apomorphine (Apokyn®) 

INITIATION DOSE IS OFFICE ADMINISTERED: SUBCUTANEOUS INJECTION

Indication(s) for Prior Authorization:

  • Parkinson’s Disease, treatment of hypomobility

Patients must meet all the following criteria for the indication above:

  • Adjunctive treatment for patients with advanced Parkinson’s Disease experiencing acute hypomobility secondary to end-of-dose wearing off  episodes or unpredictable off  episodes
  • Prescribed or recommended by a neurologist
  • Must be on concurrent therapy with: carbidopa-levodopa (Sinemet ®) at the maximum tolerated dose and a second agent such as a MAO-B inhibitor, Dopamine Agonist or COMT inhibitor
  • Concurrent therapy with trimethobenzamide (Tigan) – 3 days prior to initiation and continued for at least 2 months after apomorphine
  • Contraindicated in patients who are currently taking 5HT3 antagonists

The following indications do not meet the criteria for use established by the Western Health Advantage Pharmacy and Therapeutics Committee:

  • Any Indication not listed above

Dosing:

  • Up to 0.6 ml (6 mg) subcutaneously

 

Last review date: December 1, 2014