In the titration phase, patients (N=141) arrived at the study site in an “off” state having not taken their regular morning dose of carbidopa/levodopa or any other adjunctive PD medications, as well as having taken their last dose of carbidopa/levodopa and any other adjunctive PD medications no later than midnight the night before. Other effects may include excitement or lethargy, prolonged nausea, compromised muscle coordination and reduced respiratory rate. Other effects may include excitement or lethargy, prolonged nausea, compromised muscle coordination and reduced respiratory rate. An KYNMOBI may affect the way other medicines work, and other medicines can affect how KYNMOBI works.Taking KYNMOBI with other medicines may cause serious side effects.Know the medicines you take. The titration process was continued up to a maximum KYNMOBI dose of 35 mg or until a full “on” was achieved as determined by the investigator and the patient [see The primary endpoint of the study was the mean change from pre dose to 30 minutes post dose in the MDS-UPDRS III at the 12-week visit of the maintenance phase.A total of 54 patients were randomized to KYNMOBI and 55 patients to placebo. This Patient Information does not take the place of talking to your healthcare provider about your medical condition or treatment.KYNMOBI is a prescription medicine used to treat short-term (acute), intermittent “off” episodes in people with Parkinson’s disease (PD).It is not known if KYNMOBI is safe and effective in children.KYNMOBI also contains a sulfite called sodium metabisulfite. Dose initiation should occur when the patient is in an “off” state and in a setting where a healthcare provider can monitor blood pressure and pulse. Visit the Copyright © 2020 by RxList Inc. RxList does not provide medical advice, diagnosis or treatment.
Inform patients with a sulfite sensitivity that KYNMOBI contains sodium metabisulfite, a sulfite that may cause allergic-type reactions, including anaphylactic symptoms and life-threatening or less severe asthmatic episodes [see Advise patients that they may develop postural (orthostatic) hypotension with or without symptoms, such as dizziness, nausea, syncope, and sweating. Push in both tabs to unlock.Push finger up through the hole in the bottom of tray. Treatment with the antiemetic should only be continued as long as necessary to control nausea and vomiting, and generally no longer than two months after initiation of treatment with KYNMOBI [see Based on reports of profound hypotension and loss of consciousness when apomorphine was administered with ondansetron, the concomitant use of apomorphine with drugs of the 5HT3 antagonist class including antiemetics (for example, ondansetron, granisetron, dolasetron, palonosetron) and alosetron are contraindicated [see The dose range for KYNMOBI is 10 mg to 30 mg per dose, administered sublingually, as needed, for the acute, intermittent treatment of “off” episodes.Doses should be separated by at least 2 hours.
In clinical studies, 4% of patients receiving this drug experienced angina, myocardial infarction, cardiac arrest and/or sudden death. Sulfite sensitivity is seen more frequently in asthmatic than in non-asthmatic people.KYNMOBI may cause syncope, hypotension, or orthostatic hypotension. It is always best to bring your dog to the veterinary clinic where he can be thoroughly assessed for signs of toxicity. No patient developed hallucinations or psychotic-like behavior during the titration phase.A total of 4% of patients treated with KYNMOBI discontinued treatment because of disorientation, confusional state, or delusions, compared with 2% of patients who received placebo.Postmarketing reports with subcutaneous apomorphine indicate that patients may experience new or worsening mental status and behavioral changes, which may be severe, including psychotic-like behavior after starting or increasing the dose of apomorphine.
Apomorphine is used to induce vomiting in dogs. This finding is of questionable significance because the endocrine mechanisms believed to be involved in the production of Leydig cell tumors in rats are not relevant to humans. Physicians should consider dose reduction or stopping the medication if a patient develops such urges while taking KYNMOBI.A symptom complex resembling the neuroleptic malignant syndrome (characterized by elevated temperature, muscular rigidity, altered consciousness, elevated serum creatine kinase, and autonomic instability), with no other obvious etiology, has been reported in association with rapid dose reduction, withdrawal of, or changes in antiparkinsonian therapy.At exposures achieved with therapeutic doses of subcutaneous apomorphine, a dose-related prolongation of QTc has been observed [see Drugs that prolong the QTc interval have been associated with torsades de pointes and sudden death. Veterinarians have several options in their drug cabinets to make this happen. Sharp objects, such as bones, pins or shards of hard plastic, can perforate tissues along the way if vomited. Because of possible additive effects of alcohol use, advise patients to limit their alcohol intake [see Advise patients that hypersensitivity/allergic reaction (e.g., swelling of the lips, tongue and mouth, flushing, and, infrequently, urticaria and throat tightness) may occur because of apomorphine, sodium metabisulfite, or any KYNMOBI excipients.
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