Frequently Asked Questions

What is Parkinson's disease?

Parkinson's disease is a progressive nervous system disorder that affects movement. Symptoms start gradually, sometimes starting with a barely noticeable tremor in just one hand. Tremors are common, but the disorder also commonly causes stiffness or slowing of movement.

In the early stages of Parkinson's disease, your face may show little or no expression. Your arms may not swing when you walk. Your speech may become soft or slurred. Parkinson's disease symptoms worsen as your condition progresses over time.

Although Parkinson's disease can't be cured, medications might significantly improve your symptoms.

What are motor and non-motor symptoms of Parkinson’s?

Motor symptoms of Parkinson’s include,

  • Tremor – shaking of the hands, arms, or legs, especially when the limb is at rest
  • Rigidity – an abnormal stiffness in a limb or part of the body
  • Postural instability – impaired balance or difficulty standing or walking
  • Bradykinesia – gradual loss and slowing down of spontaneous movement

Parkinson’s is highly variable, and not every patient with Parkinson’s will experience all the symptoms. Different patients will have different combinations of symptoms as well as severity of symptoms, and each case of Parkinson’s progresses on an individual level.

Non-Motor symptoms of Parkinson's

There are many non-motor symptoms that people with Parkinson's experience, such as depression, difficulty swallowing or chewing, urinary problems, constipation, skin problems, sleep problems, pain, and cognitive problems, such as memory problems or slow thinking.

What is APOSAN®?

APOSAN® (Apomorphine) is a strong type of Dopamine agonist. Dopamine agonist drugs act like Dopamine to stimulate nerve cells. These nerve cells then control movement and other body functions, to help reduce the symptoms of Parkinson’s. Despite its name, Apomorphine does not contain Morphine.

Most other Dopamine agonists are taken as tablets, whereas APOSAN® is given by injection or continuous infusion. Continuous infusion is when medication is delivered, via mini pump at hospital.

APOSAN® is the only brand available in India which contains Apomorphine for treatment of Parkinson's patients. APOSAN® is available in 2ml and 5ml ampoules that makes it a convenient choice for home based and hospitalized PD patients.

What are off episodes and what causes them?

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.

When is APOSAN® prescribed?

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.}

How is APOSAN® administered?

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.

How quickly does APOSAN® WORK?

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.

Is APOSAN® injection or infusion right for me?

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.

Will I be trained how to use APOSAN®?

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®.


Nursing Services:

Rusan Pharma has arranged a nursing support team for Parkinson’s patients in India. The nursing team will provide home visits and supportive phone calls to help you get started on APOSAN®. They will train you on safe and effective administration of APOSAN®.


Aposan Hope Program Coordinators:

In addition to your Hope nurse, each patient is assigned a Hope coordinator. Our coordinators will provide help such as understanding your therapy cost, aligning delivery of medication and locating financial assistance programs if you need help affording APOSAN®.


Home Delivery of Medication:

You can either order APOSAN® online or over the phone with your Hope coordinator after uploading a valid prescription. The Hope coordinator will also help identifying a pharmacy near you where you can purchase APOSAN®.

What are the advantages of 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
How may APOSAN® affect other medications I take?

In general, Apomorphine does not affect other drugs that are used to treat Parkinson’s. However, when you start taking Apomorphine, your neurologist may reduce some of your other treatments, as they may no longer be needed.

What are the Side-Effect of APOSAN®?

It is important to involve a partner, close friend or relative who can give injections if you can’t move well enough to do it yourself.

Nausea, vomiting and hypotension Apomorphine can cause severe short-term nausea and sickness, so you may also be given an anti-sickness drug called Domperidone.

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.

Aposan has helped many more to get them On. We would love to hear your story.

Upload Now