The wrap-up is designed to provide you with information about medicines that have been listed on the PBS for which full NPS RADAR reviews or brief items are not available.
October 2020 sees an extension to the listing of:
See the PBS Schedule for complete details.
Apomorphine solution for injection is now listed on the PBS General Schedule (Section 85) as maintenance therapy for the treatment of Parkinson disease, as Authority Required (Streamlined).2
- 12142C apomorphine hydrochloride hemihydrate 100 mg/20 mL injection, 5 x 20 mL vials (Apomine Solution for Infusion)
- 12133N apomorphine hydrochloride hemihydrate 30 mg/3 mL injection, 5 x 3 mL cartridges (Apomine Intermittent)*
- 12137T apomorphine hydrochloride hemihydrate 30 mg/3 mL injection, 5 x 3 mL pen devices (Movapo Pen)*
*Note that PBS items apomorphine injection 30 mg/3 mL pen devices and apomorphine injection 30 mg/3 mL cartridges are equivalent for the purposes of substitution by pharmacists at the point of dispensing.2
Existing listings for apomorphine solution prescribed for the treatment of Parkinson disease under the Highly Specialised Drugs Program (Private and Public Hospital) have also been altered to include the addition of new clinical criteria.1,2
What is it?
In the treatment of Parkinson disease, apomorphine is believed to directly stimulate postsynaptic D2 receptors. Stimulation of presynaptic D2 dopamine receptors and antagonism of alpha2 adrenergic receptors may also be important.3,4
Who is it for?
PBS clinical criteria for apomorphine require that patients have:2
- experienced severely disabling motor fluctuations which have not responded to therapy
- commenced treatment in a specialist unit in a hospital setting.
What does the product information say?
Long term specialist supervision of patients taking apomorphine is advised.
For more information see the product information for the relevant apomorphine formulation being considered.
- nausea and vomiting (see above)
- transient sedation
- neuropsychiatric disturbances.
Patients with symptoms and/or a history of serious psychiatric disorders are at increased risk of psychiatric adverse effects such as impulse control disorders from dopamine agonists including apomorphine.3,4,8
Patients who develop impulse control disorders are at increased risk of dopamine agonist withdrawal syndrome with severe symptoms that may include agitation, anxiety, panic attacks, depression and drug craving.8
See the product information for important steps to follow when starting treatment with apomorphine.
See the PBS Summary of Changes for a complete list of all additions, deletions and alterations.
- Pharmaceutical Benefits Scheme. Schedule of Pharmaceutical Benefits: Summary of changes 1 October 2020 (accessed 1 October 2020).
- Pharmaceutical Benefits Scheme. Apomorphine. Canberra: Australian Government Department of Health, 2020 (accessed 1 October 2020).
- Pfizer Australia Pty Ltd. Australian product information: Apomine (apomorphine hydrochloride hemihydrate) solution for infusion. 2019 (accessed 1 October 2020).
- STADA Pharmaceuticals Australia Pty Ltd. Australian Product Information: Movapo Pen (apomorphine hydrochloride hemihydrate) solution for injection. 2020 (accessed 1 October 2020).
- Neurology Expert Group. Therapeutic Guidelines: Neurology version 5. Parkinson disease. West Melbourne: Therapeutic Guidelines Ltd, 2017 (accessed 1 October 2020).
- Carbone F, Djamshidian A, Seppi K, et al. CNS Drugs 2019; 33: 905-18,
- Deleu D, Hanssens Y, Northway MG. Drugs Aging 2004; 21: 687-709.
- Australian Medicines Handbook. Apomorphine. Adelaide: AMH Pty Ltd, 2020 (accessed 1 October 2020).