Apoquel is used to treat and control itching and inflammation in dogs resulting from a variety of causes, including flea allergy, food allergy, contact allergy and atopic dermatitis. Apoquel delivers onset of relief within 4 hours. It effectively controls itching within 24 hours. Apoquel requires a prescription from your veterinarian, and is sold per tablet.
Apoquel® is the brand name of oclacitinib, an FDA approved immune suppressant drug in the Janus Kinase (JAK) inhibitor class made by Zoetis. This drug inhibits primarily JAK-1 and -3 signaling that would normally occur when a cytokine binds to a receptor on the surface of the cell. This includes blocking the effects of inflammatory cytokines released from activated lymphocytes (IL-2, -4, -6, -13) as well as IL-31, a cytokine directly involved in the sensation of itch. JAK signaling is important to the function of the bone marrow as well. Apoquel works differently than steroids, antihistamines, or cyclosporine.
Apoquel works rapidly, usually within 24 hours, to diminish itching. It is very rare to have GI upsets with Apoquel like we can see with cyclosporine. The antipruritic effects of the Apoquel wear off quickly, within 12-24 hours, so the medication needs to be given daily in most cases.
Other drugs in the same drug class as Apoquel include drugs for humans for rheumatoid arthritis, psoriasis, and cancer. In humans, the side effects of drugs in the JAK inhibitor class of drugs include: neutropenia, anemia, thrombocytopenia, increased liver values, increased cholesterol, UTI, weight gain, herpes zoster. Apoquel side effects listed for dogs in the product insert include: vomiting, diarrhea, lethargy, anorexia, SQ or dermal masses (unspecified), decreased leukocytes, decreased globulins, and increased cholesterol and lipase. Low numbers of dogs in the studies developed demodicosis, neoplasia, pneumonia, bloody diarrhea, skin and ear infections, UTIs, and histiocytomas.
Interestingly, in early studies, a few dogs developed polydipsia, increased appetite, and aggression, similar to what may be seen with steroids- I have not seen these issues with a proven link to Apoquel.
Dosage and Administration
The dose of APOQUEL (oclacitinib maleate) tablets is 0.18 to 0.27 mg oclacitinib/lb (0.4 to 0.6 mg oclacitinib/kg) body weight, administered orally, twice daily for up to 14 days, and then administered once daily for maintenance therapy. APOQUEL may be administered with or without food.