We are going to give you all the information you forgot to ask your veterinarian when they prescribed Apoquel to your dog! We will let you know how Apoquel for dogs works, when it’s given, how effective it is and the potential side effects to look out for.
Apoquel is a drug that stops the itching sensation caused by dermatitis. In simple terms, apoquel changes how the immune system acts. Vets may prescribe it for both atopic dermatitis and allergic dermatitis – both problems that cause itchy and inflamed skin. The active ingredient in this medication is called oclacitinib. Apoquel is the commercial name of this drug.
What is Apoquel for Dogs?
Apoquel is the commercial name for oclacitinib maleate. The main active ingredient in Apoquel is oclacitinib. As we know, this drug stops itching sensations by changing how the immune system acts. More specifically, when Apoquel enters the bloodstream it blocks particular enzymes called Janus kinases. They’re the real troublemakers when it comes to the itchiness and inflammation associated with atopic dermatitis.
When these enzymes are blocked, the amount of itchiness and inflammation decreases. This can help dogs by stopping them from damaging their skin with repeated itching or rubbing.
Apoquel at a Glance
|What it treats:||Itching and associated inflammation|
|Dosage:||0.5 - 2 tablets, once or twice a day, depending on your dog’s weight.|
|How to get it:||Prescription only, via your veterinarian.|
What is Apoquel Used for Dogs?
Veterinarians prescribe Apoquel to control the itching associated with allergic dermatitis and atopic dermatitis. Dogs with these conditions often have itchy, inflamed skin that can become sore and broken with excessive scratching. When a dog suffers from allergies or sensitivities that cause dermatitis, there are two parts to treating them:
- Identifying the allergen so they can be protected from it in future, and
- Relieving the discomfort of their symptoms in the meantime.
Vets use Apoquel for the second part – relieving the discomfort of itching. Apoquel manipulates the enzyme which causes inflammation and itching. This should make the symptoms of your dog’s allergy much more tolerable. Since scratching the area frequently makes dermatitis exponentially worse, suppressing the need to scratch gives the skin a chance to heal.
In a small study at Montgomery Animal Hospital in 2017, vets also reported promising evidence that Apoquel can help to treat dogs with outer ear infections caused by allergic skin disease.
Is Apoquel Safe for Dogs?
Apoquel is the latest in a line of drugs used to help dogs with itchy skin caused by allergic or atopic dermatitis. Zoetis released it in 2013. They are the animal medicine arm of pharmaceutical giant Pfizer.
So far no anti-itching drug (including Apoquel) has been created which is completely effective or completely free from side effects. But, in the first clinical trials of Apoquel, 279 dogs benefited from receiving it. Following that trial, they were permitted to continue receiving it directly from the manufacturer until it became commercially available. This was under the FDA’s Long Term Compassionate Use rules.
Zoetis developed Apoquel as an alternative for dogs who didn’t benefit from earlier drug therapies or who couldn’t tolerate their side effects. So, for many dogs it is a safe and effective drug.
Apoquel Side Effects in Dogs
In 2015, Zoetis published the long term experiences of the dogs in the first clinical trials. Some of these dogs had been using Apoquel for nearly two years by that point. The most common adverse effects were:
- urinary tract infections
- pyoderma (a bacterial skin infection)
- otitis (ear infections)
- weight gain
- vomiting and diarrhea
Some less common side effects also include:
- cysts between the toes
- demodex mange
- blood abnormalities
If you notice any adverse side effects, don’t hesitate to contact your vet. Always stick to the recommended dose. This will usually reduce the likelihood that your dog will have a bad reaction.
A Note About These Effects
When a drug is new, it takes time and carefully controlled trials to work out whether the health problems dogs experience whilst taking the drug are because of it. Or whether they would have suffered them anyway. So the term “adverse events” was used in the 2017 Apoquel trial, instead of side effects. This is because it was hard to say whether their frequency in dogs taking Apoquel was higher than in the ordinary dog population.
