Are There Alternatives to Apoquel for Dogs?

If you're looking for alternatives to Apoquel for dogs, you're likely concerned about this drug's side effects and want to get to the bottom of your dog's underlying immune system dysfunction that leads to allergic reactions. Veterinarian Dr. Ivana shares several possible alternatives to Aqoquel.

Are There Alternatives to Apoquel for Dogs?
There are several alternatives to Apoquel for dogs

Jirakan

Alternatives to Apoquel for Dogs

If you're searching for alternatives to Apoquel for dogs, you are likely hoping for other options that don't cause as many side effects or maybe you're looking for a cheaper drug as your expenses are adding up.

Perhaps you are also determined to try to treat the root cause of your dog's allergies to get to the bottom of your dog's immune system's overreaction to allergens.

Allergies in dogs, as it happens to humans, are triggered by the immune system which for some reason or another, mistakenly labels harmless substances as potentially threatening, sending the immune system on high alert.

When the immune system is alerted, histamines are released, leading to annoying allergic reactions.

While in humans, allergens trigger sneezing, itchy eyes and a runny nose, in dogs, allergies are more likely to cause skin itchiness.

Affected dogs can get really miserable as the constant itching and scratching cycle impacts his quality of life and with time, secondary skin infections may take place, adding insult to injury.

Therefore, it's normal to seek help for our itchy canine companions, but certain drugs can cause more problems than expected.

Apoquel is a common drug prescribed for dogs with allergies. Although effective, it can trigger side effects that may sometimes be more troublesome than the allergy itself. It's not unexpected for dog owners to therefore seek a safer alternative to Apoquel for dogs.

In this article, veterinarian Dr. Ivana Crnec, a licensed veterinarian graduate of the University Sv. Kliment Ohridski’s Faculty of Veterinary Medicine in Bitola, Republic of Macedonia, will cover the following topics:

  • What is Apoquel for dogs?
  • Pros and cons of Apoquel
  • Pharmaceutical alternatives for Apoquel for dogs
  • Natural alternatives to Apoquel for dogs
Oclacitinib is the generic for Apoquel

Antonio Diaz

Information About Apoquel for Dogs

We are very familiar with the old “cure the cause and not the symptom” saying. However, when it comes to dog allergies and severe itching, we tend to rely on quick and easy fixes, such as Apoquel.

While Apoquel significantly improves the quality of life of allergic canines, it is not universally suitable for all dogs.

What Is Apoquel for Dogs?

Apoquel is an FDA-approved drug made by Zoetis used to manage skin issues, irritation, and itching.

From a pharmacology standpoint, the active ingredient in Apoquel, oclacitinib, is JAKi (Janus Kinase Inhibitor).

Currently, there are no generic Apoquel alternatives, as Zoetis holds the patent for the medication until 2026.

Mode of Action

Oclacitinib works by inhibiting cytokine production (chemicals responsible for inflammation and itching). This breaks the vicious itching and scratching cycle, thus allowing the skin to heal.

Uses

Apoquel’s main use is for dogs with atopic dermatitis. However, it can also be used in the management of other allergies, such as environmental, contact, food, flea allergies, etc.

Apoquel is best suited for otherwise healthy adult dogs that cannot take steroids and dogs with long allergy seasons.

Dosage

The recommended Apoquel dosage for dogs is between 0.18 to 0.27 milligrams per pound, twice for the first 14 days and then once a day.

It is important to stick to these doses since it is possible to overdose dogs on Apoquel. In the case of an overdose, it is vital to seek immediate vet help.

Pros and Cons of Apoquel for Dogs

As with several medications, there are several pros and cons when it comes to the use of Apoquel. The following are several benefits.

Pros of Apoquel for Dogs

First, we'll cover the pros.

Fast Acting

Apoquel is fast-acting and usually reduces itchiness in as little as four hours. In some cases, it may take up to 24 hours which is still very fast.

Effectiveness

Apoquel is effective in itchiness management. Having the same effect as prednisolone, it works in 66% of dogs with atopic dermatitis and 67% of dogs with allergic dermatitis (according to sciencedirect.com).

Safety

Apoquel use is free from steroid-linked side effects, making it a safer option for dogs with allergies, especially in the long run.

