Apomorfina
Apomorphine
Apomorphine hydrochloride
También conocido como: Apokyn · APO-go · Apofin · Apokinon · Apomine · Britaject · Ixense · Taluvian · Uprima · Apometic · apomorphini hydrochloridum
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Induction of emesis | 0.03 mg/kg IV or 0.04 mg/kg IM (IV route preferred); alternatively a portion of tablet may be crushed in a syringe, dissolved with few drops of water and administered into the conjunctival sac. After sufficient vomiting occurs, rinse conjunctival sac free of unabsorbed apomorphine. | IV/IM/Topical | Once | — | 🌎 NA |
| Induction of emesis | 0.04 mg/kg IV or 0.08 mg/kg IM or SC | IV/IM/SC | Once | — | 🌎 NA |
| Induction of emesis | 0.04 mg/kg IV, 0.07 mg/kg IM, or 0.25 mg/kg into the conjunctival sac | IV/IM/Topical | Once | — | 🌎 NA |
| Induction of emesis | 0.2 mg/kg | SC | single dose | single dose | 🌍 EU |
| Induction of emesis | 20-40 μg/kg | IV | single dose | single dose | 🌍 EU |
- Induction of emesis: IV route preferred.
- Induction of emesis: Authorized dose. Do not repeat if ineffective.
- Induction of emesis: Non-authorized dose and route but some evidence suggests it is at least as effective.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Induction of emesis | 0.04 mg/kg IV or 0.08 mg/kg IM or SC | IV/IM/SC | Once | — | 🌎 NA |
| Induction of emesis | Not recommended | IM | single dose | single dose | 🌍 EU |
- Induction of emesis: Use of apomorphine in cats is controversial and many recommend not using in this species.
- Induction of emesis: Xylazine is a potent emetic in cats and at least as safe.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La apomorfina es un derivado opiáceo sintético, pero a diferencia de la morfina, carece de propiedades analgésicas significativas. Se considera ampliamente como el emético de elección para perros en medicina veterinaria para la eliminación rápida de toxinas ingeridas.
- Acción rápida: Produce emesis muy rápidamente cuando se administra por vía parenteral (IV/IM) o tópicamente en el saco conjuntival.
- Especificidad de especie: Altamente eficaz en perros. Su uso en gatos es controvertido y generalmente no se recomienda debido a una menor eficacia y posibles preocupaciones de seguridad.
- Limitaciones: Como todos los eméticos, generalmente solo elimina del 40-60% (máximo 80%) del contenido estomacal. La inducción exitosa de la emesis no elimina la necesidad de un seguimiento o terapia toxicológica adicional (p. ej., carbón activado).
Mecanismo de acción
Apomorphine acts as a non-selective dopamine agonist.
It directly stimulates D2-dopaminergic receptors in the chemoreceptor trigger zone (CRTZ) located in the area postrema of the medulla oblongata.
Mechanism Pathway: Apomorphine administration → Crosses the blood-brain barrier → Stimulates D2 receptors in the CRTZ → Activates the central vomiting center → Initiates the emetic reflex.
Clinical Pearl: The CRTZ in dogs is highly sensitive to dopamine, making apomorphine highly effective. In contrast, the feline CRTZ is mediated primarily by alpha-2 adrenergic receptors, which is why alpha-2 agonists (like xylazine or dexmedetomidine) are the preferred emetics for cats, while apomorphine is often ineffective.
Seguridad y advertencias
Contraindicaciones
- Rodents and rabbits (unable to vomit or lack stomach wall strength)
- Hypoxia, dyspnea, or shock
- Lack of normal pharyngeal reflexes (risk of aspiration)
- Seizuring, comatose, or severely CNS-depressed patients
- Patients who have already vomited repeatedly
- Ingestion of strong acids, alkalis, or other caustic agents (risk of esophageal/gastric rupture)
- Ingestion of petroleum distillates (unless toxicity risk outweighs aspiration risk)
- Ingestion of strychnine or other CNS stimulants (may precipitate seizures)
- Oral opiate or other CNS depressant (e.g., barbiturates) toxicity
- Hypersensitivity to morphine
Efectos adversos
- Protracted vomiting
- CNS depression (lethargy, sedation)
- CNS stimulation (excitement, restlessness)
- Respiratory depression
- Corneal ulcers (anecdotal, associated with conjunctival administration)
Precauciones
If vomiting does not occur within the expected time after apomorphine administration, repeated doses are unlikely to induce emesis and may cause clinical signs of toxicity. Use with extreme caution, if at all, in cats. When using the conjunctival route, the eye must be thoroughly rinsed with sterile saline after emesis is achieved to prevent protracted vomiting and potential corneal irritation.
Interacciones farmacológicas
May negate the emetic effects of apomorphine by blocking dopamine receptors in the CRTZ.
May cause severe hypotension; concurrent use is contraindicated in humans.
Additive CNS or respiratory depression may occur.
May reduce the emetic effects of apomorphine
Additive CNS or respiratory depression
Monitorización
- CNS status (depression or excitement)
- Respiratory rate and effort
- Heart rate and rhythm
- Vomitus (quantify volume, examine for toxic contents, and save for possible later analysis)
Farmacocinética
Absorción
Slowly absorbed after oral administration with unpredictable efficacy. Rapidly absorbed after IM administration (vomiting generally within 5 minutes). Topical administration to the conjunctival sac is usually effective but less so than IV or IM.
Distribución
Readily crosses the blood-brain barrier to access the chemoreceptor trigger zone.
Metabolismo
Primarily conjugated in the liver.
Eliminación
Excreted in the urine.
Sobredosis
Excessive doses of apomorphine may result in:
- Respiratory and/or cardiac depression
- CNS stimulation (excitement, seizures) or severe CNS depression
- Protracted vomiting
Treatment:
- Naloxone may reverse the CNS and respiratory depressant effects of the drug, but it cannot be expected to halt the vomiting.
- Atropine has been suggested to treat severe bradycardias associated with overdose.
- If protracted vomiting occurs from conjunctival administration, thoroughly flush the eye with sterile saline.
Productos disponibles
Formulaciones
- Injection
- Soluble tablets (often used for conjunctival administration or compounding)
Veterinario
- Pharmaceutical dosage forms of apomorphine have been occasionally difficult to obtain; compounding pharmacies may be required to obtain the drug.
Etiquetado para humanos
- Apomorphine HCl Injection: 10 mg/mL in 2 mL amps and 3 mL cartridges (Apokyn)
Estado regulador
POM-V
POM-V
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store soluble tablets in tight containers at room temperature (15-30°C) and protect from light. Upon exposure to light and air, apomorphine gradually darkens in color. Do not use discolored tablets or solutions (green to turquoise). Solutions are more stable in acidic than in alkaline environments. Compounded sterile solutions (with sodium metabisulfite) can retain potency for two months at 25°C if protected from light. Do not autoclave solutions, as this causes a green discoloration.
Información para el cliente
La apomorfina es un medicamento de acción rápida utilizado exclusivamente en un entorno veterinario supervisado profesionalmente para inducir el vómito después de que una mascota haya ingerido una sustancia potencialmente peligrosa.
- Qué esperar: Es probable que su perro vomite a los pocos minutos de recibir el medicamento.
- Cuidados posteriores: Una vez que el estómago se vacía, su mascota puede experimentar algo de náuseas persistentes, somnolencia o letargo.
- Importante: Inducir el vómito es solo el primer paso en el tratamiento de una intoxicación. Su veterinario puede recomendar tratamientos adicionales, como carbón activado o fluidos IV, dependiendo de lo que haya ingerido su mascota.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.