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When Parkinson's
disease (PD) symptoms
reappear or worsen,
you may feel limited

Don't let your PD symptoms force you to sideline yourself

If you're taking carbidopa/levodopa to manage your PD, you may notice that it's not working consistently over time.

Sometimes your symptoms reappear or worsen between doses. These times are known as OFF episodes.

Physical symptoms icon

Physical symptoms
of OFF episodes

  • Freezing
  • Tremor
  • Difficulty walking
  • Balance issues
  • Trouble speaking
  • Stiffness

When describing OFF episodes, some people may say they feel like they “run out of gas,” others may complain about feeling “frozen or locked up…like a statue.”

“When I have an OFF time, I tend to get tense. I get speech impairment, where I don’t enunciate clearly. … I even sound like I’m a bit drunk.”

—John, living with PD for 5 years

“My toes start to curl. My legs get stiff and I start to lose my center of gravity.”

—Lisa, living with PD for 12 years

Can you relate?
If so, you may be experiencing OFF episodes

As many as 50% of people with PD experience OFF
symptoms after 5 years of carbidopa/levodopa treatment

As many as


of people with PD experience OFF symptoms after 5 years of carbidopa/levodopa treatment

About 70% of patients will experience OFF symptoms after 9
years of treatment



of patients will experience OFF symptoms after 9 years of treatment

The difference between being OFF and being ON

Light bulb turned off icon

Being OFF:
Your PD symptoms come back or worsen, despite taking your carbidopa/levodopa as prescribed

Light bulb turned on icon

Being ON:
Your PD symptoms are improved by your carbidopa/levodopa

Everyone experiences different types of OFF episodes

Alarm clock with the word 'OFF' on it

Morning OFF
After waking up and your first dose of carbidopa/levodopa hasn't taken effect yet

Bar chart that is going down from left to right

Wearing OFF
The impact of carbidopa/levodopa wears off before it's time for the next dose

A clock with the exterior resembling a loading symbol

Delayed ON
After taking carbidopa/levodopa, but it's taking longer than expected to take effect

Arrows that are intersecting and separating from one another

Unpredictable OFF
PD symptoms return unexpectedly with no relationship to the dosing schedule

A woman in a green dress looks at the camera

Hear Lisa describe her symptoms and her experience with OFF episodes before starting KYNMOBI.

Discover more

Click Here


Do not take KYNMOBI if you are taking certain medicines to treat nausea called 5HT3 antagonists, including ondansetron, granisetron, dolasetron, palonosetron, and alosetron. People taking ondansetron together with apomorphine, the active ingredient in KYNMOBI, have had very low blood pressure and lost consciousness or "blacked out."

Do not use KYNMOBI if you are allergic to apomorphine hydrochloride or to any of the ingredients in KYNMOBI. KYNMOBI also contains a sulfite called sodium metabisulfite. Sulfites can cause severe, life‐threatening allergic reactions in some people. An allergy to sulfites is not the same as an allergy to sulfa. People with asthma are more likely to be allergic to sulfites. Call your healthcare provider if you have hives, itching, rash, swelling of the lips, tongue and mouth, redness of your face (flushing), throat tightness, trouble breathing or swallowing.

Before starting KYNMOBI, tell your healthcare provider:

About all of your medical conditions, including if you:

  • have difficulty staying awake during the daytime
  • have liver problems
  • have dizziness
  • have kidney problems
  • have fainting spells
  • have heart problems
  • have low blood pressure
  • have had a stroke or other brain problems
  • have asthma
  • have a mental problem called a major psychotic disorder
  • are allergic to any medicines containing sulfites
  • drink alcohol
  • are pregnant or plan to become pregnant. It is not known if KYNMOBI will harm your unborn baby.
  • are breastfeeding or plan to breastfeed. It is not known if KYNMOBI passes into your breast milk. You and your healthcare provider should decide if you will take KYNMOBI or breastfeed.

Tell your healthcare provider about all the medicines you take, including:

  • prescription medicines
  • over-the-counter medicines
  • vitamins
  • herbal supplements

KYNMOBI may affect the way other medicines work, and other medicines can affect how KYNMOBI works. Taking KYNMOBI with other medicines may cause serious side effects.
If you take nitroglycerin under your tongue (sublingual) while using KYNMOBI, your blood pressure may decrease and cause dizziness. You should lie down before and after taking sublingual nitroglycerin.

