Apoquel for Dogs: Dosage, Side Effects, and Natural Alternatives
Reading Time:
- What Is Apoquel for Dogs?
- How Does Apoquel Work in Dogs?
- What Does Apoquel Treat?
- What Does Apoquel Not Treat?
- How Much Apoquel Should I Give My Dog?
- What Are the Side Effects of Apoquel?
- Who Should Not Take Apoquel?
- Apoquel vs. Cytopoint vs. Benadryl: Which Is Best?
- Natural Alternatives to Apoquel for Dogs
- Need Help Managing Your Dog’s Itch?
- Frequently Asked Questions (FAQs)
If your dog is scratching themself raw, you want immediate relief. That’s exactly why veterinarians prescribe Apoquel for dogs.
It’s one of the most popular allergy medications in the world (prescribed to over 13 million dogs) because it works fast. Studies show it begins to relieve itching in just 4 hours.
But speed comes at a cost. Apoquel works by suppressing parts of your dog’s immune system. It’s a tool that requires strict dosing and safety monitoring.
Here’s what you need to know to use it safely, from the critical 14-day rule to the risks you must watch for.
What Is Apoquel for Dogs?
Apoquel is a non-steroidal prescription medication used to control itching (pruritus) and inflammation caused by allergic skin diseases.
Unlike antihistamines, which are often too weak, or steroids, which affect the whole body, Apoquel is a selective JAK inhibitor. This means it works surgically to block the specific enzymes that tell your dog’s brain to scratch, providing relief without numbing their entire immune system.
What Is the Difference Between Apoquel and Oclacitinib?
It’s common to hear these terms used interchangeably, but there’s a simple description:
- Apoquel is the brand name of the product manufactured by Zoetis.
- Oclacitinib is the active drug ingredient inside the tablet.
It’s exactly like the difference between Tylenol (brand) and acetaminophen (ingredient). Currently, there’s no generic version of oclacitinib available; it’s only sold under the brand name Apoquel.
How Does Apoquel Work in Dogs?
Apoquel works by inhibiting (blocking) Janus Kinase (JAK) enzymes. When your dog has an allergic reaction, whether to pollen, fleas, or food, their body releases proteins called cytokines. These cytokines attach to receptors in the body called JAK enzymes. When they connect, they send a signal to the brain that screams, “Itch now!”
Apoquel essentially cuts the line so the brain never receives the message to scratch. This allows the skin to heal because your dog stops tearing at it.
Note: Apoquel treats the symptom (the itch), not the cause (the allergy). If you stop the medication without fixing the underlying issue (like fleas or diet), the itch will return immediately.
What Does Apoquel Treat?
Veterinarians prescribe Apoquel for one primary purpose: control. It’s FDA-approved to control pruritus (severe itching) associated with allergic dermatitis and to control atopic dermatitis in dogs aged 12 months and above.
Essentially, if your dog is reacting to the world around them, Apoquel is the shield that stops them from tearing their skin apart while you figure out the root cause. It’s most commonly prescribed for these conditions:
| Condition | Common Triggers | How Apoquel Helps |
|---|---|---|
| Atopic Dermatitis | Pollen (grass/tree), mold spores, and dust mites. | It acts as a long-term management for this chronic, genetic condition, allowing your dog to play outside without misery. |
| Flea Allergy Dermatitis | Sensitivity to flea saliva (bites). | It stops the intense itching caused by the bite, but it doesn’t kill the fleas. You still need a preventative. |
| Food Allergies | Proteins like chicken, beef, or dairy. | It provides immediate relief while you transition your dog to a new hypoallergenic diet. |
| Acute Hot Spots | Self-trauma (constant licking/biting). | It breaks the vicious itch-scratch cycle immediately, allowing the raw skin to scab over and heal. |
| Contact Dermatitis | Carpet cleaners, fertilizers, shampoos, and wool. | It suppresses the rash and reaction caused by physical contact with irritants. |
What Does Apoquel Not Treat?
You must understand that Apoquel turns off the sensation of itching, but it doesn’t kill pathogens. It’s ineffective against:
- Mange (mites): Sarcoptic or demodectic mange causes intense itching, but Apoquel will not kill the mites. In fact, suppressing the immune system can make demodex mites multiply faster.
