From the FDA Drug Label
Glycopyrrolate oral solution may produce drowsiness or blurred vision. The presence of high fat food reduces the oral bioavailability of glycopyrrolate oral solution if taken shortly after a meal In the presence of high ambient temperature, heat prostration (fever and heat stroke due to decreased sweating) can occur with the use of anticholinergic drugs such as glycopyrrolate oral solution.
The FDA drug label does not directly answer the question about hyperhidrosis treatment with glycopyrrolate. However, it does mention that heat prostration (fever and heat stroke due to decreased sweating) can occur with the use of anticholinergic drugs such as glycopyrrolate oral solution, which suggests that glycopyrrolate may decrease sweating.
- Key points:
- Glycopyrrolate oral solution is not directly indicated for hyperhidrosis treatment in the label.
- Anticholinergic drugs like glycopyrrolate can decrease sweating, which may be beneficial for hyperhidrosis.
- The label does not provide a recommended dose for hyperhidrosis treatment.
- Patients should be cautious when taking glycopyrrolate, especially in high ambient temperatures, due to the risk of heat prostration 1.
From the Research
Hyperhidrosis treatment should begin with aluminum chloride antiperspirants like Drysol (20% concentration) applied nightly to dry skin for 6-8 hours, then washed off in the morning, as recommended by the most recent and highest quality study 2.
Treatment Options
- For those who don't respond adequately to topical treatment, oral anticholinergics such as glycopyrrolate (1-2mg twice daily) or oxybutynin (5-10mg daily) can reduce sweating by blocking acetylcholine receptors, though they may cause side effects like dry mouth and constipation 3.
- Iontophoresis, which uses a mild electrical current through water to temporarily block sweat glands, is effective for palmar and plantar hyperhidrosis with 20-30 minute sessions 3 times weekly initially, then maintenance treatments 2.
- For severe cases, botulinum toxin (Botox) injections provide 4-6 months of relief by blocking acetylcholine release at nerve endings, and have been shown to be more effective than topical aluminum chloride 4, 5.
- Microwave thermolysis (miraDry) offers permanent reduction for axillary hyperhidrosis, and is a viable option for those who have failed other treatments 2.
- Surgical options, such as endoscopic thoracic sympathectomy, may be considered for severe cases of palmar hyperhidrosis, but carry risks of compensatory sweating elsewhere 6, 3.
Lifestyle Modifications
- Lifestyle modifications like wearing moisture-wicking fabrics, avoiding spicy foods and caffeine, and managing stress through relaxation techniques can complement medical treatments by reducing sweat triggers 2, 3.