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If your dog suffers from serious allergies or atopic dermatitis that is undermining their quality of life, then you have probably heard of Apoquel.
This “miracle drug” hit the market a few years ago and is a fast and effective way to save your dog from itchy, sore, red skin.
But now that dog owners and veterinarians have been using the drug for a while, we’re discovering that this medication may not be the miracle it appears to be.
Many dog owners are now desperate for alternative ways to manage their pet’s condition.
In this article, we have put together a list of some of the best Apoquel alternatives to manage your dog’s skin condition.
None are as simple as giving your dog medication, but they are much healthier and safer alternatives.
We will also take a closer look at Apoquel, how it works and why it is dangerous, and talk about the important question of how you can wean your dog off Apoquel if they are already on this expensive and potentially life-threatening drug.
Contents & Quick Navigation
- What Is Apoquel?
- Side Effects Of Apoquel
- Apoquel Dependence
- Apoquel Alternatives For Dogs
- Treating Atopic Dermatitis In Dogs
- FAQs About Apoquel
- Final Thoughts
- Save To Pinterest
- Top Picks For Our Dogs
What Is Apoquel?
Apoquel is the brand name for an FDA-approved, oclacitinib-based drug made by Zoetis that is designed to treat severe skin conditions and itching.
It’s usually prescribed for atopic dermatitis, a chronic skin condition for which there is no known cure. Before giving your dog the drug, a vet should rule out other potential causes for the condition, including parasites, infections, and food allergies.
Apoquel works by inhibiting some of the Janus kinase pathways that work within the immune system.
These pathways do important things such as police the body for tumors, control growth and development, manage white and red blood cell formation, ensure that B-cells and T-cells are functioning properly, and regulate inflammatory responses.
It is this final item on the list, an inflammatory response, that causes skin irritation. So, by disrupting these pathways, the drug stops the immune system from causing skin inflammation in response to an irritant or allergen.
Apoquel should only be given to dogs older than one year and needs to be given on a daily basis. It will start to work straight away, within 24 hours, but the effects wear off just as quickly.
Because Apoquel deals with the symptom of skin irritation rather than the underlying cause, it is only prescribed for dogs whose condition can not be “cured.” For this reason, it is expected that the dog will probably be on the medication for their rest of their life.
The drug is considered safe to use alongside the majority of other medications that your dog might need, including antibiotics, antifungals, allergy shots, and flea treatments.
Side Effects Of Apoquel
When you first put your dog on Apoquel, it may seem like a godsend as their long-term skin issues and itching disappear rapidly. But there is a high price to pay, as the drug has significant side effects.
In addition to diarrhea and vomiting, common side effects of many medications, Apoquel does its work by disrupting kinase pathways, which deals with the itching but undermines your dog’s immune system.
This makes your dog more susceptible to many other medical problems. The most common include Demodex mange, ear infections, and pneumonia.
The drug also often reduces the white blood cell count in dogs, and this can lead to serious conditions such as extreme weight loss, lethargy, and high cholesterol.
The drug can also seriously undermine your dog’s chance of survival if they develop cancer. It inhibits their ability to fight the disease, and lab tests suggest it could even encourage the growth of cancer cells.
While only six percent of dogs test positive for these side effects when using the drug for a period of 30 days, most dogs will be on Apoquel for years, which significantly increases the likelihood they will develop these related health issues over time.
Apoquel is usually prescribed for dogs that have serious, chronic skin conditions, the cause of which cannot be identified. So, it is anticipated that the dog will be on the medication for life. But what if you want to take your dog off of Apoquel?
Apoquel does not cure the skin condition, so if you take your dog off the drug, the skin irritation will return—and probably worse than ever.
This is because your dog’s kinase pathways and immune system are no longer functioning as they did before, and without the drug to tell these pathways how to function, the immune system can fall into chaos.
As a result, your dog becomes dependent on Apoquel for their body to function in any kind of balance.
If you want to take your dog off Apoquel, you will need to be prepared to deal with a withdrawal period as their immune system learns to balance itself again, as well as find an Apoquel substitute for their returned skin irritation.
Apoquel Alternatives For Dogs
So now you are asking yourself, is there an alternative to Apoquel for dogs on the market with a cheaper price tag?
The answer is no. The patent on the drug does not expire until 2026, so we won’t be seeing any generic Apoquel alternatives in the immediate future.
There are also no drug Apoquel alternatives for dogs that are effective and safe. In fact, the other drugs used for this condition carry similarly disturbing side effects.
Once a popular treatment for dermatitis, this drug, based on Cyclosporine, was actually originally developed to prevent organ transplant rejection in humans, again by suppressing the immune system. But, much like Apoquel, it has a highly destructive effect on the immune system.
It also has a long list of side effects, of which just a few are: depression, extreme weight loss, trembling, and seizures.
While this risk may be worth it for a short period of time while getting a dog to accept a new organ, these side effects are unacceptable for dogs that might use the drug in the long term to manage skin conditions.
