Dog scratching themselves on the street

Why pet owners are switching to online vet care with Dutch

  • Prescriptions delivered free to you

  • Fast access to Licensed Vets over video

  • Unlimited video visits and follow-ups

If you have an itchy dog, finding the right treatment – which may include medicine – is crucial. Allergies, underlying health issues, and inflammatory conditions can wreak havoc on your dog’s skin, with skin irritation being one of the most common symptoms of allergies in dogs.

Unfortunately, excessive scratching can lead to lesions and infections. Not to mention, it’s just plain uncomfortable for your pet. Luckily, there are several solutions for your dog’s itchy skin. For instance, Apoquel is a prescription anti-itch medication you can get from a vet. Apoquel is safe for pets, but every dog responds to medication differently, so it might not be the best option for your canine companion.

So is there an alternative to Apoquel for dogs? If, for some reason, your vet determines Apoquel is not the right solution for your pet, they may suggest several Apoquel alternatives. Keep reading to learn about alternatives to Apoquel your vet may use to treat your dog’s itchy skin.

What is Apoquel?

Apoquel is an oral prescription medication designed to treat dog itching due to inflammation and allergies like allergic and atopic dermatitis.1 The most common causes of allergic itching include skin allergies, food allergies, insect bites, and environmental allergens.2

This medication is fast-acting, typically taking just four hours to begin working and lasting 24 hours.1 With fewer side effects than steroids, Apoquel can be used long-term.

There’s a reason why Apoquel is the #1 prescribed medication for itch relief in dogs — it’s more effective than antihistamines at reducing allergic itch, a safer long-term treatment than steroids with fewer side effects, and treats the underlying cause of the itch, unlike home remedies like lotions or oatmeal baths.1

Graphic listing Apoquel side effects

Side Effects

Apoquel is tolerated well among most dogs. However, there’s always a possibility of side effects when giving your dog any medication. Mild side effects include:

  • Vomiting
  • Diarrhea
  • Anorexia
  • Lethargy
  • Increased thirst3

According to Apoquel’s 5- year review, less than one dog out of every 10,000 treated experienced a reaction.4

Dosage & Administration

Apoquel is given orally twice daily with or without food for up to 14 days, then once daily to maintain your dog’s results.1 However, your dog’s specific treatment may vary, so you should follow the dosage instructions from your veterinarian, which should be located on the medication bottle.

Is Apoquel Safe?

Every dog responds differently to medication, but Apoquel is well tolerated and is recommended by vets. According to the brand’s 5-year pharmacovigilance data, adverse reactions are rare, with the most common side effects being vomiting, diarrhea, lack of appetite, and lethargy.4

This medication is safe to use in dogs one year of age or older and can be used for long-term maintenance therapy to prevent your dog’s itchy skin from returning. However, it should not be used in dogs with serious infections or those that are pregnant or lactating.4

Apoquel is even safe to use in conjunction with other medications like nonsteroidal anti-inflammatory drugs (NSAIDs), anti-infectives like antibiotics and antifungals, pesticides, and immunotherapy. However, it has not been tested with immunosuppressive therapies like corticosteroids and cyclosporine.4

Graphic listing alternatives to Apoquel

Are There Alternatives To Apoquel?

As mentioned, Apoquel is well-tolerated by most pets, but some dogs shouldn’t use it. If your dog has any unwanted side effects or changes in their health, you should contact your vet as soon as possible for the next steps. In some cases, your vet may try alternatives to Apoquel to treat your dog’s itchy skin.

A few possible Apoquel alternatives include the following:


Cytopoint is an injectable biological allergy medication that treats skin conditions due to environmental allergies.5 The effects typically last for four to eight weeks, but your dog will need continual medications for effective treatment. Cytopoint contains antibodies that neutralize the proteins in your dog’s body that cause itching, so it’s not technically a drug, making it a potentially safer Apoquel alternative.5

Unfortunately, this treatment doesn’t work for every dog, only helping in about 75% of cases.5 Additionally, it’s not ideal for some dogs because it requires an injection. If your dog fears the vet or struggles with injections, Apoquel might be the better choice.


Antihistamines like Benadryl (diphenhydramine) are safe for dogs when administered under the supervision of your vet. Benadryl is an over-the-counter treatment many people already have in their homes and treats inflammation and the associated itchiness of allergies. However, antihistamines aren’t the right option for every dog.

While the FDA does not approve antihistamines like Benadryl and Zyrtec for veterinary use, they’re well-tolerated by dogs and work by blocking histamine receptors to relieve allergy symptoms, including sneezing, hives, and itchy skin.6


Temaril-P is a combination of the antihistamine trimeprazine, an anti-itch and cough reliever, and glucocorticoid prednisolone, an anti-inflammatory drug used to treat allergy symptoms like itching in dogs.7 The medication reduces inflammation associated with skin disorders like alopecia in dogs caused by allergic skin disease.

Like other prescription allergy meds for dogs, Temaril-P can cause mild side effects, such as:

  • Drowsiness
  • Restlessness
  • Increased appetite
  • Increased thirst and urination
  • Behavioral changes7

Additionally, some dogs shouldn’t take Temaril-P because it contains the steroid prednisolone, which can cause changes in insulin in diabetic dogs and affect dogs with Cushing’s disease that already make too much glucocorticoid.7 Temaril-P is also not an ideal long-term treatment for itchy skin because it can contribute to the development of Cushing’s disease by increasing the amount of steroids in a dog’s body.