In a review of her experiences with Apoquel for Pet Dermatology Clinic website, vet Melissa Eisenschenk agrees that incidences of ear infections, weight gain and urinary tract infections are higher in dogs on Apoquel. But, she notes that dogs with allergies tend to be more prone to urinary tract infections anyway. And the weight gain was less than usually seen with other anti-itching drugs. Eisenschenk also reported bone marrow suppression in 1% of dogs taking Apoquel and recommended monitoring to identify these patients.
Does Apoquel Make Dogs Sleepy?
One of the less common apoquel side effects in dogs is lethargy. So, there is a chance that apoquel will make your dog feel sleepy and cause lower activity levels. If this happens to your dog on apoquel and you are concerned, it is always best to contact your veterinarian to ensure that your dog is not having a bad reaction to the medication. They may suggest a different course of treatment.
How is Apoquel Given?
Apoquel comes in tablet form only. The tablets come in three dose sizes:
Always give the dose prescribed by your veterinarian. If you struggle to get your dog to take tablets, you can try hiding it in their food, or wrapping it in a tasty piece of meat. Alternatively, your veterinarian may be able to show you some techniques.
Apoquel Dosage for Dogs
No matter what it is treating, the Apoquel dosage for dogs is based on weight:
|Dog’s Weight (lbs):||3.6mg Tablet:||5.4mg Tablet:||16mg Tablet:|
|6.6 - 9.9||0.5||-||-|
|10.0 - 14.9||-||0.5||-|
|15.0 - 19.9||1||-||-|
|20.0 - 29.9||-||1||-|
|30.0 - 44.9||-||-||0.5|
|45.0 - 59.9||-||2||-|
|60.0 - 89.9||-||-||1|
|90.0 - 129.9||-||-||1.5|
|130.0 - 175.9||-||-||2|
So for the most common Labrador weights:
- 45 – 59.9lb, a single dose is two 5.4mg tablets
- 60 – 89.9lb, a single dose is one 16mg tablet
Your veterinarian will likely start your dog out at two tablets a day for 2 weeks and then reduce it to 1 per day for a duration thereafter. If you miss a dose, speak to your vet about what to do, don’t just double up without their approval.
Every dog is different. Whilst the doses listed here may be the best place to start, your veterinarian might recommend tweaking the dose for reasons specific to your dog. So, if your vet advises a different dose, always follow their advice. They should be happy to discuss their reasoning with you!
How Long Can Dogs Take Apoquel For?
Veterinarians may prescribe Apoquel for short term for dermatological flare ups. Or, they may prescribe it for the long term alongside other medications. This would be in cases of atopic dermatitis or other conditions. If it is no longer needed, Apoquel can be stopped quickly, without needing any gradual tapering off.
Apoquel usually begins to work within a couple of days. And the consensus among vets who have used it is that if it isn’t working within two weeks, then it isn’t going to work at all. After the first two weeks, the treatment is usually reduced to one dose a day. This is described as “maintenance therapy”.
Apoquel for Dogs – Precautions
Apoquel is NOT safe or suitable for your dog if they:
- are less than a year old
- have a serious infection
- are being used for breeding
- are pregnant or nursing puppies
In safety studies before Apoquel was released onto the market, puppies under one year old experienced an increased rate of bacterial pneumonia and demodex mange. Your vet might advise against using Apoquel if your Labrador has certain infections. Since it works by suppressing part of the immune system. Your vet might also advise against using Apoquel if your dog has had any kind of tumor in the past.
A great advantage of Apoquel is that it can be taken at the same time as anti-parasitic drugs or topical ointments for bacterial and fungal skin infections. And it doesn’t interfere with allergy testing. In fact, current studies have not reported any specific drug interactions with Apoquel.
But, it’s important to keep an eye on the most recent research and make sure your veterinarian is aware of any other medication your dog is on. And, your dog should not be taking Apoquel if they fit into any of the categories mentioned in the previous section of this guide.
What to Do in Case of Emergency
Your vet will monitor your dog while they are taking Apoquel for any sign that he’s not responding well to it. This should include taking blood samples to check bone marrow function. But, like virtually all effective drugs, Apoquel is not without side effects. And because it’s so new to the market there may be long term side effects which we don’t fully understand yet.
If your dog experiences any minor side effects, report them to your veterinarian. But, if your dog is experiencing more serious side effects, or your vet isn’t available, you may need to go straight to an emergency veterinary clinic.
