In 2014, Zoetis released an oral medication that significantly changed how itchy dogs are treated today. Apoquel (oclacitinib maleate) is an FDA-approved medication for use in dogs at least 12 months of age to treat atopic and allergic dermatitis. In 2024, a flavored, chewable form of Apoquel was made available (pork liver flavor, containing pork and soy). Apoquel has provided a way to quickly address itching in dogs, with relief possible in as little as four hours.
Controlling the Itch
Generally, the three primary reasons a dog might be itchy are:
- External parasitism (fleas, mites, etc.)
- Airborne allergies (atopic dermatitis)
- Dietary sensitivity (allergic dermatitis)
Prior to the release of Apoquel, treating an itchy dog was difficult and largely disappointing. Typical treatments included:
- Control of external parasites (spot-on topicals, flea/tick collars, oral medications, lime-sulfur dips)
- Steroids (these had multiple side effects, including excessive drinking, urination, and appetite)
- Modified cyclosporine (cost-prohibitive for many dog owners)
- Hyposensitization therapy (injectable or sublingual, which can take months to years to have an effect, only 60% to 70% success rate),
- Strict dietary therapy with a prescription diet (hydrolyzed or novel protein/novel carbohydrate)
- Medicated baths
- Oral antihistamines
- Omega-3 fatty acid supplements
Enter Apoquel for Dogs
Apoquel is an immunomodulator (JAK inhibitor) that inhibits cytokines involved in the itch and inflammation pathways. Onset to relief is as soon as four hours. The approved dose of Apoquel is 0.18 to 0.27 mg oclacitinib/lb (0.4 to 0.6 mg clacitinib/kg) body weight, administered orally, twice daily for up to 14 days, and then administered once daily for maintenance therapy. Apoquel can be used seasonally, or throughout the year. Apoquel can be given with or without food. Apoquel is available in 3.6 mg, 5.4 mg, and 16 mg tablets and is a prescription medication. Follow your prescriber’s recommendation for dosages, but you can access the Zoetis dosing chart here.
Cautions With Apoquel
Apoquel should not be used in dogs less than 12 months old, dogs who are breeding, pregnant or nursing, or dogs who have severe infections. Apoquel can make a dog more susceptible to infection, including demodicosis (overgrowth of Demodex mite) or severe cancerous conditions. Dogs on Apoquel should be monitored for these potential conditions.
While Apoquel is not likely to increase the risk of new cancers, it can make pre-existing cancer worse. In other words, a pre-existing tumor may get bigger. Apoquel can be given with antibiotics and vaccines. According to Zoetis, Apoquel has not been evaluated for use in conjunction with steroids, cyclosporine, or other systemic immunosuppressive agents.
Apoquel Side Effects
The most commonly reported side effects in the post-approval period include vomiting, lethargy, inappetence, and diarrhea.
In the itchy dog, external parasites and infections will still need to be treated, as these disease states can cause more problems than just itching.
There are dogs whose itch cannot be fully controlled using Apoquel, and for those cases, a discussion with the dog’s veterinarian or a veterinary dermatologist is recommended for additional or replacement therapies.
Apoquel has potentially serious short and long-term side effects. Why recommend it when you could recommend Cytopoint? I have personal experience with Cytopoint, which I used for my last dog. We struggled with her environmental and flea allergies for years, at great expense, and with little, lasting relief. Enter Cytopoint, which we started not long after it was approved. Within a day, my girl’s symptoms were substantially reduced, and within a few days, she had no symptoms at all. Cytopoint changed both of our lives.
When my current dog started showing seasonal allergies, I started him on Cytopoint and he now gets a shot about 1 time per year.
I would never, ever, recommend Apoquel, but will always recommend Cytopoint to any friend with a dog who suffers from allergies.
I agree. This article reads more like an advertisement.
I really appreciate these comments. My Golden Retriever is dealing with tremendous itch as I write. He is just tapering off prednisone (yes, there were side effects: frequent urination, and panting) but it has helped tremendously…however, the itching is very gradually returning. The plan with my vet was to try Apoquel next if itch returned; I will have more conversation about Cytopoint after reading this.
I have also recently read an WDJ article about kibble coated with probiotics as a great way to provide your dog with this supplement and it left me wondering about how authentic the advice was. Very disappointing.
Oh the Apoquel works well for itching. My dog was on it for over 2.5 years. Then, this year, her allergies she had she no longer has, and I said she is not taking it anymore. When she was on Apoquel she was constantly getting sick with something – she would get kennel cough just looking at an infected dog. She no longer gets Kennel cough now, it goes straight to bronchitis, and then went to pneumonia the one time with an overnight stay in the hospital. She hasn’t been on Apoquel since February 2024, and I can’t be happier for her. Been to camp with the threat of kennel cough in the area and hasn’t gotten it. She gets Cytopoint. Her last shot was in April. If she is itchy now, she gets Benadryl twice a day and it seems to work. I used to love the Apoquel but I’m not giving it to her anymore.
I agree with your comment. I tried Apoquel on 2 of my dogs; on one the drug was not terribly effective, and the other dog had bad vomiting. Cytopoint injections yearly (or less frequently) ended the itching for good with no apparent side effects.
Yes, that ‘article’ definitely read like an ad for Apoquel! Not what I expect from WDJ.
Two of my dogs have seasonal “itchy” skin. I have used Cytopoint on each of them with success. They each needed two shots to get through the summer last year. This past spring I started giving them Wild Salmon Oil capsules. The larger dog gets two a day, the small one only one. Withing two days all itching stopped and they have stayed itch free since April. It has also done wonders for the larger dog who is 14 and came to me 18 months ago with a horribly dry skin and poor coat. It had improved tremendously after a year of high Quality kibble and home cooking, but since starting him on the salmon oil his skin and coat have gotten much better.
I firmly believe in giving holistic a chance whenever it is possible.
Knowing the chief side effect of this immune suppressing drug appears to be cancer, I have a deep sinking feeling. I would seek out a qualified homeopathic vet who’s regularly working with chronic disease and whose practice is mainly or only homeopathy.
If I had a friend whose dog was struggling with itchy skin or ears , I would warn them about Apoquel. It’s an expensive drug, but the cost of the drug pales in comparison to the cost of lives lost after its use.
You did not understand what was written in the article. Apopquel can exacerbate existing cancers – it does not cause them. This is a well-known side-effect of all immuno-suppressing drugs. Tens of millions of humans who suffer with auto-immune disease choose to take these medications daily as their quality of life without them is so horrible.
Homeopathy is voodoo and has absolutely zero therapeutic action. Please do not deny a suffering or sick dog the benefit of real medication.
Short version of long story, our rescued Whippet mix was diagnosed at age 2 yr. with severe environmental allergies. We took her for 3 years to a highly regarded, wonderful DVM who was also certified in advanced Homeopathic treatments. We had limited success with MANY homeopathy remedies over the years but I was grateful to mostly keep our dog’s itching & licking somewhat under control. Then 4 years ago a fast-developing, painful ear yeast infection hit when there were no appointments available except at our prior, regular DVM. We got antibiotic ointment for the ear & then tried Cytopoint injections twice. But they each only lasted less than 6 weeks before lots more itching & licking returned. So we tried Apoquel & it’s been a game-changer! It’s made a HUGE improvement in our dog’s daily quality of life for almost 4 years with NO SIDE EFFECTS. And sometimes, depending on the time of year, she can get by with Apoquel every other day. Apoquel, along with daily sublingual immunotherapy drops (formulated for her specific allergies from annual specialized blood tests) has kept our sweet dog living the life all dogs deserve.