Medications

There are a variety of oral prescription medications used to manage excessive sweating for people with certain types of hyperhidrosis; each works systemically (in your body's "sytem") but through different mechanisms. In the end, they each work by preventing the stimulation of sweat glands and thus limit overall sweating. 

It sounds simple: take a pill; stop sweating. But this therapy is a bit more complex than that…To begin with, oral hyperhidrosis medications are not for every kind of hyperhidrosis. They are best suited for patients with certain types of excessive sweating—people with excessive facial sweating, cranio-facial hyperhidrosis, generalized hyperhidrosis, and those who have not had success using other first-line therapies such as clinical strength antiperspirants, iontophoresis, Botox, or a combination of these. People who have compensatory sweating from ETS surgery  or sweating secondary to a medication or medical condition can also have success with oral medications in many cases.

The most commonly used medications for managing excessive sweating are anticholingerics. These include medicines such as glycopyrrolate, oxybutynin, benztropine, propantheline, and others. Because the drugs used to control excessive sweating have not been studied in controlled trials, their use is based primarily on years of anecdotal evidence. While these oral therapies have not been approved by the US Food and Drug Administration (FDA) specifically for the treatment of hyperhidrosis, these medications have a substantial history of off-label use and are safe when used as directed. Some, such as glycopyrrolate and oxybutynin, have also been found to be safe in young children. Many medical professionals and hyperhidrosis patients experience great success with them.

Anticholingerics do not affect the central nervous system. They work by blocking transmission of the chemical messenger (acetylcholine) to the receptors on the sweat glands that are responsible for triggering sweating. Because similar receptors are located in multiple areas of the body, there can be a range of side effects from anticholingeric therapy such as: dry mouth, constipation, impaired taste, blurred vision, urinary retention, and heart palpitations. These side effects may be managed by adjusting the individual’s dose. David M. Pariser, MD International Hyperhidrosis Society (IHHS) founding board member and an expert in treating patients with hyperhidrosis, characterizes the side effects of anticholingeric treatments as “predictable, manageable and usually mild.”

That said, there are some hyperhidrosis patients who need to be very cautious when using anticholingerics. Dee Anna Glaser, MD, president and founding board member of the International Hyperhidrosis Society, treats hundreds of hyperhidrosis patients a year and is well versed in their use. She cautions her patients, or, in the case of pediatric patients, their parents, saying, “When taking anticholingerics, the body may have more difficulty keeping itself cool with the sweat mechanism ‘turned off.’ Therefore, athletes, people who participate in sports, people who work outdoors and anyone who may potentially cause themselves injury by becoming overheated must use extra care when considering these treatments.” Because anticholinergic medications work systemically and cannot target any one area in particular, they decrease sweating over the entire body, even those locations not sweating too much at baseline. This overall decrease in sweating can put the patient at risk for overheating. Patients or parents of children taking the medication must remain aware of temperature, water intake, exertion, and any symptoms of overheating such as pale skin, dizziness, muscle cramping, weakness, headache, and nausea. 

Further, patients with glaucoma (especially narrow-angle glaucoma) and those who have impaired gastric emptying or a history or symptoms of urinary retention should not use anticholingeric therapy.

Two of the most commonly prescribed anticholinergic medications are available in liquid formulations, which is important for parents and their children who suffer from hyperhidrosis. The FDA recently approved a liquid form of the anticholinergic glycopyrrolate (brand name, Cuvposa) to reduce drooling in pediatric cerebral palsy patients. This new formulation of a commonly used anticholinergic medication offers an excellent alternative for children who are unable or unwilling to swallow the pills. Oxybutynin is also available in a liquid formulation and is approved for use in young pediatric patients for certain bladder and urinary conditions.

Oral medications in liquid form provide safe and more easily administered treatment options for the young segment of our hyperhidrosis population. Dr. Pariser said its benefits would be immediate.

“I had an 8-year-old child who couldn't swallow the tablets, no matter how crushed or mixed with food. Here’s a great solution. And because this medicine is approved for children it gives reassurance to patients of all ages who have safety concerns with this therapy.”

There are other oral medications that are successful in treating patients with specific types of hyperhidrosis. Beta blockers (propranolol) and benzodiazepines work by “blocking” the physical manifestations of anxiety. 