How to Store Apoquel for Dogs
Apoquel only comes in tablet form. This means it is easy to store, and usually won’t spoil. Keep it shut away out of your dog’s reach so they can’t consume more than their normal dosage. And out of reach of any children. A dry, dark cupboard is ideal. Keep the tablets away from any water which could seep into the packaging. The packaging of each prescription will have more information on storage, including a potential use by date. On average, shelf life for Apoquel is around two years.
Apoquel for Dogs – Evidence of Effectiveness
In Zoetis’ own tests, 186 out of 216 dogs with allergic or atopic dermatitis (86%) showed an improvement in symptoms within 30 days of taking Apoquel in a blind trial. Veterinary feedback is also quite positive. For instance, vet Nicole Heinrich’s describes giving Apoquel to 250 dogs on the VetGirl blog. Heinrich concludes that it is a promising replacement to steroids. But also stresses the importance of monitoring patients for blood abnormalities.
Apoquel is most suited to being used alongside carefully planned immunotherapy to isolate the cause of the itching and build up an appropriate immune response instead of an allergic one.
More recently, a 2021 study compared Apoquel to other anti-pruritic therapies in dogs with allergic dermatitis. It found that dogs treated with Apoquel were less likely to need additional antibacterial treatment than those treated with alternative anti-pruritic therapies. And, in 2018, a study into 10 Beagles with atopic dermatitis found that Apoquel delayed the development of dermatitis (itchy, inflamed skin) when an allergen was applied to the area.
If you have the time and inclination, you can read even more feedback from vets at a workshop on the pros and cons of Apoquel therapy (including side effects) in 2017.
Is There an Alternative to Apoquel for Dogs?
So, is there an alternative to Apoquel if it doesn’t help your dog’s symptoms? If Apoquel isn’t working for your dog, you should contact your vet first. They may be able to prescribe a steroid alternative. Or, they may undergo trials with you to find exactly what is causing your dog’s itching and deal with the problem at its root.
When Apoquel for Dogs Doesn’t Work
Remember, Apoquel does not by itself cure allergies or dermatitis. Vets usually prescribe Apoquel to:
- Treat the discomfort of itching while they find and remove the cause of allergic dermatitis
- Protect a dogs skin during summer if they get seasonal allergies
- Or treat chronic atopic dermatitis over the long term if they never find the cause
Sadly, atopic dermatitis has a genetic component and is inheritable. Labradors are particularly predisposed to it. Apoquel will usually only help ease your dog’s discomfort if they are suffering from atopic or allergic dermatitis. You may need to undergo further tests and trials with your veterinarian to determine the cause of the problem. For instance, moving your dog onto a limited ingredient diet.
Apoquel for Dogs
Like most kinds of medicine, Apoquel comes with its own list of side-effects. Your vet will not prescribe Apoquel unless she thinks it’s going to help. Always consult your vet if your dog has skin problems or is scratching. Helping dogs with dermatitis is often a lengthy process of trial and error to find and eliminate the cause(s).
Anti-itching drugs can give your dog relief from the misery of dermatitis while that process takes place. If your Lab has reacted badly to corticosteroids or other anti-itching drugs in the past, Apoquel might be the alternative they need. Don’t forget, Apoquel is a prescription only drug. You should only give it to your dog on the advice of a qualified veterinarian. Remember to pay strict attention to their instructions.
