Sexual Health & Vascular

Apomorphine

Non-selective dopamine agonist (high D2/D3 affinity) acting centrally to modulate neural drive and arousal. Unlike PDE5 inhibitors, it targets the central nervous system to initiate response rather than maintaining vascular engorgement.

Indications & Usage

FDA Label Indications

NEUROLOGY
  • ▸ Target: Parkinson's Disease (Advanced).
  • ▸ Condition: Acute intermittent treatment of hypomobility ("off" episodes).

Off-Label / Functional Use

CLINICAL PRACTICE
  • ▸ Target: Men & Women (Central Activation).
  • ▸ Condition: Psychogenic ED, Delayed Ejaculation, Hypoactive Desire (HSDD).

Dosing Protocols

Select administration route to view specific protocols.

SUBLINGUAL TROCHE

GOLD STANDARD
Standard Dosage
2.0 mg Start

Place under tongue. Allow full dissolution (approx 10 mins). Do not swallow saliva immediately.

Titration Strategy

Start with 2.0 mg test dose to assess nausea tolerance. Titrate up to 3.0-4.0 mg if needed at next trial. Doses >4mg significantly increase nausea risk.

Timing & Onset
Onset of Action
20 mins
Peak Effect
45 - 60 mins
Duration
2 Hours
⚠️ Clinical Note

Nausea is the primary dose-limiting side effect. The "Yawn" reflex typically precedes therapeutic onset by 5-10 minutes.

Pharmacokinetics Profile
Estimated plasma concentration over time

Cycling & Safety Limits

The "Pre/60/120" Rule

1

Pre-Medicate (Tigan)

Initiate Trimethobenzamide 300mg TID, 3 days prior to first dose to prevent severe emesis.

2

60 Minute Window

Therapeutic window is short. Activity should be planned 45-60 mins post-dose (SL).

3

120 Min Washout

Wait at least 2 hours between doses to allow receptor reset and prevent accumulation.

Dosing Frequency Based on standard safety profile
Active Pulse Safe Redose Zone
~15%
Yawn Incidence
Transient
Hypotension
Rare
Priapism
CONTRAINDICATION

DO NOT COMBINE with 5HT3 Antagonists (Zofran). Risk of severe hypotension.