Apoquel: What Is It? Is it Safe for Humans?

pill for dog in hand

The Bottom Line

Apoquel® is the brand name for oclacitinib, a medication approved for use in dogs to stop itching caused by many different reasons.  This medication is similar to corticosteroids but, has fewer side effects. Oclacitinib is only indicated for use in dogs and is not for human consumption.

woman experiencing stomachache

What is Apoquel® for dogs? 

Apoquel® is the brand name for a prescription medication called oclacitinib. This medication is known as a JAK inhibitor because it blocks an enzyme called janus kinase (JAK), which is responsible for activating many different bodily responses, especially within the immune system.

Oclacitinib specifically blocks the JAK-1 type enzymes responsible for inflammation and allergic reactions. For this reason, it is used for the treatment of allergic itching conditions. Apoquel® is only approved for use in dogs.  Other medications used for the management of skin itchiness in dogs include glucocorticoids, modified cyclosporine, lokivetmab (Cytopoint® injection), antihistamines, and essential fatty acids.

Can humans take Apoquel®?

Oclacitinib is not indicated for use in humans. There are other medications similar to oclacitinib that were created for use in humans, which affect the body in slightly different ways. These similar medications are known as “tinibs” because their drug names all end in “tinib.” 

“Tinibs” are used in humans to treat inflammatory conditions such as rheumatoid arthritis, atopic dermatitis and psoriasis, and inflammatory bowel disease. One member of this group, baricitinib, was approved for emergency use by the FDA for use in children ages 2-18 years old to decrease inflammation due to COVID-19 infections. This specific use has not been approved for other drugs in the “tinib” class. Baricitinib is only used in severe COVID-19 cases where a patient requires oxygen treatment due to inflammation in the lungs and has a severe immune response to the infection. This is not a medication that would be prescribed and used for patients who are not hospitalized. Medications in this class should not be substituted for one another, as each is formulated to treat specific illnesses. They are not interchangeable.

Can Apoquel® treat COVID-19 infections in humans?

No. Apoquel® is not indicated or approved for use in humans. This medication is only approved for use in dogs. The medical use in dogs is to treat itching and inflammation, not COVID-19 infection.  

What to do if someone accidentally takes Apoquel®?

There is no antidote for oclacitinib. Overdose symptoms are treated individually. There is no antidote. In order to minimize the risk of accidental ingestion, it is recommended to deliver the dose to your dog immediately upon unwrapping the medication from the package. If oclacitinib is accidentally ingested, it is recommended to obtain medical advice from a physician and/or to call Poison Control. Help from experts is available through the webPOISONCONTROL online tool and by phone at 1-800-222-1222. Poison Control’s expert guidance is always free, confidential, and available 24 hours a day.

What are the side effects of oclacitinib?

JAK inhibitors are very effective targeted medications. Nausea, vomiting and diarrhea are among the most common side effects experienced by dogs. Less frequent side effects include cancer and blood disorders. FDA has issued warnings about serious side effects with other medications in this class including risk of severe heart-related events, cancer, blood clots and death. Oclacitinib is similar to these medications, so caution is advised when using it. Studies in dogs did find oclacitinib should not be used in dogs who have a history of neoplasms, mange, or impaired immune systems.  In dogs with cancer, this medication did make the condition worse in some cases.

Oclacitinib is not indicated for dogs 12 months of age and younger or less than 3 kg bodyweight. It is also not regarded as safe to use in pregnant or lactating dogs, or in breeding dogs.

 

Kit DeMarco, PharmD
Community Pharmacist

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Poisoned?

Call 1-800-222-1222 or

HELP ME online

Prevention Tips

  • Oclacitinib is considered a hazardous drug. Wear gloves when handling the medication.
  • Do not handle this medication if you are pregnant or nursing.
  • Wash your hands immediately after administering.
  • Periodic bloodwork monitoring is recommended during long term use.
  • This medication should be stored at room temperature (20°C – 25°C or 68°F -77°F).
  • Store medicines up, away, and out of sight of children.

