Kynmobi™ (apomorphine HCl sublingual film; Sunovion) is now available for the acute, intermittent treatment of off episodes in patients with Parkinson disease (PD). The treatment was approved in May 2020 based on results from a phase 3 trial that demonstrated significant improvements in motor symptoms.

Apomorphine is believed to treat off episodes associated with PD through stimulation of postsynaptic dopamine D2-type receptors within the caudate-putamen in the brain. The product, which is supplied as a sublingual film in 10mg, 15mg, 20mg, 25mg, and 30mg dosage strengths, is designed for use as a fast-acting, on-demand treatment for all types of motor off episodes.

Dose initiation and titration of Kynmobi should occur when the patient is in an off state and in a setting where a healthcare provider can monitor blood pressure and pulse, as syncope and hypotension may occur. As the drug may cause nausea and vomiting, an antiemetic (trimethobenzamide 300mg; 3 times daily) is recommended beginning 3 days prior to the initial dose. The administration of antiemetic drugs other than trimethobenzamide has not been studied and Kynmobi is contraindicated with concomitant use of 5HT3 antagonists. Additionally, oral mucosal irritation may occur with treatment and could require pausing or discontinuing therapy.

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The most common adverse reactions reported with Kynmobi included nausea, oral/pharyngeal soft tissue swelling, oral/pharyngeal soft tissue pain and paraesthesia, dizziness, and somnolence. Additional prescribing information can be found here.

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Sunovion announces the commercial launch of KYNMOBI™ (apomorphine hydrochloride) sublingual film for the treatment of parkinson’s sdisease OFF episodes. Accessed October 5, 2020.