- Yeast or bacterial infections: Allergies often cause secondary infections (smelly, greasy skin). Apoquel might stop the scratching, but the infection will continue to rage unchecked unless treated with antibiotics or antifungals.
Golden Rule: If the itch stops but the smell remains, your dog likely has a secondary infection that needs a different medication.
How Much Apoquel Should I Give My Dog?
The standard veterinary dosage for Apoquel for dogs is 0.4 mg to 0.6 mg per kilogram (approx. 0.18 mg to 0.27 mg per pound).
Apoquel isn’t a medication where you can eyeball the dose. It requires a precise schedule to balance the immediate relief with long-term safety. Zoetis, the manufacturer, established a strict two-phase schedule that you must follow:
- Day 1–14 (loading phase): Give the dose twice daily (every 12 hours) to stop the itch immediately.
- Day 15+ (maintenance phase): Drop to once daily (every 24 hours). Do not extend the twice-daily phase past 14 days, as this increases the risk of immune suppression.
Apoquel comes in three tablet strengths: 3.6 mg, 5.4 mg, and 16 mg. Your veterinarian will mix and match these to hit your dog’s specific weight bracket.
| Dog Weight (lbs) | Tablet Strength | Tablets Per Dose |
|---|---|---|
| 6.6 – 9.9 lbs | 3.6 mg | ½ |
| 10 – 14.9 lbs | 5.4 mg | ½ |
| 15 – 19.9 lbs | 5.4 mg | ½ |
| 20 – 29.9 lbs | 3.6 mg | 1 |
| 30 – 44.9 lbs | 5.4 mg | 1 |
| 45 – 53.9 lbs | 16 mg | ½ |
| 54 – 59.9 lbs | 16 mg | ½ |
| 60 – 89.9 lbs | 16 mg | 1 |
| 90 – 129.9 lbs | 16 mg | 1 ½ |
| 130 - 175.9 lbs | 16 mg | 2 |
Apoquel is generally gentle on the stomach, but if your dog is sensitive, wrap the pill in cheese or wet food to prevent issues.
If you miss a dose, just give the next one at the scheduled time. Never double up to make up for it, as this can lead to toxic levels.
What Are the Side Effects of Apoquel?
Side effects generally fall into two categories: mild “adjustment” symptoms and serious immune-related risks.
Because Apoquel works by modulating the immune system, it affects more than just the skin. While millions of dogs take it safely, you must be vigilant, especially during long-term use. Here’s what to watch for:
Common Side Effects
In FDA clinical trials, the most common side effects were gastrointestinal. These typically appear in the first few weeks as the body adjusts to the medication.
- Vomiting and diarrhea are common side effects. In a medical trial involving 283 dogs, 6% of them had diarrhea and 9.2% experienced vomiting. Giving the pill with food often solves this.
- Lethargy is common; your dog might seem sleepier than usual. In some cases, this is simply the dog finally catching up on sleep after weeks of keeping themselves awake scratching.
Serious Long-Term Risks
Because Apoquel inhibits JAK enzymes (which help control the immune response), it lowers your dog’s defenses against other threats.
If your dog is on Apoquel for months or years, their body may struggle to fight off:
- Infections: Increased risk of pneumonia, ear infections, and urinary tract infections (UTIs).
- Demodectic mange: This is a specific red flag. Demodex mites live naturally on dogs in small numbers. A healthy immune system keeps them in check. Apoquel can suppress that control, leading to a sudden, severe outbreak of mange.
- New cutaneous lumps (warts/histiocytomas): You may notice small benign growths appearing on the paws or eyelids.
Does Apoquel Cause Cancer in Dogs?
Apoquel doesn’t necessarily create cancer in a healthy dog. However, if your dog already has a hidden tumor or early-stage cancer, Apoquel can disable the immune system’s ability to fight it, allowing the cancer to grow faster.
That’s why the label explicitly states that Apoquel “may exacerbate neoplastic conditions.”
Warning: If your dog develops a new lump, has a history of cancer, or develops a severe infection, stop Apoquel immediately and call your vet.
Who Should Not Take Apoquel?