Temaril-P also has considerably more drug interactions than Apoquel, including some NSAIDs, anti-diarrheals, diuretics, and seizure medications.8


Steroids, like prednisone, are used to treat a wide range of conditions in dogs, including allergic reactions, itchy skin, skin diseases like seborrhea, arthritis, autoimmune diseases, and much more. Prednisone and prednisolone are glucocorticoids used to treat itchy skin in dogs by reducing inflammation and suppressing the immune response to an allergen.9

Unfortunately, as we’ve mentioned, steroids can cause serious side effects in dogs, including weight gain, muscle atrophy, decreased energy and weakness, and increased risk of infections.9 In addition, some dogs shouldn’t take steroids because it can increase their risk of or worsen diabetes and other underlying health issues.

Environmental Changes

Environmental allergies can be challenging to diagnose in dogs, but it’s still possible. First, your vet will rule out any other possible non-allergic diseases that may cause similar symptoms. Once your dog is diagnosed with allergies, they may try to pinpoint the exact cause of their symptoms using allergy testing, which determines whether your dog is allergic to dust, pollen, mold, and fleas.10

Unfortunately, allergy tests are often unreliable and inaccurate. In many cases, if your vet believes your dog suffers from environmental allergies, they’ll provide you with more information about what you can do at home, such as investing in an air purifier, cleaning more, and more frequent bathing. However, since removing every allergen from your dog’s environment is impossible, they’ll also suggest some form of treatment, which might include oral medications or injectables.

Flea and Tick Preventatives

Apoquel is effective for treating itchiness caused by fleas but is not a flea treatment. Instead, if you want to prevent fleas and ticks from biting your dog, you’re better off investing in a preventative treatment like Credelio or NexGard, which are designed to eliminate fleas and ticks and prevent infestations.

Dietary Changes

Itchy skin is a common sign of food allergies in dogs, and one of the best ways to treat your dog’s food allergies is to help them avoid the ingredient that causes the symptoms. Unfortunately, finding out which ingredient makes your dog itch can be challenging, and there’s no accurate test to diagnose dog food allergies.

To diagnose food allergies in dogs, vets use the elimination diet, which eliminates an ingredient from their diet for several weeks, with the pet parent monitoring the symptoms. Once it’s determined which ingredient your dog is allergic to, your vet can suggest a new diet, such as a novel protein diet that may contain proteins like rabbit or venison instead of beef and chicken.

Young Black woman petting her dog on bed while on her laptop during a televet appointment

Final Notes

Apoquel is one of the most well-tolerated, safest, and most effective treatments for dogs with itchy skin. But, of course, the best treatment for your dog will ultimately depend on their diagnosis, so your vet may recommend Apoquel alternatives based on their findings.

Worried about your dog’s itchy skin? Get your dog a prescription online by scheduling a virtual appointment with one of our vets. We can diagnose and treat the common causes of itchy and irritated skin in dogs to provide them with relief. Try Dutch.




  2. Moriello, Karen A. “Itching (Pruritus) in Dogs - Dog Owners.” Merck Veterinary Manual, 19 May 2023,

  3. Van Gels, Amy, and Stephanie Howe. “Apoquel® (Oclacitinib).” PetMD, 5 Aug. 2022,

  4. “Apoquel Safety I Zoetis Us.” Apoquel Safety I Zoetis

  5. CYTOPOINT - UW Veterinary

  6. Burke, Anna. “Benadryl for Dogs.” American Kennel Club, 21 Sept. 2021,

  7. “Pharmacy Trimeprazine with Prednisolone .” Colorado State

  8. “Temaril p.” PetMD, 7 Nov. 2012,

  9. Howe, Stephanie. “Prednisone and Prednisolone.” PetMD, 7 July 2022,

  10. “Allergy Testing.” UW Veterinary Care

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Frequently Asked Questions

Who is Dutch?

Dutch is an online veterinary pet telehealth service, created by pet parents and board-certified veterinary specialists. We use a science-backed approach to provide pets relief for their everyday physical and behavioral health issues. Dutch connects you with licensed veterinarians over video chat and messaging to help you get care for your dog or cat quickly wherever you are — without the stress or expense of a vet visit. We also partner with pharmacies who can deliver prescription medication (in applicable states only) and over-the-counter treatments directly to your door. Dutch isn’t a veterinary practice or pharmacy, but a company that helps facilitate these services for pet parents to make veterinary care more accessible to all.

What is a visit with Dutch like?

When booking a video call with a vet, you'll be asked a few questions about your pet’s health issue. Depending on the issue, you may also be asked to fill out a longer questionnaire about their symptoms and share photographs of them so our veterinarians can better understand what’s going on. You’ll then pick an appointment time that works best for you.

During your video call, one of our licensed veterinarians will talk to you about the symptoms your pet is experiencing, ask you questions, review your pet’s medical history if you’ve provided it, and answer any questions you have. The vet will ask to see your pet and their environment. And they may ask you to perform some simple checks on them if needed.

After your video call, the vet will send you a message with a custom treatment plan to help your pet feel better, including a link to buy any recommended prescription or over-the-counter medications. Place your order and we’ll ship it free.

How much will it cost for Dutch to treat my pet?

The Dutch membership starts at $11/mo for unlimited access to the vet. No more long waits for appointments or surprise bills.

In addition to the base membership plan, our veterinarians may also recommend additional medication (Rx and/or OTC) that you will have the option of adding to your plan at an additional cost.