References and Resources
- Zoetis United States
- Cosgrove (et al), ‘Long‐Term Compassionate Use of Oclacitinib in Dogs with Atopic and Allergic Skin Disease: Safety, Efficacy and Quality of Life’, Veterinary Dermatology (2015)
- Eisenschenk, ‘My Clinical Experience with Apoquel (Oclacitinib)’, Pet Dermatology Clinic (Accessed 2019)
- Rosenkrantz & Bourgeois, ‘Pros and Cons of Oclacitinib Therapy. Advances in Veterinary Dermatology’, Wiley Publishing (2017)
- Rosenkrantz, W. ‘Canine Atopic Dermatitis – Where Do The New Treatments Fit In?‘, Animal Dermatology Clinic – Online World Congress of Veterinary Dermatology (2020-2021)
- Barrett, L. (et al), ‘Safety and Toxicity of Combined Oclacitinib and Carboplatin or Doxorubicin in Dogs with Solid Tumors: A Pilot Study‘, BMC Veterinary Research (2019)
- Rynhoud, H. (et al), ‘The Association Between the Use of Oclacitinib and Antibacterian Therapy in Dogs with Allergic Dermatitis: A Retrospective Case Control Study‘, Frontiers in Veterinary Science (2021)
- Marsella, R. & Ahrens, K. ‘A Pilot Study on the Effect of Oclacitinib on Epicutaneous Sensitization and Transepidermal Water Loss in a Colony of Atopic Beagle Dogs‘, Veterinary Dermatology (2018)
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My dog Twinky apple head chi suffered day and night !!! The vet gave her a shot and that only lasted a few days so we got pills from the vet of the same drug’ half a pill two times a day has kept her from just rubbing her belly raw’ but she is very skinny now when she used to be over weight . She is about 13 years old and is still pretty active but as soon as the drug wears off its back to scratching and rubbing her self raw’ poor thing and the pills are very costly and the shot is thru the roof . I don’t think dog medication should be so expensive but what can you do and its very sad to see a animal in pain like that ! So its worked so far with no side effects that i have noticed other than weight loss she and has been taking them them for two months now . I hope nothing happens to her because she is a great little dog ‘ actually she is the best dog i have ever had ‘hands down.
Gizmo was scratching and itching NONE STOP and his skin became full of scabs and his hair fell out. He’s been on Apoquel for about 1 1/2 weeks, along with antibiotics and medicated shampoo. Such a huge improvement! No chewing or scratching, his horrible smell went away, and his hair is already growing back. Tonight he started peeing blood, and it looks like the meds can cause UTI’s. Vet office is closed and I was wondering if anyone has experienced this and what did the vet say to do? Stop the meds immediately ? Thanks for any help….
My 5 year old dog has been on Apoquel for approximately one year and has developed lymphedema and diarrhea. Don’t be fooled by a veterinarian in to giving this drug to your dog for itching. It could be a death sentence.
My poor dog Riley (Australian Terrier) has been put on Prednizone every year for itching. This year he was put on Apoquel and within 3 days he has either suffered from a major seizure or stroke since getting put on Apoquel. The vet must not have read some dogs could have serious side effects and thinks that it may not be related. He was a healthy running around, 2 mile a day walker and now can hardly walk. He walks crooked and falls down. I am hoping that by taking him off it right away that he will come back to me. I also feel the vet may have been overdosing him as he broke the 16 mg tablets in 4 and told me to give him a piece twice a day for 6 days. We were into 2 1/2 days. Has cost me considerable in vet bills because someone can’t go along with what has worked for him. I don’t know if he will recover or not. I am praying he will.
My 7 1/2 yr old golden retriever was destroying herself with scratching and stopped 95% of scratching with first dose. Was told to keep her off meats so she is getting salmon Sweet potato Fromm dog food. I add some fruits and veg and olive and salmon oil for her skin. I hear labs and Goldens have developed many problems because of the breeding even In the top lines.
This is a dangerous drug. I had a healthy Doberman and after giving Apoquel to her, for 2 years, she developed liver problems. After much research, it was determined that her liver problems were due to the Apoquel. If you love your dog, PLEASE DO NOT GIVE THEM APOQUEL.
I have a Doberman having liver issues, and had been on apoquel for about 4 months. Did the issues ever resolve? I’m working with a vet to determine what is happening-just wondered how your dober was doing. Thanks for any info.
I am going through the same thing right now! Didn’t realize it until she almost died and for a short time she was off apoquel. Started her on it again and extreme nausea came back after one dose.
I have a Teacup poodle, she weights 3 pounds, shes 13 months old, she scratches all the time. Is she too little for this medicine?
My wire haired Jack Russell (Scruff) has been on Apoquel for 2 years. His life was miserable for 12 years as he constantly chewed himself. I tried everything but he only found relief when put on Apoquel. I have noticed that he is developing many weird looking lumps on his body. At least 10 at the moment. I have read that this is side effect of Apoquel. Hoping it is not dangerous. Vet does not seem worried.