Apoquel is also relatively safe to use simultaneously with many common meds like antibiotics, antihistamines, and NSAIDs (non-steroid anti-inflammatory drugs).

Helping in Diagnosis

Apoquel provides relief while allowing the vet to keep searching (performing diagnostic procedures) for the exact underlying cause of itchiness.

Cons of Apoquel for Dogs

There are several cons of Apoquel for dogs to keep in consideration. Following is a list of several cons of Apoquel.

Selectively Suitable

Apoquel must not be used in puppies (less than 12 months old), dogs with serious infections, and dogs with cancer or cancer history. Also, its safety has not been evaluated in breeding, pregnant, and lactating dogs.

Expensive

Depending on the dog’s size, a monthly Apoquel supply may cost between $60 and $90. This is costly, especially for dogs needing this medication year-round. It makes therefore sense for dog owners to seek a cheaper alternative to Apoquel for dogs.

Possible Side Effects

While safer than most allergy meds, Apoquel still affects the dog’s immune system and is linked with several side effects:

  • Vomiting and diarrhea
  • Reduced appetite and weight loss
  • Severe lethargy (tiredness)

Low blood cell counts and high cholesterol

  • Increased risk of infections
  • Ear infections
  • Demodex mange
  • Pneumonia
  • Increased risk of lumps and cancer

Dependence

Apoquel acts as a Band-Aid rather than a cure. Therefore, the itchiness will return if the Band-Aid is removed (the dog is taken off Apoquel).

There are several Apoquel alternatives for dogs

Drug Alternatives to Apoquel for Dogs

There are various Apoquel alternatives for dogs classified into three groups: drug alternatives, non-drug alternatives as well as supplements and natural remedies. Here's a more detailed look at the different options.

The group of drug alternatives includes both prescription and over-the-counter medications. All meds are efficient, but they come with a list of cons and potential side effects.

1. Cytopoint Injections

Cytopoint is an injectable antibody treatment, also made by Zoetis. The active ingredient, lokivetmab, destroys the cytokines responsible for causing itchiness.

In simple words, Apoquel and Cytopoint have the same end effect, they just achieve that effect differently.

According to the manufacturer, Cytopoint works for up to two months. However, based on reports, super itchy dogs experience a comeback of the symptoms within three to four weeks.

Cytopint is fast-acting and safe for dogs of all ages and dogs with cancer. Plus, it eliminates the need for daily pills, which can be a challenge with some dogs.

On the downside, the Cytopoint treatment requires a vet visit. Also, with frequent use, its efficacy may reduce. Finally, being a relatively new drug, we do not know much about its potential long-term side effects.

2. Atopica Pills

Atopica pills feature cyclosporine—a natural substance isolated from fungi. Cyclosporine has strong immune-suppressing properties. Therefore, it is very effective for dogs with allergies.

However, Atopica is the priciest option on this list. Moreover, it must be used cautiously in dogs with cancer, kidney disease, and diabetes.

Lastly, it is linked with many side effects (stomach upset and gingival hyperplasia) and reduces the efficacy of killed virus vaccines.

Atopica is usually recommended for dogs that do not experience proper itch relief with Apoquel and Cytopoint.

3. Corticosteroids

Corticosteroids, or simply steroids, are among the oldest meds used for allergy management. They include three main drugs:

  • Prednisone
  • Methylprednisone
  • Dexamethasone

While affordable and very effective, corticosteroids are associated with a plethora of short and long-term side effects.

The short-term side effects include increased drinking (polydipsia), increased urination (polyuria), and increased appetite (polyphagia). In the long run, steroids affect the liver and endocrine system and cause severe immune suppression.

Additionally, corticosteroids are not recommended for dogs with diabetes and congestive heart failure. They are also unfit for dogs receiving NSAIDs.

The bottom line, corticosteroids can be used in otherwise healthy dogs with very short allergy seasons.

4. Antihistamines

Antihistamines work by blocking the substance histamine, which is the main inflammatory mediator. Commonly used antihistamines are:

  • Benadryl (diphenhydramine HCL)
  • Claritin (loratadine)

    Zyrtec (cetirizine HCl)

Antihistamines are relatively safe. The most frequently reported side effect is drowsiness. Plus, antihistamines are available over the counter and inexpensive.

