![]() Apoquel is effective very quickly, so there is no need to transition slowly from steroids to Apoquel. If steroids are needed with Apoquel, evaluate how well the Apoquel is actually working for the patient. My clinical experience would suggest that steroids at anti-inflammatory doses of 0.5mg/kg twice daily and taper is seems to be safe for the short term. Long term studies of giving Apoquel along with other immunosuppressants like steroids and cyclosporine have not been done. I recommend using caution with other drugs that may affect the bone marrow however. I have not seen bad side effects giving almost any drug with Apoquel, including ketoconazole. In humans, it is not recommended to give some of these JAK inhibitor drugs with CYP3A4 inhibitors like ketoconazole. Most moderate to severe skin diseases need combinations of several therapies to keep the patient well controlled. Zoetis reports that 60% of moderate to severe atopic dermatitis cases are controlled long term at once daily dosing, some severe cases may do better on twice daily dosing long term, but this is off label use (not FDA approved). Infections with yeast, bacteria, or mites may prevent apoquel from working as well as it should. I have seen some mild cases that are managed with lower doses.Īpoquel works rapidly, most dogs see complete relief within just a few days. The dose range is very strict, I do not recommend going above the recommended dose due to immune suppression, below the range and it doesn’t seem to work in most cases. Apoquel is not FDA approved to use twice daily longer than 14 days. The dose of Apoquel is 0.4-0.6 mg/kg every 12 hours for up to 14 days, then 0.4-0.6 mg/kg once daily thereafter. The antipruritic effects of the Apoquel wear off quickly, within 12-24 hours, so the medication needs to be given daily in most cases. It is very rare to have GI upsets with Apoquel like we can see with cyclosporine. Apoquel works differently than steroids, antihistamines, Cytopoint, or cyclosporine.Īpoquel works rapidly, usually within 24 hours, to diminish itching. JAK signaling is important to the function of the bone marrow as well. 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. 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. My clinical experience with Apoquel ® (oclacitinib), updated 1 /3 1/2023Īpoquel® is the brand name of oclacitinib, an FDA approved immune suppressant drug in the Janus Kinase (JAK) inhibitor class made by Zoetis. ![]()
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