Key takeaways

  • Onapgo is a wearable infusion system approved by the FDA to treat motor fluctuations in adults with advanced Parkinson’s disease.
  • The device provides a continuous dose starting at 1 milligram (mg) per hour, with a maximum of 6 mg per hour for up to 16 hours per day. You can also receive up to 3 extra doses daily if needed, with at least 3 hours between doses.
  • Common side effects include infusion site reactions (such as nodules and skin discoloration), nausea, sleepiness, dyskinesia (involuntary movements), and headache.

Here are a few quick facts about Onapgo:

  • active ingredient: apomorphine hydrochloride
  • generic available?: no
  • class of medication: dopaminergic agonist
  • prescription needed?: yes
  • approved: 2025

Onapgo is approved by the Food and Drug Administration (FDA) to treat motor fluctuations in adults with advanced Parkinson’s disease.

Parkinson’s disease is a neurological condition that affects movement due to a decrease in dopamine production in the brain. The four major motor problems seen in Parkinson’s disease are:

  • problems with balance and a tendency to fall
  • stiffness of arms, legs, and trunk
  • slow movements
  • tremor (shaking that occurs at rest)

More common side effects of Onapgo include:

  • infusion site reactions, including nodules and skin discoloration
  • nausea
  • sleepiness
  • dyskinesia (involuntary, uncontrollable movements)
  • headache
  • trouble sleeping

Other possible side effects of Onapgo include:

Most side effects may be temporary or easily managed. Some side effects may be bothersome or not go away. In those cases, talk with your doctor for recommendations on how best to manage these side effects.

If you experience serious or life threatening side effects, call 911 or your local emergency number right away.

Note: These lists may not include all side effects of Onapgo. Refer to the drug’s prescribing information for details about side effects.

Experiencing side effects? After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while taking this drug and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

Onapgo is given as a continuous dose throughout waking hours. You can also receive extra doses of Onapgo if needed.

The recommended initial continuous dosage of Onapgo is 1 milligram (mg) per hour (hr). The maximum continuous dosage is 6 mg/hr for up to 16 hours per day.

If people need an extra dose during the day, the first extra dose will be 0.5 mg. Additional doses range from 0.1 mg to 1 mg based on someone’s response to the drug and what they are able to tolerate. The maximum extra dose is 2 mg.

Extra doses should be given at least 3 hours apart. There is also a maximum of 3 extra doses per day.

The maximum recommended total daily dosage of Onapgo, including the continuous dosage and any extra dose(s), is 98 mg, generally administered over the waking day (about 16 hours).

How it’s given

Onapgo is available in single-dose cartridges in one strength: 98 mg/20 milliliters (mL). It is given as a subcutaneous infusion using a wearable, portable device.

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The cost of Onapgo may vary depending on your location, the pharmacy you use, and your insurance coverage.

The manufacturer of Onapgo offers a program called Circle of Care that may be able to help with the cost of the medication.

Below is safety information to consider before starting treatment with Onapgo.

Interactions

Onapgo is reported to interact with certain medications, including:

  • high blood pressure medications and vasodilators
  • dopamine antagonists, such as neuroleptics or metoclopramide

This is not a full list of possible interactions with Onapgo. Talk with your doctor or pharmacist about all the medications, including prescription and over-the-counter, as well as supplements, you take.

Quick tip: Create a medication list to share with your doctor and pharmacist. This can help prevent interactions.

Warnings

It may not be safe to receive Onapgo if you have certain health conditions or take certain medications. Examples include:

  • if you take 5HT3 antagonists, such as ondansetron, granisetron, dolasetron, palonosetron, and alosetron
  • having a previous allergic reaction to Onapgo or its ingredients, such as sulfite
  • if you have a history of dyskinesia
  • if you have a history of heart problems
  • if you have a history of falls
  • pregnancy
  • breastfeeding

Your doctor may prescribe Onapgo to help with motor fluctuations associated with Parkinson’s disease. It is a wearable pump that provides a continuous infusion throughout the day.

If you have questions about whether Onapgo is right for you, talk with your doctor.

Disclaimer: While Healthline strives for factual, comprehensive, and current information, this article is not a substitute for a licensed healthcare professional’s expertise. Always consult a doctor before taking or discontinuing any medication. Drug information is subject to change and may not cover all uses, directions, precautions, warnings, interactions, reactions, or adverse effects. The lack of a warning does not guarantee a drug’s safety, effectiveness, or appropriateness for all patients or specific uses. Learn more about our approach to content integrity.