New Allergy Meds

[Lucy & AnnaBelle's Mom]

In our continuing saga of Lucy's allergies, we have just started a couple new Drugs to see if they work better than the old ones.  She has been on Atopica and her Immuno suppressent Injections for coming up on two years and we were still having trouble keeping her from itching.  So back in December at her Dermatologist appointment we made the decision to try a couple new things.  No, they haven't been on the market as long, but at some point we had to opt for her comfort ... itching like crazy just isn't an option.  So, we switched the Atopica to Apoquel.   We saw her relief immediately and it has continued since we started.  She gets it once a day.  Then the Dr also wanted to add a mold component to her injections ... however, if she did that it couldn't be added to the current ones but would require a second injection.  The other option to try since the injections didn't seem to effective was another fairly new to the market liquid version of the shots.  These are drops.  She gets two drops under her tongue in the am and two in the pm.  They arrived yesterday and her first ones were last night.  So, we shall see how this goes.  If all continues to go well she will eventually be able to come off the Apoquel.  The liquid version is much more convenient as it does not have to be kept in the refrigerator and it taste good so she doesn't seem to mind it.  We shall see. 

[Dianna Ruiz]

Hmmmm..... We have been on the liquid drops for over a year now & we have to keep ours in the frig. Our Cooper is also on Atopica & with that & his 'allergens' he is much better but not 100%. Please keep us informed on how the apoquel works. Is it any cheaper??

[Karen, Jasper and Jackdoodle]

Apoquel is significantly cheaper than Atopica, but I'm not sure how it compares price-wise with the generic version of Atopica, which is cyclosporine. 

[Lucy & AnnaBelle's Mom]

Diana -- The Apoquel is significantly cheaper than the Atopica Generic cyclosporine.  Lucy was on a 100 one day and 50 the next which cost about $121.00 a month.  Sometimes she was on 100 everyday which was a little over $150 a month.  We got two months worth from our regular Vet and it was $73.50.  At the dermatologist it was $36.00 for 15 pills.  We fill our perscriptions at our regular vet because they are normally cheaper and PetPlan also pays the whole amount that way.  However, I'm not sure how the drops are going to compare to the injections as I haven't gotten the bill for them yet from my Vet.

[Karen, Jasper and Jackdoodle]

Do you know if Apoquel is available at the pharmacy? It's almost always cheaper than buying from the vet. 

[Lucy & AnnaBelle's Mom]

I don't know, but I will check.  I know that PetPlan will pay for a prescription from the pharmacy because the Dermatologist wrote a perscription that we had to fill there the last time we were there.

[Karen, Jasper and Jackdoodle]

That's one of the things I love about specialists; just like human doctors, they don't sell you the drugs, food, shampoos, ointments, probiotics, vitamins, or anything else they recommend or prescribe. They don't sell anything. So no conflict of interest, lol. 

I get almost all of Jack's meds at CVS.

[Nancy & Echo]

According to the package insert, Apoquel is For oral use in dogs only

https://www.zoetisus.com/bmst-minisite-apoquel/documents/finalapoqu...

From the website, it looks like there have been some supply issues.

Today more than 16,000 veterinary clinics in the U.S. have access to APOQUEL. That is more than double the number of clinics who were able to offer it to patients and pet owners in 2014. We continue to make progress on strengthening our manufacturing capacity to produce APOQUEL, which has given us the confidence to expand order limits for current customers and make APOQUEL available with order limits for new customers. Our overarching goal is to bring APOQUEL to all customers as soon as possible, and to do so in a manner that will consistently deliver it over the long term—through increased manufacturing capacity and continued use of temporary order limits to avoid hoarding and diversion. 

We recognize and appreciate the challenges that our supply situation has caused for veterinarians and their patients. We want to reiterate our thanks to veterinarians and pet owners for their patience as we have worked through APOQUEL manufacturing and supply issues.

https://www.zoetisus.com/bmst-minisite-apoquel/faqs.aspx?utm_source...

I work at a (human, hospital) pharmacy, and, while when we did some outpatient prescriptions for animals, we only carry medications that can be used in humans.  (The regulations for drugs for human use are higher than that for animal use.)

I certainly hope that Lucy's itching will be controlled.  That must be absolutely miserable for Lucy.

[Karen, Jasper and Jackdoodle]

Yes, it's labeled for use in dogs only, just like Atopica is labeled for use in dogs only, but the drug itself is used in humans under other names. It's a Janus kinase inhibitor, as I'm sure you know, and there are many similar human versions.

Apoquel just doesn't have a generic version yet, like Atopica does. And many pharmacies, at least in my area, do carry veterinary drugs. Worth checking. 

Apoquel is in short supply because it's very popular among GP vets who would prefer to get the $ for treating their clients' allergies rather than referring to a dermatologist. And of course, it's popular because it's so much cheaper than cyclosporine.

[Lucy & AnnaBelle's Mom]

Our Vet carries it because being in such a Rural area many people aren't even going to consider going to a specialist so she tries to do as much as she can to help those dogs.  Just like she can do the CCL suture surgery that we paid close to $2000 for she will do for about $600 but she just isn't as experienced.  However, some people will pay $600 but not $2000.

[Karen, Jasper and Jackdoodle]

I just wanted to clarify that in the second sentence where you say " Immuno suppressent Injections", you really meant Immunotherapy injections, lol. The immunotherapy shots don't suppress the immune system; they increase the threshold of exposure required for the dog's immune system to notice or react to the allergens, so eventually the amount of allergen naturally found in the environment will be smaller than the dog's threshold to respond to it.

I do think adding the molds to the antigens is important. 

As far as I know, the side effects from Apoquel are no worse than those of Atopica, although as you mentioned, it hasn't been around nearly as long. 

I hope this new regimen works well for Lucy. I agree, itching like crazy is just not an option. I hope you'll keep us posted. 

[Lucy & AnnaBelle's Mom]

I knew when I typed that it didn't sound right!  Thanks for fixing that.  Our dermatologist feels that the initial thoughts on the Atopica have not proven themselves to be true and it has been around for quite a while now.  Hopefully Apoquel will turn out to be the same.  I know that it certainly is helping Lucy.

[Karen, Jasper and Jackdoodle]

That's the main thing.