About
In February 2025, the U.S. Food and Drug Administration (FDA) approved Onapgo (apomorphine hydrochloride), an under-the-skin device that delivers continuous infusion of apomorphine for the treatment of “off” time and motor fluctuations, or ups and downs in symptom control, throughout the day in people with progressing Parkinson’s disease (PD).
Apomorphine is a dopamine agonist, which means that it looks and acts like dopamine, the brain chemical that is lost in Parkinson’s and affects the body’s ability to control movement.
Pros
Because Onapgo is delivered continuously through an under-the-skin infusion, the medication bypasses the gastrointestinal track and directly enters the brain, stimulating dopamine receptors — potentially leading to more predictable symptom improvement.
Researchers evaluated Onapgo in the Phase III TOLEDO clinical trial. In this study, investigators examined under-the-skin apomorphine infusion in a group of 107 people with PD who had inadequate control over their motor fluctuations. People in the treatment group experienced a nearly two-hour reduction in “off” time, which was also associated with a reduced need for simultaneous oral antiparkinsonian medications.
The manufacturer of Onapgo, Supernus Pharmaceuticals, also offers an injectable form of apomorphine for PD (Apokyn). Injectable apomorphine can be used to manage sudden symptoms of “off” times. Infused apomorphine — already available in several other countries — provides regular, ongoing symptom management.
Cons and Complications
Common potential side effects of Onpago include headache, insomnia, nausea, daytime sleepiness, dizziness, dyskinesia, and bruising, redness, or nodules at the needle infusion site.