I started my 9 year old lab/springer spaniel mix on Apoquel 4 months ago. He seems to have food and environmental allergies. He was castrated too early at 8 weeks old . I believe he has endocrine issues as well, his head would get very hot when excited, then he would get frantically itchy. Apoquel was a life-changer!
My 12 yr old lab has always had severe allergic reactions to routine vaccines, but never seasonal allergies. Suddenly last summer he began licking and scratching his belly and eye raw bc of some type environmental allergy. Within 1 day of Apoquel he stopped itching and his skin was able to heal. We were able to take him off of it from November until now (late May). He has begun to itch again, (grass and tree pollen are horrific here right now) we started the Apoquel again today and tonight he has stopped itching and is snoring away. This med is an absolute life saver for dogs that will incessantly lick/itch at themselves due to allergies. Its literally a “magic pill” for our old man. Worth every penny to keep him comfortable and save his skin. At 12yrs old with significant arthritis (and meds for that) we are not concerned about side effects ( which he has not had) it’s all about him being happy and comfortable.
I just started my dog Buddy on Apoquel and it started working within the first day. I am very torn on if I should keep him on it or not I keep hearing mixed reviews on it. He has suffered since the summer with scratching and licking and I tried everything from changing his food, Benadryl and bathing him with anti itch shampoo. I did not want to put in on medication but I felt I had no choose, he is so much more comfortable on it. The vet told us it was safe and I am just hoping I am doing the right thing.
2-27-2019 Just lost my 11 yr old Yellow Lab to Pulmonary Fibrosis & Metastatic Neoplasia. He had severe allergies his entire life and been on Apoquel for 4 years…I wish I had known about the possible side effects. He was tested for allergies, placed on special diet, but in Florida what can you do when they’re allergic to Palm Trees & Grasses…
Is there anyone out there that knows how we can get Apoquel at less than what we are paying for our Labs pills thru Drs. Foster and Smith. All on line pharmacies will honor the price I am paying. but my husband and I are on Social Security, and it is hard for us to pay $2,49 a pill. Our dog takes 1 pill a day, hr also has been on it for almost 8 months and it is getting hard to get enough money together, with Vet bills being so expensive we don’t know what bto do. Anyone out there have any ideas for us old folks. Our Hudson is 9 yrs old and otherwse in good health Just has this severe itching just above his tail, we just cant find an answer. Any ideas sure would be helpful. Thanks Patricia
Seems every post here is positive about Apoquel. Well I’m going to give you the truth. This drug is deadly to your animal. If a vet tells you they’ve had good experience prescribing it, I did and my advise is be doubtful of their claim. My girl had something that made her lick and chew her feet. The apoquel blocks the sensation and they stop scratching and chewing on themselves. I just put down my 5 1/2 year old beautiful boxer because this drug ruined her immune system and she developed T-cell lymphoma. The vet that put her down told me it was the third dog he’d seen with lymphoma that was taking Apoquel. Apoquel suppresses the immune system and destroys the ability for the white blood cells fight infection. Your dog is susceptible to lymphoma. I could say more but I hope that those that read this pay attention or you’ll be in the situation I’m in, struggling to get over the loss of my best friend.
The same thing just happened to my best friend Bruno. 8 years old, Apoquel was a miracle drug until he quickly developed T-cell Lymphoma. 🙁
My dog, Natasha has only been on Apoquel for 17 days and is sleeping more, wanting to eat often and more food, also she’s peeing more than usual. She is only 4 1/5 years old. I will definitely be talking to the Vet again and seeing if there is another natural alternative. Thank you for the information.
Seemingly out of no where, our 12yr old lab developed really bad dermatitis. Within a few days it was all over his body, he scratched constantly crying whilst doing it, and smelt terrible. Vets tested for basically everything, but could not find the route cause. We put him on Apoquel , antibiotics and medicated shampooing twice a week. We’ve also put him on a hypoallergenic diet. Apoquel basically saved his life, he could not have continued to live in that constantly distressed state, it immediately stopped the itching. He has been on it for 5months now and is still getting bathed twice weekly, because the problem hasn’t gone away , but it is much better. At his age I’m not too worried about long term effects, I’d rather his remaining time with us be comfortable and happy., and as a bonus it seems to have helped with his arthritis, he’s much more mobile and generally happier.
