In May 2020, the U.S. Food and Drug Administration (FDA) approved Kynmobi (apomorphine), an under-the-tongue dissolvable medication to quickly reverse “off” time, when Parkinson’s symptoms return between medication doses. Kynmobi is a dopamine agonist, which mimics dopamine, the brain chemical responsible for normal movement, which decreases in Parkinson’s. Kynmobi is meant to be used as needed for “off” time, up to five times per day, in addition to scheduled Parkinson’s medications.
For those who experience “off” time, it can come on in different ways and with different symptoms. “Off” time can happen suddenly or unexpectedly; gradually, as a wearing off before the next dose is scheduled; or in the morning, before the first dose is taken. For many people, “off” involves movement symptoms, such as tremor, slowness or stiffness. For some, it includes non-movement symptoms, such as anxiety or mental fogginess.
Potential benefits may include quick treatment of “off” time (which might offer a bridge until the next dose of scheduled medication kicks in); the security of knowing a “rescue” is there if needed, which might expand social or exercise opportunities; and others. In clinical trials (which were funded in early stages by The Michael J. Fox Foundation), participants found that Kynmobi significantly decreased movement symptoms within 30 minutes.
Cons and Complications
Possible side effects could include tongue soreness or swelling, nausea, sleepiness or dizziness. This drug also does not replace a person’s daily Parkinson’s medications, but is an add-on, as-needed therapy.