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Veterinarian holding a Jack Russell terrier dog with dermatitis

The essentials

  • Apoquel is an allergy medication — Apoquel is a medication used to relieve itchiness and eczema in dogs with airborne environmental allergies.
  • Apoquel treats itching at the cellular level — Unlike steroids and antihistamines, Apoquel works from within to inhibit the chemicals that cause itchy, irritated skin.
  • It’s not for every dog— Apoquel is currently only FDA-approved for dogs over a year of age, and can trigger tumors in dogs with a history of cancer. Consult a vet before starting your dog on Apoquel.

Dogs suffer from allergies just like humans. When dogs are allergic to something in their environment, their skin gets itchy and irritated, leading to painful biting and scratching that puts them at a higher risk of developing skin and ear infections.

To lessen the unwanted effects of airborne allergens, veterinarians prescribe medications like oclacitinib, known conventionally as Apoquel. Apoquel provides fast-acting relief for short-term flare-ups and effective symptom management for long-term allergies.

How does Apoquel work? 

The itchy, irritated skin allergic dogs commonly experience is caused by chemicals called cytokines , which are produced by the body’s cells in response to environmental allergens. Apoquel works by inhibiting a specific cytokine known as Janus kinase, which sends a signal to the brain to trigger itching and inflammation. This controls the cause of the itching at a cellular level before the dog is exposed to potential allergens.

Unlike other allergy medications, Apoquel isn’t an antihistamine or a cortisone-type drug. It proves very effective in treating around 50% of cases, with less potential for unwanted side effects than steroids. Apoquel takes effect four hours after ingestion and provides relief over 24-hour periods.

Benefits of Apoquel for dogs

Apoquel is a top choice among vets for treating airborne allergies and atopic dermatitis in dogs because it controls itching at the source. Other benefits include:

  • Long-term itch relief. While other allergy treatments like corticosteroids can lead to life-threatening conditions like Cushing’s disease, Apoquel hasn’t been shown to have many long-term effects on a dog’s overall health. This means owners can reliably keep their dog on a low dose to control itching over long periods of time. One study found dogs could successfully be treated with Apoquel for up to two years.
  • Allows the skin to heal. Since Apoquel curbs itching before it begins, it breaks the cycle of itching and scratching that normally occurs with airborne allergies and allows your pup’s skin to heal properly.
  • Minimal side effects. As many as 50% of pet owners reported side effects when attempting to treat their dog’s allergic itch with steroids. Studies with Apoquel found that significantly fewer dogs were adversely impacted by the medication, with side effects occurring in just 1 dog out of every 10,000 dogs treated.
  • Can be taken with other drugs. Apoquel is safe for dogs to take in combination with most antibiotics and antifungals, as well as shots and drops for seasonal allergies. The medication can also be safely ingested by dogs with pre-existing conditions, showing no adverse reactions with anti-arthritis drugs, flea, tick, and heartworm preventatives, thyroid supplements, and seizure medications. This is especially useful since some dogs require multiple medications to successfully treat the cause of their itch.

🚨 Ask a vet before giving your dog Apoquel in combination with cortisone-type medications or Atopica (cyclosporine).

Possible side effects of Apoquel 

While Apoquel is known to produce relatively few side effects in dogs, there are still some symptoms to watch for.

Short-term side effects

In some cases, Apoquel can produce mild short-term side effects including vomiting, diarrhea, decreased appetite, and decreased energy (lethargy). These symptoms can often be mitigated by giving your dog Apoquel with food.

Contact your vet if you notice any serious short-term side effects after giving your dog Apoquel, including difficulty breathing, skin, coat, or urine changes, fever, and the formation of new masses on the skin, or changes to existing ones.

Since Apoquel is considered an immunomodulatory drug, it can change how the immune system  normally functions. In some cases this can cause the formation of skin masses. While a pet is on Apoquel, it is important pet owners monitor closely for any appearance of new skin masses. It is also important pets  on Apoquel get regular check ups, at least every 6 months.

Dr. Dwight Alleyne

Long-term side effects

Because Apoquel may increase a dog’s risk of a demodex mite infestation and other skin infections over time, vets usually advise against using the medication to treat itching associated with demodectic mange. If your dog’s itching results from an infection, a medication like Apoquel can make the condition worse.

Apoquel isn’t known to cause cancer, but how it interacts with the immune system may increase the likelihood of benign and cancerous tumors appearing in dogs with a history of cancer.

Correct dosage and administration 

Follow your vet’s instructions and the directions on the label when giving your dog Apoquel. Apoquel tablets are taken orally, with or without food. In many cases, it’s initially prescribed twice daily for 14 days before decreasing to once a day for maintenance. In cases of long-term use,  the goal is to keep the dog on the lowest possible dose without compromising the medication’s effectiveness.