My 8 year old lab is taking Apoquel and it has been working for her from the first day on! The only side effect we have is weight gain. I am hoping to get that under control during winter when she doesnt need the medicine. But its safe to say that its a wonder medicine!
Our bull mastiff is 3 has been on apoquel for 12 days is now at vets for 3rd night now wad vomiting for 2 days so In hospital them the diarrhea started very worried about our boy Thor
We have a 5 year old male Leonberger. He suffers from seasonal allergies. I have tried everything over the last 4 years to control his itching, this year I failed miserably, all the things that normally helped just wasn’t working and he was totally miserable poor thing, so I succumbed and took him to the vets. She game him a thorough investigation and prescribed Apoquel and medicated shampoo. Within 4 hours of starting him on the tablets he was calm and stopped tearing himself to pieces. 2 days on he is healing well, sleeping well and has started eating again. His coat is glossy and he looks like a healthy, happy dog. I will try reducing the dosage in a day or so, (he is on 1.5 16mg tabs twice a day) and monitor him closely. I should also add, I haven’t used the shampoo … the vet did say some people just use the tablets when needed, which is what I am hoping to do.
My 10 year old Lab has been on Apoquel for about 6 months. His itching decreased the very first day! He takes 1 1/2 pills a day which is a bit expensive but he is so much happier and smells much better! My vet did not test him for his specific allergies, but I believe it is pollen/grass etc. We live in southern Florida so he is on it year round. If I was up north, I would try to stop during the winter months.
Our 16 year old Jack Russell has been miserable for years, chewing his feet till they bleed and scratching and chewing himself. He became completely deaf a few years ago. He’s been on and off prednisone. That helped a bit. The vet has put him on Apoquel and it is a miracle cure for him. He’s got back his joy for life and has also got his hearing back. Not fully but he can hear his name and clapping which he couldn’t before. He’s an old dog so quality is the best for him.
My boy Buddy, has spent the whole summer itching, and I have been trying topical lotions and medicateed shampoos from vet, antihistamine tabs, to no avail,
Today I gave in and went to the vet,
He has scratched , and shaken his head, he developed a hemotoma on his ear, poor fella,
So we were prescribed Apoquel, two tabs for two weeks,
And some ear drops for fungus,
Anyway! Came home gave him the ear drops, and one tab, and a medicated bath,
Well, bugger me, he is asleep, has stopped scratching and so calm, … like he I said for all other seasons of the year besides summer!
That’s a short, 4 hours later, my boy has relaxed and is finally getting some real relief
We have a 2 year old female yellow lab. Even though we changed her diet by deleting chicken & most grains she continued to lick & scratch & had frequent ear infections. We’ve had her on Apoquel for 4 months & she no longer has paw or ear problems & is much happier
Our Bailey, 12 yr old yellow lad, is on Gabapentin for arthritis, and was on prednisone before that for licking. It was under control. When we started giving Gabapentin our vet switch to apoquel, saying prednisone conflicted with Gabapentin. His licking immediately returned.
We rescued a pitbull from the local shelter and from day one this poor dog suffered. Scratching constantly. The poor thing couldnt get a moment of relief. we tried everything from food to bedding to baths.. The vet prescribed Apoquel and for the first time in months he is finally getting relief.. he now sleeps thru the night and is comfortable.
My 6 yr old yellow lab has been on Apoquel 16mg 1 & 1/2 tabs for 2 yrs now and it was a miracle saver for him. The only side effect has been weight gain. After trying every remedy known prior to starting Apoquel, my dog was miserable and so uncomfortable! With the first dose, within 4 hours his itching and scratching stopped!! It was amazing!!!
We have a female Lab/American Staffordshire Terrier mix a who was itching terribly before starting Apoquel. The vet found a flea on examination so we eliminated that issue & she eats a grain-free diet. So far our experience has been a good one. None of the adverse effects have occurred & she is a much happier dog without the itching.