However, in many cases of dog allergies, antihistamines are not potent enough and, therefore, inefficient. Used alone, antihistamines can only work for dogs with very mild symptoms.

The good news is that adding antihistamines to the dog’s treatment plan may reduce the need for other stronger medications.

5. Temaril-P Pills

This medication is formulated based on the synergistic effects of antihistamines and corticosteroids. The drug features two active ingredients - trimeprazine tartrate and prednisolone.

Temaril-P comes in the form of oral tablets that are scored and easy to dose. They are available via prescription and are relatively affordable. Plus, according to the manufacturer, the pills provide itch relief in as much as 80% of dogs.

However, Temaril-P can cause severe side effects because of the steroid component, especially when used long-term.

Prednisone is an alternative to Apoquel, but can cause numerous side effects

Alexadry all rights reserved

Non-Drug Alternatives to Apoquel for Dogs

Non-drug alternatives include immunotherapy and lifestyle changes. They are safe but not effective or possible for all dogs. Also, it takes time until their effects kick in.

6. Allergen Avoidance

Avoiding the dog’s allergens is effective. However, to avoid the culprit, first, it must be identified, which is not always possible. Also, some allergens cannot be avoided, especially in dogs with inhalant allergies.

7. Frequent Bathing

Frequent bathing provides temporary relief. It is best to use an oatmeal shampoo. Oatmeal has anti-inflammatory and soothing features while also being budget-friendly.

On the downside, oatmeal baths are not as potent as mainstream meds and hard to do in dogs that hate water/bathing.

8. Immunotherapy Injections

Allergy shots work great for dogs with certain types of environmental allergies. However, they are expensive, and the dog will need adjuvant treatment until the immunotherapy injections start working.

An oatmeal shampoo using cool water can help sooth irritated skin

Natural Alternatives to Apoquel for Dogs

Supplements and natural remedies can provide some level of relief for itchy dogs. However, on their own, they are not enough to manage the allergy symptoms and should be combined with other alternatives.

9. Omega Fatty Acids

Omega fatty acids are an excellent option for dogs with allergies because of their anti-inflammatory features.

The best source of omegas is fish oil, or better said, salmon oil. Salmon oil is readily available, easy to use, and has many health benefits.

However, omega fatty acids are not effective for all dogs with allergies. Also, fish oils are caloric and not suitable for overweight and obese dogs.

10. Probiotics

Probiotics support a healthy gut which boosts the immune system and helps manage inflammation. These features are helpful when it comes to allergy management. Plus, probiotics are safe for long-term use.

However, they are not as effective and as fast-acting as the medical alternatives. Additionally, probiotics alone are rarely enough to stop the itching.

11. Natural Supplements

According to anecdotal reports, there are many natural options that can help reduce itchiness. Common examples include yucca, quercetin, coconut oil, CBD oils and treats, green tea, calendula, honey, etc.

Final Thoughts

All in all, Apoquel is a great anti-itch Band-Aid for some dogs with allergies. The emphasis of the conclusion is placed on the words “Band-Aid” and “some.” Therefore, in certain cases, it is best to seek alternatives.

The Apoquel alternatives are classified into three groups: drug, non-drug, and supplements/natural remedies. Some of them work alone, and others should be used in conjunction with other approaches.

If you want the best Apoquel alternative for your dog, consult your trusted veterinarian. Also, remember that finding what works best for your dog’s allergy symptoms may take trial and error.

References

  • Lancellotti BA, Angus JC, Edginton HD, Rosenkrantz WS. Age- and breed-matched retrospective cohort study of malignancies and benign skin masses in 660 dogs with allergic dermatitis treated long-term with versus without oclacitinib. J Am Vet Med Assoc. 2020 Sep
  • Gonzales AJ, Bowman JW, Fici GJ et al. Oclacitinib (APOQUEL®) is a novel Janus kinase inhibitor with activity against cytokines involved in allergy. J Vet Pharmacol Ther. 2014
  • Medvet: Lessons Learned From Using Apoquel, John G. Gordon DVM, DACVD November 23, 2016
  • Science Direct: Oclacitinib

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