Apoquel is a wonderful medication, but it’s not safe for every dog. Because it modifies the immune system, giving it to a dog with an underdeveloped or compromised system can be dangerous.
Before starting this prescription, ensure your dog passes these three safety checks.
1. The 12-Month Age Limit
Never give Apoquel to a puppy under 12 months old.
This is a strict FDA warning, not a suggestion. In young puppies, the immune system is still building the body’s defenses.
Clinical studies showed that puppies under a year old who took Apoquel developed pneumonia and, in rare cases, demodicosis (mange) at alarming rates.
If your puppy has allergies, ask your vet about Cytopoint or mild medicated shampoos instead.
2. Dogs with Serious Infections
If your dog is currently fighting a severe infection, Apoquel will disarm the very system they need to win that fight.
Do not use this medication if your dog has:
- Systemic fungal infections.
- Severe bacterial pneumonia.
- Demodectic mange.
3. Dogs with a History of Cancer
If your dog has a history of cancer (neoplasia) or is currently undergoing chemotherapy, Apoquel is generally contraindicated.
Since the drug works by dampening immune surveillance, it might prevent the body from detecting and destroying early-stage cancer cells. Always have a frank conversation with your vet about your dog’s cancer risk profile before starting long-term treatment.
Note on Breeding: Apoquel hasn’t been proven safe for pregnant, lactating, or breeding dogs. If you plan to breed your dog, you must discontinue use well in advance.
Apoquel vs. Cytopoint vs. Benadryl: Which Is Best?
Apoquel is effective, but it’s not your only option. The two biggest competitors you’ll likely discuss with your vet are Cytopoint (an injection) and Benadryl ****(an over-the-counter antihistamine).
The table below compares how they stack up in terms of speed, safety, and effectiveness.
| Feature | Apoquel | Cytopoint | Benadryl |
|---|---|---|---|
| Type | Daily Pill | Injection | Daily Pill |
| How it Works | Blocks the signal receptor by inhibiting JAK enzymes. | Neutralizes the signal itself by targeting the IL-31 cytokine specifically. | Blocks histamine to stop reactions to insect bites/hives. |
| Relief Speed | ➡️ Fast (4 Hours) | ⏳ Slow (24 Hours) | ⏩ Very Fast (1 Hour) |
| Duration | 12 to 24 Hours | 4 to 8 Weeks | 4 to 6 Hours |
| Safety Profile | 🟠 Moderate. It suppresses the immune system and requires blood work. | 🟢 High. It mimics natural antibodies and is safe for all ages/cancer patients. | 🟢 High. Safe, but causes drowsiness. |
| Cost | ~$94 (3.6 mg/30 tablets) to ~$379 (16 mg/120 tablets). Daily cost adds up. | $50 to $200 per shot. Expensive upfront. | ~$4.50 (25 mg/100 tablets) to ~$5.50 (50 mg/100 tablets). Very cheap. |
| Best For | Stopping severe acute flares quickly. | Long-term maintenance without immune risks. | Mild insect bites or hives (ineffective for severe dermatitis). |
If you’re wondering which medication is right for you, here’s how to decide:
- Choose Apoquel if you need to stop a severe allergic flare-up today and want a daily pill you can control at home.
- Choose Cytopoint if you have a puppy, a dog with cancer, or a dog that’s impossible to pill. It’s safer long-term because it doesn’t suppress the immune system, but it’s more expensive.
- Choose Benadryl if your dog has a simple bug bite or bee sting, but note that it’s generally ineffective for atopic dermatitis.
Natural Alternatives to Apoquel for Dogs
Many pet parents hate the idea of keeping their dog on a strong immunosuppressant for life. The cost is high, and the long-term risks are real. However, stopping Apoquel cold turkey often leads to a rebound effect, where the itching comes back worse than ever.
We recommend using safe, natural remedies for dogs to manage baseline inflammation. Here’s what will allow you to work with your vet to lower the Apoquel dosage while keeping your dog comfortable:
- Inflammation management: While Apoquel disconnects the itch signal, CBD interacts with the Endocannabinoid System (ECS) to lower the body’s inflammatory response. Adding CBD oil for dogs can manage the itching, potentially allowing you to space out prescription doses.
