# Apoquel vs Cyclosporine



## iGirl (Oct 5, 2009)

Our vet clinic recently did a switch on us and gave us a new DVM. Due to regular staph infections from living in Florida, the new one recommended discontinuing Cyclosporine and going on Apoquel. The staph infections have been pretty routine once moving to FL - one every 3-4 months.

The new vet claims Apoquel is a "miracle drug" for eliminating skin/allergy issues and is much less hard on dogs than Cyclosporine...

So - we just finished the 1st 2 weeks loading dose and I've read some of the threads here and am now concerned about Phoebe's immune system getting messed up. She's a senior and has some lumps already, but I've noticed more now.

We had been buying our Cyclosporine online for much lower than the vet clinic cost, and have a 6 month supply on hand. Apoquel on the other hand is exclusive/vet direct only as there is no generic.... which always makes me suspicious. Daily Apoquel = $800/year vs part time Cyclosporine = $400/year. 

Costs aside though, I'm questioning the whole regimen of this. I know this is a new med - but in some ways would prefer to be cautious. Less is more (in medicine) in my book. Avoid pills and doctors if at all possible. 

If you've tried it - how did it work out? Cautionary tales and/or amazingly good reports all welcome...


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## jennretz (Jul 24, 2013)

Several of us have been updating a thread that sophieanne started titled Apoquel- has anybody have it stop working. I can't copy link on my phone but would be great if you wanted to add your thoughts/experiences to that thread.


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## iGirl (Oct 5, 2009)

Thanks - yes I've been reading that thread, but because of the title (Apoquel stopped working) I was hoping to see more pros/cons vs Cyclosporine or other approaches possibly, and cases where it is working. Like I said we just started it - so certainly can't say it stopped working just yet.


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## Ljilly28 (Jan 22, 2008)

I am avidly following any thread on Apoquel and appreciating all discussion and input. It works terrifically well for Lush, but truthfully I am afraid it will maybe not give her cancer but encourage her immune system to let cancer grow unchecked. I wish I could keep her on it bc pred is awful long term, but I guess I am going to try allergy shots. The thing is with her though, she has one localized itchy spot over her eye and no other issues. It seems to have started with porcupine quills and actually altered the make up of the cells. She had a punch biopsy and a year of prednisone. She stayed in a cone at LibertyMe's house for 3 weeks! Nothing nothing helps. The Apoquel works like a miracle drug.


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## sophieanne (Feb 4, 2014)

Hi..not sure what to tell you. The fact is Apoquel worked great for 4 months then stopped. In the case of Jenn and myself, both of our dogs have developed lumps (a side effect). In my case it just stopped working.
Overall I think it's a good drug, you just have to be aware of potential side effects and watch for changes. It suppresses the immune system and that can be trouble if you're dog has an underlying issue that hasn't surfaced.
So the fact is anyone can have it working, then have problems develop or have it stop working, whether it's 4 months or 2 years.


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## jennretz (Jul 24, 2013)

As sophieanne mentioned, you need to be aware of the watch-outs. Apoquel is still working really well for Duke and he's been on it almost a year. He hardly itches at all anymore. The problem is that he is prone to benign tumors and they're happening more frequently since he's been on Apoquel. As it suppresses the immune system, it could either be related to the dog having an underlying condition; or unknown at this time is if it's causing the lumps. What they do know is there is a correlation. I don't really know much about cyclosporine.

Duke's dermatologist provided me with a couple of alternatives (see below) if the allergy drops don't control his itching enough. As with anything, there are potential side effects or cons to any medicine. It's finding the right thing that works for your dog...

There is a new injection - canine atopic dermatitis immunotherapeutic (CADI) that works differently than Apoquel. This injection is a monoclonal antibody that binds to molecules that cause itch in dogs. This injection is under conditional license (not fully licensed) and is being provided to dermatologists while it undergoes the final licensing procedure. To date, side effects of the injection are uncommon, but include mild lethargy, vomiting or diarrhea. Skin tumors have not been seen in association with this medication. 

Another alternative to Apoquel is Atopica, this medication takes longer to provide anti-itch benefit (up to 2 weeks in some dogs), and can sometimes cause stomach upset. This medication suppresses the immune response more than Apoquel and CADI, but is generally well-tolerated. It tends to be expensive in larger breed patients.


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