Onapgo (apomorphine): Dosage, side effects, and $0 copay
Onapgo (apomorphine hydrochloride) is a continuous subcutaneous infusion prescribed for advanced Parkinson’s disease with motor fluctuations. It can reduce off time, but it requires monitoring for side effects.
Onapgo is a prescription drug used to treat OFF episodes in adults with advanced Parkinson’s disease. OFF episodes are periods in which your standard treatments (such as levodopa) stop working well and motor fluctuations — such as stiffness, tremors, or moving difficulties — return.
Onapgo is a dopamine agonist, a drug that acts like dopamine in the brain to help control movement. Unlike pills, Onapgo infusions deliver the medication continuously under your skin to provide a steadier level into your system throughout the day.
Onapgo is given as a continuous infusion (a steady drip) using a small, wearable pump. The drug enters your stomach, thigh, or back via a needle placed just under the skin (subcutaneously), bypassing your digestive system.
Infusions are usually given over the course of about 16 hours per day (while you’re awake).
Your doctor will start you on a low dosage — typically 1 milligram (mg) per hour — and increase it slowly over time until your symptoms are well managed. (They likely won’t change your dose more than once per day, as they’ll want to see how your body reacts to a specific amount for at least 24 hours. Reaching your final maintenance dose typically takes 1 to 4 weeks.)
The Onapgo pump can also provide extra doses (called “on demand” or “bolus” doses) which your doctor will set at a specific amount for sudden OFF episodes while the pump is going. Your total daily intake of this medication should not exceed 98 mg.
Note: It’s important that you switch the infusion site (where you insert the needle) and use a new drug cartridge every day.
Onapgo can cause a number of side effects ranging from mild to serious.
Most of the common side effects of Onapgo are mild and can often be managed with the help of your healthcare team.
The following reactions occurred in 10% or more of people receiving Onapgo treatment in the drug’s clinical trials:
While many of Onapgo’s side effects are relatively mild and manageable, this drug can cause serious adverse reactions. These include:
A contraindication is a condition or factor that prevents a doctor from prescribing a certain medication, due to the risk of harm. Onapgo is contraindicated if you:
If you need help paying for this medication, Supernus Pharmaceuticals (the drug’s manufacturer) offers a program called Circle of Care (833-366-2746). This program provides help through a coordinator who will review your benefits, help your doctor with prior authorizations and insurance paperwork, and determine your eligibility for financial assistance.
Private insurance
For people with commercial (private) insurance, Circle of Care offers a copay card that can lower your out-of-pocket cost to as little as $0 per prescription.
For those on Medicare or without insurance, a Circle of Care coordinator can suggest patient assistance programs or refer you to non-profit foundations.
Talk with your doctor or pharmacist if you have questions about Onapgo.
Disclaimer: While Medical News Today strives for factual, comprehensive, and current information, this article is not a substitute for a licensed healthcare professional’s expertise. Always consult a doctor before taking or discontinuing any medication. Drug information is subject to change and may not cover all uses, directions, precautions, warnings, interactions, reactions, or adverse effects. The lack of a warning does not guarantee a drug’s safety, effectiveness, or appropriateness for all patients or specific uses. Learn more about our approach to content integrity.