OUR EXPERIENCE: Stetson had some extreme skin allergies and we tried many different remedies to help relieve his itching. Several years ago our veterinarian at the time recommended and prescribed Atopica. We tried it for a few weeks, but the side effects weren’t worth it for Stetson. He was noticeably nauseous every morning and vomited at least once daily. Also, the price tag was a bit high at about $250 a month.
Prednisone is a steroid-based treatment, which comes with all the dangers associated with giving your dogs steroids for long periods of time.
These include dehydration, extreme weight gain or loss, lethargy and depression, and skin conditions that can flare up again, worse than ever, while the dog is on the medication.
OUR EXPERIENCE: Before Atopica our vet used Prednisone to suppress Stetson’s skin allergies. It worked for the short term and the only side effect we noticed was excessive urination (he had to pee all the time). However, it is not a practical long term solution.
While antihistamines do not carry any dangerous side effects for dogs, they are generally ineffective against both allergies and dermatitis.
Treating Atopic Dermatitis In Dogs
So, if there are no Apoquel substitutes for dogs, and you don’t want to give your dog this potentially dangerous drug, what can you do?
There are a number of steps you can take, all of which will have a different level of effect depending on the cause of your dog’s condition. With all of them, it is really a game of trial and error, testing each to see if it is effective.
This can be a long and painful process as you watch your dog suffer as you look for a way to help him. Here are some things you can try:
1. Change Their Diet
Often, chronic skin conditions are caused by an unidentified allergen or sensitivity to something in the food they eat regularly. It is then your job to figure out what that allergen might be.
The best way to do this is with an elimination diet. You restrict their diet to the bare basics, which are unlikely to be causing them problems.
If their condition calms down once they are on this diet for a week or two, you can be confident they’re suffering from a food allergy.
To then identify what they can and can’t eat, every two weeks you can introduce a new food into their diet and observe whether it causes their skin condition to flare up.
This is a long process, and there is a lot of work involved, as it will mean making all of your dog’s food yourself from scratch so you know exactly what is going in their diet.
This can also present alternative problems; if the diet is not properly balanced, they may start to miss some of the other nutrients they need.
Commercial dog foods usually contain a “nutrient pack,”which contains supplements to ensure that your dog is getting all of the nutrients they need. So, your dog will be missing these for a while.
If you do decide to go down this path, check out our list of Homemade Dog Treat Recipes.
If this seems like something you simply won’t be able to do, you can try eliminating the most probable allergens and irritants in their food. These include:
- Artificial additives
- Meats including beef, chicken, lamb, pork, and fish
Does that seem like a long list of meats? Dogs tend to develop allergies and sensitivities to the meats they eat most.
That is why it is always recommended to mix up your dog’s diet, including novel proteins such as venison and rabbit, so they become less likely to develop these sensitivities.
OUR EXPERIENCE: Our auntie’s Beagle had extreme skin allergies and by changing the protein in his diet to rabbit solved many of his allergy problems.
Also, remember that most dogs are allergic to more than one thing, so again, there will be a lot of trial and error involved in detecting the source of the problem.
You can read more about undertaking an elimination diet with your dog here.
2. Address Environmental Allergens
Food is not the only source of allergens that may be affecting your dog. Skin irritation can also be caused by air or surface contact allergens.
You can try and address these allergens by using powerful air purifiers in your home, ensuring you change the HVAC filters frequently.
You can also try to test your dog for allergies by limiting their contact to common allergens such as grass and pollen.
If you find that air filters help to relieve, but not eliminate, your dog’s allergies, you can then try immunotherapy. This will narrow down the potential allergens affecting your dog, assisting in identification.
Your dog is then exposed to the allergen through a series of shots or oral drops, making the dog accustomed to the allergen and reducing their reactions to it.
OUR EXPERIENCE: Stetson’s skin allergies went from mild to severe so we tried as many remedies we found available.
While some like Prednisone and and Atopica worked, the side effects were too serious to use the drugs long term.
The good news is we did find a solution for Stetson. Our home became too small for our growing family and we wanted a large backyard. Shortly after moving to a new home Stetson’s allergies magically disappeared!
The skin allergies that had plagued him his whole life was somehow tied to the environment (our previous home) we lived in.
3. Try Supplements
Supplements can make a big difference to your dog’s condition, as there are some supplements that naturally reduce skin inflammation, and a lack of certain vitamins and minerals can also make it more difficult for your pooch to fight allergies.
For example, you could start with a Vitamin D test, as this is a major player when it comes to your dog fighting off allergies.
Fish oil is also one of the first supplements to consider, as the omega fatty acids in fish oil can relieve itching.
WE LIKE: Amazing Nutritionals Omega 3 Chews Pure Fish Oil – Fish oil was recommended by our vet for Stetson’s skin allergies. I didn’t notice an improvement. However, we’ve kept all of our dogs on fish oil for the added health benefits.
Adding digestive enzymes and probiotics to their diet can also make a big difference if an unidentified food source is the cause of their problem.