This Really Happened

A man in his 70s with a long history of skin disease with itching decided to prescribe himself oclacitinib even though this medicine is only approved for dogs. Treatment with traditional medication therapies for his skin condition were not working. Fortunately, he experienced relief from the itching which lasted 7 months without adverse events.

For More Information

How Apoquel Works | Video

References

Gonzales AJ, Bowman JW, Fici GJ, Zhang M, Mann DW, Mitton-Fry M. Oclacitinib (APOQUEL®) is a novel Janus kinase inhibitor with activity against cytokines involved in allergy. J Vet Pharmacol Ther. 2014 Aug;37(4):317-24. doi: 10.1111/jvp.12101. Epub 2014 Feb 5. PMID: 24495176; PMCID: PMC4265276. Accessed 5/7/2024.

Manufacturer information webpage for Apoquel®. https://www.apoquel.com/ Accessed 5/1/2024.

Haugh IM, Watson IT, Alan Menter M. Successful treatment of atopic dermatitis with the JAK1 inhibitor oclacitinib. Proc (Bayl Univ Med Cent). 2018 Sep 21;31(4):524-525. doi: 10.1080/08998280.2018.1480246. PMID: 30949000; PMCID: PMC6413965. Accessed 5/7/2024.

Rosanna Marsella, DVM, DACVD; Katherine Doerr, DVM, DACVD; Andrea Gonzales, PhD; Wayne Rosenkrantz, DVM, DACVD; Jennifer Schissler, DVM, DACVD; Amelia White, DVM, DACVD. Oclacitinib 10 years later: lessons learned and directions for the future JAVMA.  June 2023 Vol 261 (Vo. S1) doi.org/10.2460/javma.22.12.0570.  Accessed 5/7/2024.

Rania Gollakner, BS, DVM, MPH; Catherine Barnette, DVM. Oclacitinib. VCA Hospitals. https://vcahospitals.com/know-your-pet/oclacitinib. Accessed 5/8/2024.

Apoquel: EPAR - Summary for the public.  Reference Number: EMA/436990/2013. European Medicines Agency.  https://www.ema.europa.eu/en/documents/product-information/apoquel-epar-product-information_en.pdf  First published 10/15/2013. Last updated 1/21/2022. Accessed 5/9/2024.

Qian J, Xue X, Shannon J. Characteristics of adverse event reporting of Xeljanz/Xeljanz XR, Olumiant, and Rinvoq to the US Food and Drug Administration. J Manag Care Spec Pharm. 2022 Sep;28(9):1046-1052. doi: 10.18553/jmcp.2022.28.9.1046. PMID: 36001100; PMCID: PMC10372959. Accessed 5/10/2024.

Dupuis D, Fritz K, Ike E, Arogundade O, Adewara EO, Monday EO, Ayinde BO. Current Use of Baricitinib in COVID-19 Treatment and Its Future: An Updated Literature Review. Cureus. 2022 Sep 1;14(9):e28680. doi: 10.7759/cureus.28680. PMID: 36199657; PMCID: PMC9526681. Accessed 5/10/2024.

PharmaVet. Oclacitinib. Plumb’s Veterinary Medication Guides. 2019. https://dogcatdoc.com/wp-content/uploads/2021/05/VMG-Oclacitinib-APOQUEL.pdf. Accessed 5/22/2024.

Poisoned?

Call 1-800-222-1222 or

HELP ME online

Prevention Tips

  • Oclacitinib is considered a hazardous drug. Wear gloves when handling the medication.
  • Do not handle this medication if you are pregnant or nursing.
  • Wash your hands immediately after administering.
  • Periodic bloodwork monitoring is recommended during long term use.
  • This medication should be stored at room temperature (20°C – 25°C or 68°F -77°F).
  • Store medicines up, away, and out of sight of children.

This Really Happened

A man in his 70s with a long history of skin disease with itching decided to prescribe himself oclacitinib even though this medicine is only approved for dogs. Treatment with traditional medication therapies for his skin condition were not working. Fortunately, he experienced relief from the itching which lasted 7 months without adverse events.