What are the oral treatment options for hyperhidrosis (excessive sweating)?

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Last updated: April 25, 2025View editorial policy

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From the FDA Drug Label

Glycopyrrolate oral solution is a prescription medicine used in children with medical conditions that cause too much (abnormal) drooling. Drugs like glycopyrrolate can reduce sweating, and if the patient is in a hot environment and flushing of the skin occurs this may be due to overheating Avoid exposure of the patient to hot or very warm environmental temperatures to avoid overheating and the possibility of heat exhaustion or heat stroke.

Oral treatment for hyperhidrosis: Glycopyrrolate oral solution can be used to treat hyperhidrosis (excessive sweating) by reducing sweating. However, it is essential to note that this medication can cause overheating, especially in hot environments, due to its anticholinergic effects.

  • Key considerations:
    • Glycopyrrolate oral solution is typically started at a low dose and gradually increased as directed by the doctor.
    • Patients should avoid exposure to hot or very warm environmental temperatures to prevent overheating and heat stroke.
    • Common side effects include dry mouth, vomiting, constipation, flushing, and nasal congestion. 1

From the Research

Oral glycopyrrolate (1-2mg twice daily) is the recommended oral treatment for hyperhidrosis, especially for patients with palmar and plantar hyperhidrosis, as it has shown excellent safety and reasonable efficacy 2. When considering oral treatment for hyperhidrosis, it is essential to individualize the treatment approach, taking into account the severity of symptoms, patient preferences, and potential side effects.

  • Key considerations for oral glycopyrrolate treatment include:
    • Starting with a low dose and gradually increasing as needed while monitoring for side effects
    • Common side effects include dry mouth, blurred vision, urinary retention, and constipation
    • Elderly patients should use these medications cautiously due to increased risk of side effects
    • Adjusting the dose according to seasonal temperature variations may improve treatment outcomes, as shown in a prospective study where patients who varied the dose according to the time of year were more likely to report an "Excellent" response after 12 months of treatment 3
  • Other oral medications, such as oxybutynin (5-10mg daily) and clonidine (0.1mg twice daily), may also be effective for hyperhidrosis, but glycopyrrolate is generally preferred due to its excellent safety profile and reasonable efficacy 2.
  • It is crucial to note that oral medications should be used as part of a comprehensive treatment plan, which may include topical treatments, iontophoresis, botulinum toxin injections, or surgical options, depending on the severity and location of the hyperhidrosis 4, 5.

References

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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