Oral medications containing Levodopa are the most commonly prescribed treatment for Parkinson’s disease and usually work quite well when first given. After some time you may start experiencing decreased "ON" time (when you are feeling your best), and may be having what are known as "off episodes." These off episodes such as tremor, rigidity, slowness and difficulty moving happen when your Parkinson’s symptoms are at their worst. Off episodes can interfere with your everyday work, recreation, or even routine daily activities for a few minutes up to a few hours.

Off episodes are fairly common in Parkinson’s and can happen at any time. They can occur as your Levodopa medications start to wear-off. This can happen first thing in the morning prior to your first dose of Levodopa medications or before it’s time to take your next dose.

Some people experience multiple off episodes every day. APOSAN^® can help people with Parkinson's manage and treat OFF episodes, returning them to an ON state.

A neurologist (specialist) will try to find the treatment that is best for you as per the disease condition. Because the symptoms of Parkinson’s change over time, your medication regime will sometimes have to change as well.

APOSAN^® is usually used in Parkinson’s, as a rescue treatment. Your neurologist will suggest trying APOSAN^® if you:

• Have sudden and unpredictable changes in your symptoms
• Have severe OFF* periods that aren’t controlled by other Parkinson’s medications, or
• Have severe swallowing difficulties that mean you cannot take medication orally

{*'ON/OFF' refers to movement fluctuations, usually caused by Levodopa medication 'wearing off' before the next dose is due. 'ON' is when your symptoms are controlled and when you feel at your most capable. Being 'OFF' is when your Parkinson's symptoms reoccur and affect you the most.}

APOSAN^® is injected subcutaneously, and can be administered as,

• Intermittent injections

Injections can be effective if you have several 'OFF' periods a day. The injection can be repeated several times a day, whenever you need it. You can change where you inject each time.

APOSAN^® is administered through a fine needle inserted into the fatty layer under the skin (a subcutaneous injection). It is not an injection given into a vein (intravenously).

• Continuous infusions

APOSAN^® infusion can be given over a period of several hours.

If you have so many 'OFF' periods that you need more than 7 to 10 APOSAN^® injections a day, you may be hospitalized and APOSAN^® infusion can be given.

The syringe has a fine needle that will be inserted under your skin, either in your lower stomach or on the outside of your thighs. This can be secured with some clear dressing to hold it in place.

APOSAN^® should normally run for waking hours, however If you have severe symptoms at night-time then it may be left in place for 24 hours.

APOSAN^® can rapidly stop OFF episodes after it is administered. APOSAN^® starts working as early as 4 to 10 minutes after injection; most people get relief from their OFF symptoms within 20 minutes. The Effect of APOSAN^® lasts usually for 60-90 minutes. So it’s important that you continue to take your usual Parkinson’s Medications as directed by Doctor. Since APOSAN^® bypasses stomach, you need not worry about your meal time. APOSAN^® will work just as effectively at any time of the day.

The choice will depend on your symptoms, disease severity, how often you need to take Apomorphine, your lifestyle and whether you have anyone to help you if you need it. Hope team and your neurologist can best guide you on that front.

Yes. Because APOSAN^® has to be taken by injection, you and your caregiver (if you have one) will learn how to do this. Ideally, Apomorphine will be started in hospital, under the guidance of a Neurologist and nurses. This may mean you will have to stay in hospital for a few days to be trained, or you may be trained at home.

Rusan Pharma's Hope program offers you an ongoing and comprehensive support regarding the use of the product from the point you are prescribed with APOSAN^®.

• APOSAN^® Injections can act as a rescue treatment for Parkinson's
• APOSAN^® works within 4 to 10 minutes, much faster than oral medications
• APOSAN^® is very useful to treat a sudden OFF period and keep you ON
• The effects generally last for 60 to 90 minutes
• APOSAN^® improves your Quality of Life:

  -By helping you continue your day to day activities
  -Improving the night time sleep problems from insomnia and hypersomnia to Rapid Eye Movement (REM).

• With APOSAN^® continuous infusion over several months, you can significantly reduce the number of "OFF" periods
• Non-Narcotic | Non-Addictive | Non-Morphine

Cardiac problems APOSAN^® may affect your underlying heart problem. APOSAN^® can cause your blood pressure to drop slightly. If you feel dizzy, you may need to check your blood pressure with your GP/Neurologist/Nurse.

Sleeping problems APOSAN^® can make some people feel sleepy or experience sudden onset of sleep.

Injection sites can become sore and irritated Lumps (nodules) may appear under the skin where the needle is inserted, You can prevent them by making sure the place where the needle is inserted is clean, changing the injection site every day and gently rubbing your skin once you’ve taken the needle out.

Some people experience an itchy or sore reaction at the injection site, but this is rare. If this does happen, speak to your neurologist/nurse.

Hallucinations and delusions Speak to your GP, specialist or nurse about any hallucinations or delusions that you or the person you care for are experiencing.

Impulsive and compulsive behaviour Some people who take Dopamine agonists, including Apomorphine, may experience impulsive and compulsive behaviour.