Try giving future doses with food if your dog experiences vomiting or diarrhea after taking Apoquel, and see a professional before continuing treatment.

The typical dosage protocol is twice daily , then it decreases to once daily for maintenance in most dogs as long as they are responding well to the medication. If a dog is to remain on a daily dosage to control their allergies, it is important they have routine lab work done. On average this is done every 6 months but will depend on your veterinarian.

Dr. Dwight Alleyne

🚨 Apoquel isn’t intended for human use. Wash your hands after handling the medication to prevent skin irritation. 

What to do if you miss a dose

It’s usually fine if you accidentally miss an Apoquel dose now and then. Just skip the missed dose and resume the normal dosing schedule at the next appointed time. Avoid skipping too many doses, as it can cause an increase in itching and skin inflammation. Never give your dog a double dose of Apoquel — or any other prescription medication — to make up for a missed one.

Interactions with other medications

Apoquel is considered safe to take with most other medications, but owners should avoid a few combinations. Ask your vet if you’re unsure how two medications will interact before giving them to your dog.

Common drug interactions with Apoquel

Since dogs with an underlying skin infection usually require a secondary form of itch relief in addition to Apoquel, it’s common for vets to prescribe the medication alongside antibiotics and antifungals to treat the root cause of the itching. Most vaccines are also safe in combination with Apoquel.

What to avoid when your dog is on Apoquel

Vets generally advise against taking Apoquel with other immunosuppressive drugs like steroids or cyclosporine, as their interactions have not yet been thoroughly evaluated by the FDA. Similarly, the safety of Apoquel has not been evaluated in pregnant or nursing dogs, and it shouldn’t be given to dogs with a history of cancer.

🚨 Always tell your vet about any drugs or supplements your dog is taking before starting them on Apoquel. 

Cost and accessibility of Apoquel 

Federal law currently restricts Apoquel to veterinary use, which means it’s only available with a doctor’s prescription. Apoquel is most commonly given in the form of 3.6mg, 5.4mg, and 16mg tablets, with each tablet averaging around $2.50. This cost is relatively manageable in the short-term, but in cases of long-term treatment it can run upwards of $900 a year.

Apoquel is significantly more expensive than common antihistamines like hydroxyzine (24 cents a tablet) and corticosteroids like prednisone (18 cents a tablet). However, the cost of Apoquel averages out to the same or less expensive than that of other popular allergy medications like Atopica, which costs $55 to $57 for a 15-capsule pack. The cost of Apoquel can also be reduced (or covered completely) with the help of a quality pet insurance plan.

No one likes dealing with the irritating symptoms of an allergic reaction. If your dog suffers from constant itching, scratching, and biting as the result of airborne allergies, Apoquel may be able to provide them with some relief. Ask your vet about the best treatment for your dog’s itching, and follow the directions on the label to make sure you’re administering the medication in a way that’s safe, comfortable, and effective.

Frequently asked questions

Can Apoquel cause weight gain in dogs?

Some clinical studies have shown weight gain in dogs as a result of JAK inhibitors like Apoquel. However, the degree of weight gain is usually less than that experienced by dogs treated with steroids.

Is it safe for puppies to take Apoquel?

No. Dogs under 12 months of age should not be given Apoquel, as the medication may increase their chances of developing a serious infection.

What does Apoquel do for my dog?

Apoquel or oclacitinib maleate is a prescription allergy medication that alleviates the itching and inflammation dogs experience in response to airborne allergies.

What are the side effects of Apoquel in a dog?

While Apoquel has fewer side effects than other popular allergy medications, there are still some symptoms dog owners should be on the lookout for. These include vomiting, diarrhea, lethargy, and anorexia. Apoquel may also contribute to the formation of new growths in dogs with a history of cancer and may make dogs more susceptible to skin, ear, and urinary tract infections.

Is Apoquel better than Benadryl for dogs?

While Benadryl is a popular antihistamine used to treat allergies in both dogs and humans, Apoquel has been shown to relieve a dog’s itch more effectively. Benadryl also has a higher risk of side effects like lethargy or sedation, especially in higher doses. On the other hand, Apoquel is more expensive than Benadryl, and it’s an immune suppressant drug that leaves dogs more susceptible to contracting certain skin conditions. The best medication ultimately depends on your dog’s specific needs.

Is Apoquel a steroid or antihistamine?

Neither. While steroids and antihistamines are both common allergy medications, Apoquel is a unique class of medication that works by inhibiting the allergic response at a cellular level.