Apomorphine HCl

What is this medication for?

• Induction of emesis after toxic ingestion — emetic of choice in dogs for many clinicians
• Sometimes used, but less effective and possibly less safe — xylazine historically preferred

How is it given?

Give exactly as your veterinarian prescribed — never change the dose or stop on your own unless your veterinarian has told you to.

• Always rinse the eye after conjunctival dosing to stop further absorption and prevent corneal irritation.

What if I miss a dose?

• Give it as soon as you remember — unless it is almost time for the next dose (then skip the missed one; never double up).
• Call your clinic if you miss more than one dose in a row.

Side effects — what should I watch for?

Effects listed as common in this handout

• Protracted vomiting (Principal effect at usual doses)

Worth a phone call to your veterinarian

• Sedation at high doses (≥0.1 mg/kg) (Can mask signs of the ingested toxicant)
• Conjunctival irritation (pH 3–4), anecdotal corneal ulcers (Ocular route)

⚠️ Contact your veterinarian or an emergency clinic IMMEDIATELY if you notice

• CNS/respiratory depression, excitement, seizures (Overdose)

Before starting (or refilling), tell your veterinarian if your pet:

• has or has had: Rodents/rabbits (cannot vomit / weak stomach walls); coma, seizure, severe CNS depression, lacking pharyngeal reflexes, shock, trouble breathing/hypoxia, extreme weakness
• has or has had: Prior repeated vomiting; ingestion of caustics (acids/alkalis) or petroleum distillates (aspiration risk, unless toxin risk outweighs); strychnine/CNS-stimulant ingestion (may precipitate seizures); opiate/CNS-depressant ingestion; morphine hypersensitivity
• has or has had: If the first dose fails, do not repeat — subsequent doses may be anti-emetic (vomiting-center depression) and toxic. Cats sensitive to opiates — use caution; xylazine is the more reliable feline emetic

• is pregnant, nursing, or used for breeding
• is taking any other medications, supplements, or flea/tick products, including:
  • Phenothiazines (acepromazine), atropine, antiemetics
  • Ondansetron
  • Opiates/other CNS depressants

Storage and handling

Room temperature, tightly sealed container. Injection 10 mg/mL (Apokyn). 6 mg tablets dissolved extemporaneously for conjunctival use.

Good to know

• Naloxone reverses apomorphine's CNS and respiratory depression but NOT the vomiting. Atropine for severe unusually slow heart rate.
• In dogs, 3% hydrogen peroxide 2.2 mL/kg by mouth (max ~50 mL) is an equally effective, cheaper alternative when the patient is alert — apomorphine remains preferred when rapid/deeper induction is needed.
• Always rinse the eye after conjunctival dosing to stop further absorption and prevent corneal irritation.
• One-and-done: repeated dosing is ineffective and dangerous (see warning above).