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 is 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 (extra label. Many drugs are commonly prescribed for off-label use in veterinary medicine. “Off label” means the drug is being used in a way that has not been reviewed or approved by the U.S. Food and Drug Administration (FDA) or Health Canada. In these instances, follow your veterinarian’s directions and cautions carefully, as they may be significantly different from those on the label.
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.
How do I give my pet oclacitinib?
- Oclacitinib is given by mouth in the form of a tablet.
- Give this medication with or without food. If stomach upset occurs when dosed on an empty stomach, give future doses with food.
- Wash your hands immediately after administering.
Oclacitinib is considered a hazardous drug, so it is essential to avoid accidental exposure. Wear gloves when handling the medication and do not handle it if you are pregnant or nursing. If your pet vomits after receiving this drug, wear gloves while cleaning up.
This medication should take effect within one to two days, and improvements in clinical signs should follow.
What if I miss giving my pet the medication?
If you miss a dose, give it as soon as you remember, and then continue with the regular dosing schedule. However, if it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not give the pet two doses at once.
Are there any potential side effects from oclacitinib?
Oclacitinib may cause the following side effects:
- Gastrointestinal effects, such as vomiting, diarrhea, and decreased appetite
- Lethargy
- Increased susceptibility to infections, such as urinary tract, respiratory, and skin infections
- New skin growths
Serious adverse reactions may occur. If any of the following signs develop, stop giving oclacitinib and contact your veterinarian immediately:
- Development of a skin mass
- Fever
- Shortness of breath
- Other signs of infection
Drug sensitivities can develop over time, with repeated exposure. Your pet may have no reaction after the first few doses but may develop a sensitivity later. It is important to watch for signs of an allergic reaction over the entire course of treatment.
Other side effects may occur. If you notice anything unusual, contact your veterinarian immediately. 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?
DO NOT USE oclacitinib in:
- Pets with current or recent demodectic mange (Demodex)
- Pets with serious infections, such as pneumonia
- Pets with cancer or with a history of cancer (oclacitinib may exacerbate some cancerous conditions)
- Dogs that are pregnant, nursing, or breeding (safe use has not been evaluated)
- Dogs younger than 12 months old
Are there any drug interactions I should be aware of?
Several medications should be used with caution when given with oclacitinib, including:
- Tigilanol tiglate (Stelfonta®), a type of chemotherapy
- Prolonged use of corticosteroids or cyclosporine (has not been evaluated and is not recommended)
Short-term use of corticosteroids or cyclosporine (Atopica®) while on oclacitinib has been demonstrated to be safe. 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 before starting any treatment.
Is any monitoring needed with this medication?
- Your veterinarian will let you know when and how they want to reassess your pet to ensure the medication is working and not causing side effects.
- Periodic bloodwork monitoring is recommended for dogs receiving oclacitinib long-term. 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.
- Monitoring for signs of infections and for masses on/under the skin is recommended.
- At home, monitor for any side effects such as those noted above. If any occur, stop using the medication and contact your veterinarian.
How do I store oclacitinib?
- Store this medication at room temperature (68°F–77°F or 20°C–25°C).
- Keep the container out of reach of children and pets.
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. Be prepared to provide information about the product and your pet’s weight and symptoms.