- Gut restoration: Chronic allergies are often linked to “leaky gut,” where toxins enter the bloodstream and trigger skin irritation. Our Probiotic Healthy Gut Bundle seals the gut lining to stop inflammation at the source.
- Natural flea control: If your dog is allergic to flea saliva, you don’t need immune suppression; you need a shield. Our Flea Protection Bundle uses essential oils to prevent bites without using chemical neurotoxins.
- Barrier strengthening: Sometimes, the best defense is physical. Wash off pollens with the best dog shampoo for itchy skin and add Wild Alaskan Salmon Oil for Dogs to their food. The omega-3s act as internal moisturizers, strengthening the skin so allergens can’t penetrate as easily.
Need Help Managing Your Dog’s Itch?
Apoquel is a lifesaver, but it doesn’t have to be the only tool in your arsenal. Perhaps you’re worried about side effects or you just want to strengthen your dog’s natural defenses. Either way, there are options.
If you have questions about how to safely use CBD, probiotics, or natural flea protection alongside your vet’s prescription, our team is here to help. Call us at (310) 817-5731. We can help you build a plan that stops the itch and protects your dog.
Frequently Asked Questions (FAQs)
Can I stop giving Apoquel to my dog cold turkey?
No, you should not. Stopping suddenly often causes a "rebound effect," where the itching returns more intensely than before because the immune system is no longer suppressed.
If you want to take your dog off Apoquel, work with your veterinarian to create a tapering schedule (gradually reducing the dose) while introducing natural supports like CBD oil to manage the transition.
Is Apoquel a steroid?
No. Apoquel (oclacitinib) is a JAK inhibitor, not a corticosteroid (like prednisone). This means it generally has fewer side effects than steroids; it doesn't typically cause excessive thirst, urination, or muscle wasting. However, it is still an immunosuppressant.
Can I crush Apoquel tablets?
Yes. If your dog refuses to swallow the pill whole, you can crush it and mix it into a small amount of wet food or cheese. Just make sure they eat the entire amount so they get the full dose.
Can I give Apoquel with other medications?
Generally, yes. Apoquel is safe to use with antibiotics, NSAIDs (like carprofen), and vaccines.
However, it should not be used with other potent immune suppressants (like corticosteroids or cyclosporine) as this shuts down the immune system too completely, inviting serious infection.
Always give your vet a full list of supplements and drugs your dog is taking.
Does Apoquel cause weight gain?
Not directly. Unlike steroids, Apoquel doesn't typically slow the metabolism. However, many dogs who were too miserable to eat when they were itching may suddenly regain their appetite once the relief kicks in. This is usually a sign of returning health, not a side effect.
What if Apoquel stops working?
If your dog starts itching again while on the medication, do not increase the dose yourself. This usually means one of two things:
- The underlying cause has flared up (e.g., a massive pollen spike or a new flea infestation).
- Your dog has developed a secondary infection (yeast or bacteria), which Apoquel can’t treat.
Visit your vet to check for infections rather than just adding more pills.
Approved by:
Dr. Ivana Vukasinovic
Doctor of Veterinary Medicine, University of Belgrade
Ivana Vukasinovic grew up in Serbia and attended the University of Belgrade where she received a degree in Veterinary medicine in 2012 and later completed surgical residency working mostly with livestock. Her first year of practice was split between busy small animal practice and emergency clinic, and after two more years of treating many different species of animals, she opened her own veterinary pharmacy where an interest in canine and feline nutrition emerged with an accent on fighting animal obesity. In her free time, she acts as a foster parent for stray animals before their adoption, likes to read SF books and making salted caramel cookies.
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Sincerely,
The Innovet Team
Please do not ask for emergency or specific medical questions about your pets in the comments. Innovet Pet Products is unable to provide you with specific medical advice or counseling. A detailed physical exam, patient history, and an established veterinarian are required to provide specific medical advice. If you are worried that your pet requires emergency attention or if you have specific medical questions related to your pet’s current or chronic health conditions, please contact or visit your local/preferred veterinarian, an animal-specific poison control hotline, or your local emergency veterinary care center.
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