Comparative Pharmacology
Head-to-head clinical analysis: APOKYN versus NEUPRO.
Peer-Reviewed Evidence
Head-to-head clinical analysis: APOKYN versus NEUPRO.
APOKYN vs NEUPRO
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Apomorphine is a non-ergoline dopamine agonist that stimulates dopamine D2 and D1 receptors. It also activates D3, D4, and D5 receptors and has some serotonergic and adrenergic activity.
Rotigotine is a non-ergoline dopamine agonist with high affinity for dopamine D1, D2, D3, D4, and D5 receptors; also binds to serotonin 5-HT1A and alpha2-adrenergic receptors.
Subcutaneous injection: 0.2 mL (2 mg) as a test dose, then 0.1-0.6 mL (1-6 mg) as needed for episodes of hypomobility; maximum single dose: 0.6 mL (6 mg); maximum daily dose: 2.0 mL (20 mg).
Apply transdermally once daily; initial dose 2 mg/24h, titrated weekly by 2 mg/24h up to 6 mg/24h, maximum 8 mg/24h.
None Documented
None Documented
Terminal elimination half-life approximately 30–60 minutes (range 0.5–1 hour); clinically, rapid clearance necessitates continuous or frequent dosing for sustained effect
Single dose: 5-7 hours (transdermal); steady state: 7-10 hours; effective half-life for dosing is 8 hours due to reservoir in skin
Renal (approx. 90% as metabolites and unchanged drug; <5% unchanged in urine); biliary/fecal (minor, <10%)
Renal: 45% (metabolites), Fecal: 40% (metabolites), Biliary: 15%
Category C
Category C
Dopamine Agonist
Dopamine Agonist