Comparative Pharmacology
Head-to-head clinical analysis: APOKYN versus PERMAX.
Peer-Reviewed Evidence
Head-to-head clinical analysis: APOKYN versus PERMAX.
APOKYN vs PERMAX
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.
Dopamine D1/D2 receptor agonist; also activates α2-adrenergic and serotonin receptors, reducing prolactin secretion.
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).
Initial: 0.05 mg orally once daily; titrate by 0.05-0.1 mg/day every 2-3 days; usual therapeutic dose: 0.1-0.5 mg three times daily; maximum: 1.5 mg three times daily.
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
Terminal elimination half-life: 27 hours (range 24-30 hours) in healthy adults; significantly prolonged in renal impairment (up to 100+ hours in ESRD), requiring dose adjustment.
Renal (approx. 90% as metabolites and unchanged drug; <5% unchanged in urine); biliary/fecal (minor, <10%)
Renal: ~50% unchanged drug; biliary/fecal: ~40% as metabolites and parent drug; total clearance approximates hepatic blood flow.
Category C
Category C
Dopamine Agonist
Dopamine Agonist