FOI release

FOI2026/00237 – Case reports on Apoquel

Published 22 May 2026

Your request

I have recently diagnosed a dog with hyperadrenocorticism, that is on apoquel long term for atopy. I contacted the manufacturer of apoquel who advised to contact the VMD to see if you have any case reports on continuing to use apoquel when treating a dog for hyperadrenocorticism.

Our reply

The following Apoquel products are currently authorised in the UK: 

• Apoquel 3.6mg Film-coated Tablet for Dogs
• Apoquel 5.4mg Film-coated Tablet for Dogs
• Apoquel 16mg Film-coated Tablet for Dogs
• Apoquel 3.6 mg Chewable Tablets for Dogs
• Apoquel 5.4 mg Chewable Tablets for Dogs
• Apoquel 16 mg Chewable Tablets for Dogs

You have requested “any case reports on continuing to use Apoquel when treating a dog with hyperadrenorcortism.” Across all Apoquel products, there are 62 cases in which either hyperadrenocorticism or Cushing’s was mentioned in the case narrative. Of these:

• 23 cases reported hyperadrenocortism prior to treatment with Apoquel
• 14 cases described hyperadrenocortism developing after the dog began Apoquel
• 19 cases mentioned hyperadrenocortism as suspected in the narrative, but with no confirmed diagnosis reported
• 2 cases initially referenced hyperadrenocortism, but it was later determined that the dog did not have the condition
• 4 cases were unclear regarding whether hyperadrenocortism occurred before or after Apoquel treatment.

The number of adverse event reports includes reports:  

• where the method of hyperadrenocortism diagnosis is not disclosed
• where more than one product was used
• when the product was used off-label, that is using a medicine in a way that is not specified on the product’s label, including prescribing of unauthorised medicines following the cascade
• where the reporters, medical professionals or MAH did not consider an association between the product administration and the adverse event to be likely
• where, on further evaluation, there were other reasons for the adverse event occurring such as underlying illnesses or an alternative cause for the clinical signs seen.

We do not have outcome information for all of these cases.

Evaluation of adverse event reports is dependent on the accuracy and quality of data received within adverse event reports from veterinary professionals and animal owners.  

Although adverse event report information can be useful to provide a general overview of a veterinary medicinal product (VMP), it is important for any clinical decisions regarding the use of a VMP to be based on a risk/benefit discussion specific to the animal or group of animals being administered the VMP. An overall frequency of an adverse event occurring for a VMP does not reflect the actual risk for an individual animal, as there are many individual factors that may contribute to the likelihood of an adverse event occurring.  

Data published by the VMD are not subject to independent verification and the VMD does not guarantee their accuracy. Figures may be different to those provided by different regulatory authorities, pharmaceutical companies, and other authorities within the United Kingdom.  

All medicines whether for human or animal use come with risk, and the benefits of use in wider populations need to outweigh the potential risks. Information on adverse events that have been known to occur following administration of a particular product are summarised in sections 3.6/4.6 of the Summary of Product Characteristics (SPC).  The SPC is a document describing the properties and the officially approved conditions of use of a medicine. The SPC and associated product information are updated as new information is available, and the latest version of an SPC can be found on our publicly available Product Information Database. It is important for veterinary professionals to ensure that this information is reviewed, and any risks discussed with the animal owner or keeper, prior to administering the product. A rolling 6-month list of Summary of Product Characteristic (SPC) changes for veterinary medicines can be found on the monthly medicines update page Vet practice & supply.  

Please note that the SPCs for both the filmcoated and chewable Apoquel tablets state in Section 4.3 (Contraindications): “Do not use in dogs with evidence of immune suppression, such as hyperadrenocorticism.”

Pharmacovigilance updates are published on gov.uk at https://www.gov.uk/guidance/urgent-safety-updates-for-veterinary-medicines; this also includes any updates involving non-veterinary medicines used in animals. To receive these pharmacovigilance updates via email, please click on the ‘Get emails about this page’ button.