By Rania Gollakner, BS, DVM, MPH; Catherine Barnette, DVM

What is oclacitinib?

Oclacitinib (brand name Apoquel®) is an oral medication used to manage itching associated with allergic dermatitis (including atopy) in dogs at least 12 months of age. It may also be effective for treating other skin conditions in dogs and has been used occasionally to treat certain skin conditions in cats.

The use of oclacitinib for conditions other than allergic dermatitis in dogs or its use in cats is considered off-label. Many drugs are commonly prescribed for off-label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully.

How does oclacitinib influence itch?

Oclacitinib works by inhibiting enzymes involved in itch, inflammation, and allergic reactions (janus kinase enzymes 1 & 3 [JAK1 & JAK3]). In many patients, this medication is as effective as corticosteroids but with fewer side effects.

This medication should take effect within one to two days, and improvements in clinical signs should follow.

How do I give my pet oclacitinib?

Oclacitinib is given by mouth in the form of a tablet. This medication may be given with or without food. If stomach upset occurs when dosed on an empty stomach, give future doses with food.

Oclacitinib is considered a hazardous drug. Wear gloves when handling the medication, and do not handle if you are pregnant or nursing. Wash your hands immediately after administering.

What if I miss giving my pet the medication?

If you miss a dose, give it when you remember, but if it is close to the time for the next dose, skip the dose you missed and give it at the next scheduled time and return to the regular dosing schedule. Never give your pet two doses at once or give extra doses.

Are there any potential side effects from oclacitinib?

Most dogs demonstrate few side effects from oclacitinib, provided it is given according to label recommendations and at the prescribed interval. The most common reported side effects include gastrointestinal effects (such as vomiting, diarrhea, and decreased appetite) and lethargy. These effects can often be alleviated by giving the medication with food.

Less common side effects may include increased susceptibility to infections, such as urinary tract infections, respiratory infections, and skin infections as well as new skin growths. Although these effects are rare, contact your veterinarian immediately if your dog develops a skin mass, fever, shortness of breath, or other signs of infection. Make sure your veterinarian is aware of any other medications/natural remedies that you are giving to your pet.

This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

Oclacitinib should be avoided in patients with current or recent demodectic mange (Demodex). In clinical trials, a small number of patients developed demodectic mange while on this medication due to changes in the skin’s immune function. Oclacitinib should also be avoided in patients with serious infections, such as pneumonia.

"Oclacitinib should be avoided in dogs younger than 12 months old."

Oclacitinib has not been evaluated for use in pregnant, nursing, or breeding dogs, and therefore should be avoided in these patients. Oclacitinib should be avoided in dogs younger than 12 months old. There is a small risk that oclacitinib may exacerbate some neoplastic (cancerous) conditions. For this reason, oclacitinib should be avoided in patients with cancer or with a history of cancer.

Are there any drug interactions I should be aware of?

Tigilanol tiglate (Stelfonta®), a type of chemotherapy, should be used with caution when given with oclacitinib. Short-term use of corticosteroids or cyclosporine (Atopica®) while on oclacitinib has been demonstrated to be safe, but prolonged usage while on this medication has not been evaluated and is not recommended.

Oclacitinib can be safely combined with antihistamines, non-steroidal anti-inflammatory drugs (NSAIDs), anti-seizure medications, allergy immunotherapy, and vaccines. Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

Is there any monitoring that needs to be done with this medication?

Periodic bloodwork monitoring is recommended for dogs that will receive oclacitinib on a long-term basis. Although uncommon, some patients will develop decreased white blood cell counts on this medication, which may make them more prone to infection. Early detection through routine monitoring bloodwork is important to prevent adverse effects. Talk to your veterinarian to determine the recommended bloodwork monitoring schedule for your pet.

Monitoring for efficacy, for signs of infections, or for masses on/under the skin is also recommended.

How do I store oclacitinib?

This medication should be stored at room temperature (20°C – 25°C or 68°F -77°F).

What should I do in case of an emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.

Related Articles