KYNMOBI can cause serious side effects, including:

  • nausea and vomiting. Nausea is a common side effect of KYNMOBI. Nausea and vomiting can happen with KYNMOBI. Your healthcare provider may prescribe a medicine called trimethobenzamide, an antiemetic, to help decrease nausea and vomiting, either before starting or during treatment with KYNMOBI. Follow your healthcare provider’s instructions on how to take and when to stop taking trimethobenzamide.
  • sleepiness or falling asleep during the day. Sleepiness is a serious, and common side effect of KYNMOBI. Some people treated with KYNMOBI may get sleepy during the day or fall asleep without warning while doing everyday activities such as talking, eating, or driving a car.
  • dizziness. Dizziness is a serious, and common side effect of KYNMOBI. KYNMOBI may lower blood pressure and cause dizziness. Dizziness can happen when KYNMOBI treatment is started or when the KYNMOBI dose is increased. Do not get up too fast from sitting or after lying down, especially if you have been sitting or lying down for a long period of time.
  • mouth (oral) irritation. Mouth (oral) irritation is a common side effect of KYNMOBI. You should call your healthcare provider if you develop any of these signs or symptoms:
    • redness
    • mouth sores (ulceration)
    • dryness of the mouth, lips or tongue
    • swelling
    • pain
    • pain with swallowing
  • falls. The changes that can happen with PD, and the effects of some PD medicines, can increase the risk of falling. KYNMOBI may also increase your risk of falling.
  • hallucinations or psychotic-like behavior. KYNMOBI may cause or make psychotic-like behavior worse including hallucinations (seeing or hearing things that are not real), confusion, excessive suspicion, aggressive behavior, agitation, delusional beliefs (believing things that are not real), and disorganized thinking.
  • low red blood cells (hemolytic anemia). Tell your healthcare provider if you have any of the following signs or symptoms:
    • you become pale
    • skin or eyes look yellow
    • chest pain
    • dizziness
    • fever
    • dark-colored urine
    • fast heartbeat
    • feel more tired or weaker than usual
    • shortness of breath or trouble breathing
    • confusion
  • strong (intense) urges. Some people with PD have reported new or strong uncontrollable urges to gamble, increased sexual urges, increased urges to spend money (compulsive shopping), and other intense urges, while taking PD medicines, including KYNMOBI. If you or your family members notice that you have strong urges, talk to your healthcare provider. The strong urges may go away if your KYNMOBI dose is lowered or stopped.
  • high fever and confusion. KYNMOBI may cause a problem that can happen in people who suddenly lower their dose, stop using, or change their dose of KYNMOBI. Symptoms include:
    • very high fever
    • confusion
    • stiff muscles
    • changes in breathing and heartbeat

    Do not stop taking KYNMOBI or change your dose unless you are told to do so by your healthcare provider.

  • heart problems. If you have shortness of breath, fast heartbeat, chest pain, or feel like you are going to pass out (faint) while taking KYNMOBI, call your healthcare provider or get emergency help right away.
  • tissue changes (fibrotic complications). Some people have had changes in the tissues of their pelvis, lungs, and heart valves when taking medicines called nonergot derived dopamine agonists like KYNMOBI.
  • prolonged painful erections (priapism). KYNMOBI may cause prolonged, painful erections in some people. If you have a prolonged and painful erection, you should call your healthcare provider or go to the nearest hospital emergency room right away.

The most common side effects of KYNMOBI include:

  • nausea
  • dizziness
  • sleepiness
  • mouth swelling, pain, or sores


KYNMOBI® (apomorphine HCl) sublingual film is a prescription medicine used to treat short-term (acute), intermittent “off” episodes in people with Parkinson’s disease (PD).

You are encouraged to report negative side effects of prescription drugs to the FDA.
Visit or call 1-800-FDA-1088.

For more information, please see the KYNMOBI Patient Information, full Prescribing Information, and Instructions for Use.