WE LIKE: Purina Pro Plan Veterinary Diet Fortiflora Probiotic – We use this with our dog, Raven when she has an upset stomach. However, we’ve never used it for skin allergies so I can’t attest to its effectiveness for clearing up an itchy, scratchy dog.
4. Topical Soothing
There are a number of topical treatments that can help ease your dog’s pain and itchiness while you look for a more permanent solution.
There are many pre-made remedies on the market, or you can make your own at home. Many of the best treatments are based on coconut oil, as it is a natural skin soother and has antibacterial properties.
Green tea, camomile tea, baking soda, oatmeal, and apple cider vinegar are also good base ingredients for these types of skin soothers.
FAQs About Apoquel
Can I Stop Giving My Dog Apoquel?
If your dog is taking Apoquel, you can take them off the drug at any time, but you should expect them to go through a period of withdrawal.
Apoquel changes the way the Janus kinase pathways in the immune system work. They no longer function in their natural way, and rely on the medication to inform them how to function.
When you take your dog off Apoquel, their immune system can be thrown into crisis, as it no longer knows how to function normally and does not have the drug to guide it. This means their skin condition can return significantly worse than before.
No tests have been conducted to indicate how long it takes for their immune system to restore itself, but you can expect it to take several weeks at least.
What Is The Generic Alternative To Apoquel?
There are currently no generic Apoquel alternatives for dogs. The drug is patented until 2026, so it is not expected that a generic Apoquel substitute will hit the market until after that time.
How Long Can A Dog Stay On Apoquel?
The FDA has not placed a limit on the length of time a dog can remain on Apoquel. Testing conducted with Apoquel suggests that six percent of dogs develop negative side effects while taking the drug for a period of 30 days, but studies for longer periods do not currently exist.
It is anticipated that a dog’s likelihood to be negatively affected increases the longer they are on the medication.
Is Apoquel Safe?
Apoquel is a highly effective medicine against skin irritation, but it also has serious potential side effects. The drug works by altering the immune system, which can have unexpected consequences including making your dog more susceptible to certain conditions, causing depression and extreme weight loss, and even potentially increasing the likelihood of developing cancer.
Testing suggests that six percent of dogs will develop negative side effects when using the drug for 30 days.
Tests for longer periods do not exist, but it is suspected that a dog’s likelihood of developing side effects increases the longer they spend on the drug.
Apoquel is a highly effective drug when it comes to treating serious skin irritation in dogs, and can seem like a lifeline for many dog owners and their pups. However, the risks associated with the drug should not be understated.
The medication changes the way your dog’s immune system works, and this leaves them susceptible to many other health conditions.
Tests have shown that dogs can also develop depression and suffer from extreme weight loss while using Apoquel, and even that it may increase the likelihood and severity of cancer.
Testing suggests that six percent of dogs that take the drug for a period of 30 days develop these negative side effects. If your dog is on the drug for longer, their likelihood of developing these side effects increases.
Apoquel is generally prescribed as a long-term treatment for skin irritation, and once your dog is on the drug, it is not simple to wean them off.
When you take them off the drug, their skin condition can flare up worse than before.
Moreover, their immune system is left in chaos, as it is no longer functioning how nature intended and is also no longer guided by the drug. It can take a significant period of time for their system to correct itself.
Whether Apoquel is worse than the risk depends on your dog, the potential cause of the condition, its severity, and how it is affecting their quality of life.
Unfortunately, there is no simple and safe Apoquel substitute on the market. Other medications used for the same purpose tend to be less effective and carry similar side effects.
If you want to take your dog off Apoquel, prepare for a long challenge ahead. You will need to engage in a process of trial and error to identify the underlying cause of their condition, while also looking for safer ways to ease their itching, which will likely be less effective than Apoquel.
It can be very difficult to watch your dog suffer as you look for a way to help them.
As I mentioned we did try some of the Apoquel alternative drugs including Prednisone and Atopica, however the side effects far outweighed the risk. We declined to try a third drug (Apoquel) that may have debilitating side effects.
The good news for us is we did find (accidentally) a solution for Stetson. Changing his living environment magically cleared up his skin in a short amount of time.
Unfortunately, moving to a new home may not be a practical solution for you.
Have you found a solution to help with your dog’s allergies?
Tell us about what has and has not worked for you in the comment section below.
Save To Pinterest
Top Picks For Our Dogs
- BEST PUPPY TOY
We Like: Snuggle Puppy w/ Heart Beat & Heat Pack - Perfect for new puppies. We get all of our Service Dog pups a Snuggle Puppy.
- BEST CHEW TOY
We Like: KONG Classic - Great toy for heavy chewers like our Labrador Retrievers.
- BEST DOG TREATS
We Like: Zukes Mini Naturals - One of our favorite treats for training our service dog puppies.
- BEST FRESH DOG FOOD
We Like: The Farmer's Dog - A couple months ago we started feeding Raven fresh dog food and she loves it! Get 50% off your first order of The Farmer's Dog.
For a list of all the supplies we get for our new service dog puppies check out our New Puppy Checklist on the PuppyInTraining.com blog.