Most patients will experience off episodes with disease progression1,2

Compared to patients who do not experience OFF episodes, patients who do experience OFFs are more likely to report3*:

Having difficulty washing and dressing themselves.
  • Having difficulty washing and dressing themselves
Having difficulty getting around in public.
  • Having difficulty getting around in public
Having problems getting around the house.
  • Having problems getting around the house
Having difficulty speaking and communicating with other people.
  • Having difficulty speaking and communicating with other people
  • Having difficulty washing and dressing themselves
  • Having difficulty getting around in public
  • Having problems getting around the house
  • Having difficulty speaking and communicating with other people

When I'm OFF, almost everything is difficult. Walking is difficult. Exercising, of course, is difficult, and it's difficult for me to do things that require fine motor skills.Eva, living with Parkinson's disease for 16 years

Adding an apomorphine treatment to your patient's carbidopa/levodopa
regimen may help to treat disruptive OFF episodes2,4-6

*As measured by the 39-item Parkinson's Disease Questionnaire.3

Your Patients may experience different OFF episodes during their day7

Morning OFF
Morning Off
When a patient wakes up with OFF symptoms as a result of the wearing OFF of the last oral levodopa dose prior to bedtime.7,8
Additionally, a patient may experience an OFF episode in the morning as a result of a delay or an absence of the effect of the first oral levodopa dose of the day (delayed ON/no ON).7,8
Delayed ON/no ON and Wearing OFF
Delayed On/No On
and Wearing Off
These may recur throughout the day and are the result of an oral levodopa dose having a delayed effect (delayed ON) or no effect (no ON) or if a previous oral levodopa dose is no longer working (wearing OFF).2,7,8
Unpredictable OFF
Unpredictable Off
A random and abrupt transition from ON to OFF that may happen unrelated to the timing of oral levodopa doses.2
Because the beneficial effects of oral levodopa can be delayed, absent, or wear off, adding KYNMOBI® (apomorphine HCl) when needed may help patients get back ON2,4-6,9

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References: 1. Thanvi BR, Lo TCN. Long term motor complications of levodopa: clinical features, mechanisms, and management strategies. Postgrad Med J. 2004;80(946):452-458. 2. Hauser RA, Olanow CW, Dzyngel B, et al. Sublingual apomorphine (APL-130277) for the acute conversion of OFF to ON in Parkinson’s disease. Mov Disord. 2016;31(9):1366-1372. 3. Thach A, Jones E, Pappert E, Pike J, Wright J, Gillespie A. Real-world assessment of the impact of "OFF" episodes on health-related quality of life among patients with Parkinson's disease in the United States. BMC Neurology. 2021;21(46):1-12. 4. Hauser RA, Ellenbogen A, Khanna S, Gupta S, Modi NB. Onset and duration of effect of extended-release carbidopa-levodopa in advanced Parkinson's disease. Neuropsychiatr Dis Treat. 2018;14:839-845. 5. Merims D, Djaldetti R, Melamed E. Waiting for ON: a major problem in patients with Parkinson disease and ON/OFF motor fluctuations. Clin Neuropharmacol. 2003;26(4):196-198. 6. Obering CD, Chen JJ, Swope DM. Update on apomorphine for the rapid treatment of hypomobility ("off") episodes in Parkinson's disease. Pharmacotherapy. 2006;26(6):840-852. 7. Metman LV. Recognition and treatment response fluctuations in Parkinson's disease: review article. Amino Acids. 2002;23:141-145. 8. Chou KL, Stacy M, Simuni T, et al. The spectrum of "off" in Parkinson's disease: what have we learned over 40 years? Parkinsonism Relat Disord. 2018;51:9-16. 9. Kynmobi. Prescribing Information. Sunovion Pharmaceuticals Inc; August 2021.

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