disease with a noted decrease in peak dose dyskinesia and off time. The major limitation is that it does not help something called biphasic dyskinesia (dyskinesia occurring as levodopa is kicking in and wearing off, compared to peak dose when dyskinesia occurs only when levodopa’s effect is at its max).

The easiest way to think of the apokyn pump as something in the range of treatments such as DBS and Duopa pump.

In terms of the Apokyn injectable pens (already available), these are very good for “sudden” off times and disabling off time (though they can worsen dyskinesia if used frequently). If interested we can set you up at the Apokyn clinic (to note we do not have the pump yet only the injectable pens) to test it (it needs to be tested in the clinic to monitor your blood pressure)."

Cathadriae in reply to Cbgs

Thank you for your feedback. My first Apokyn injection will be this Thursday afternoon at my Neuro 's practice with 1 Apokyn commercial delegate. I should be off which makes me wonder how I can get to my Neuro who is not even 4 km away from my home but all stiff and unwell 1 m is a challenge when off, all the more so that I tend to panick when off, I am in Europe, Belgium Where we call the pen Apogo pen. For the switch of Thursday I had to half m'y Stalevo , increase slightly Mirapexin and go on with 1 mg .Azilect.. With the Levodopa reduction my dyskinesia is almost gone, which I am glad about. Though I do not dare to go out because I am not sure about my on an off periods. 2 days before the Apokyn trial I have to take Domperidone which is an anti vomiting medecine

Wait and see... cathadriae

you have a driver I hope???

Best of luck..

keep us posted

Cathadriae in reply to Cbgs

Yes I have a driver but I am so panicky when off that my legs refuse to move.... I prefer to sit on the floor because I feel safer. I wonder if they are other specimen like me.

LOL !! There are plenty of specimen like you!! You are NOT alone!

Being OFF is horrible.. I tend to lie down on my stomach til I can move.

Can you ask your Dr if there is something you can take to " take the edge off"??

So how did it go ?

It went well, I had reduced by half my Levodopa intake 15 days before the Apokyn pen because I was highly dyskinetic. At the Neuro I was explained the pen when I could feel the "off" period starting. I was invited to inject myself 1 mg of Apomorphine which did not have any effect then 2 mg which was decided to be my personal dosage. After 4-5 minutes I was feeling on and back to normal again for one hour.

It is easy and of great help to get out of off period. I had no nausea so far, no hypotension I touch wood.

That sounds wonderful

Effects with in 5 minutes ??

Did they talk about abusing it?

I feel like I'd be injecting all day!!!

So glad to hear it went well for u !!


It is to be used when you are off waiting for your oral medication to take effect. The effect of the Apo go pen last 1 hour and you should wait 2 hours after the next injection. I had hypotension and nausea when using it upon waking up so I avoid the morning use. Later during the day I have no problem whatsoever. When starting you take Domperidone, an anti vomiting . On the whole it is a great invention i like it. Cathadriae

Does it cause dyskinesia ?

I have much less dyskinesia than before Apokyn but it I was so dyskynetic that I need to add that before I started with Apokyn I was asked by my Neuro to reduce my intake of Levodopa, which I managed to cut by 50%, not without intense difficulty during 10 days during which I did not put a foot outside . I had to slightly increase Pramipexol and now with the Apo go pen and my reduced intake of Levodopa i can get of "off" periods in between 4 to 7 minutes which is so great that no abuse is allowed, it wears out after 1 hour so if you Oral medication still does not work you have to accept the "off" time anyway and wait another 2 hours before the next injection.

I hope I am clear in my explanation English is not my first language which is French.

Very interesting post and comments. Wondering how it is going ? What was the amount of Levadopa taken before and after ?

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