These drugs act on the central nervous system and are best for patients who experience episodic or event-driven hyperhidrosis (such as excessive sweating brought on by job interviews or presentations). Side effects limit their long-term use: Benzodiazepines can be habit-forming and many patients cannot tolerate the sedative effects caused by both of these drug therapies.

There have also been single-case or small samples of patients with specific types of hyperhidrosis who responded to a variety of other oral medications. Agents such as Clonidine, Indomethacin, gabapentin, and multiple others have shown effectiveness in very specific cases of hyperhidrosis.

If you are interested in learning more about using oral medications to treat excessive sweating, find a healthcare provider who is well-versed in hyperhidrosis care and oral medications in the IHHS’s Physician Finder database. 

We like to remind readers that there are always positive or innovative developments on the horizon of hyperhidrosis care; but there are also great treatments available right now. Maybe systemic oral medication isn't right for you but...in the future? Who knows what may become available!

Here is another promising use for oral anticholinergic medications. Some physicians and their patients have had great success treating sweaty palms and sweaty feet by adding a crushed anticholinergic tablet to the water used during iontophoresis. Learn more about iontophoresis and how anticholinergics can make the process even more effective.

Next Steps

Have you talked to your doctor about excessive sweating? If not, now is the time! Learn more about how you and your doctor can work together to find the right treatment, or combination of hyperhidrosis treatments, to manage your hyperhidrosis.

If you’re considering an oral medication to treat excessive sweating, please know that experts in the field recommend that you try antiperspirants, iontophoresis, or Botox injections first. Click on the links provided to learn more about the usefulness of these treatments.

And remember, because hyperhidrosis is a serious medical condition - you deserve insurance coverage and reimbursement for your doctor’s visits and treatments! We’ve got tips to help you navigate the health insurance realm and receive coverage.

Express Sign-Up Here

  1. We email the latest news in hyperhidrosis and excessive sweating directly to you. Stay in the Know!
  2. Email*
    Invalid email address. Please try again.
  3. First Name*
    Please type your first name.
  4. Last Name
    Please type your last name.
  5. Year of Birth. Example 1986*
    Must be 4 digits.
  6.  
  1. Gender*
    Please indicate your gender.
  2. Tell us about you.*





    Please tell us who you are in the hyperhidrosis community.
  3.  
  1. Country*
    Please select your country where you live.
  2. Postal / Zip Code
    Invalid Input
  3.  
  1. Where do you sweat excessively?*







    Please tell us where you sweat so we can help you and others.
  2. Click 'Submit' to complete your subscription. Thanks!
      

Latest Newsletter Articles

Prev Next Page:

Sweat-Proof Your New Tech Toys!

Sweat-Proof Your New Tech Toys!

  You’ve unwrapped your new tech toys and totally fallen in love with them. But could sweaty palms, snowdrift calamities, or hot tub errors wreck havoc on those expensive gifts? Start...

Read more

What is your sweat really costing you?

What is your sweat really costing you?

If you have excessive underarm sweating you already know it’s uncomfortable, embarrassing, and usually something you have to think about all the time.  But it’s easy to lose perspective on how much sweat...

Read more

Consequence of Taking Antidepressants: Excessive Sweating!

Consequence of Taking Antidepressants: Excessive Sweating!

As if stress sweat alone weren’t bad enough, there are many in our community who suffer from stress, depression, and excessive sweating. In fact, excessive sweating is a rather common...

Read more

Stress Sweat Stinks!

Stress Sweat Stinks!

  This morning, I just barely got my daughter to school on time. As I chivvied her to eat her breakfast, brush her teeth, and get dressed, I kept thinking about...

Read more

In Search of a Good Night’s Rest: Battling Excessive Sweating…

In Search of a Good Night’s Rest: Battling Excessive Sweating at Night

Having trouble getting a good night’s sleep?  Gaining an extra hour of daylight is a fine beacon of spring, but it’s just another obstacle to getting a solid 8 hours....

Read more

Spicy or Mild? Help for Eating-Induced Hyperhidrosis

Spicy or Mild? Help for Eating-Induced Hyperhidrosis

No matter what's on the menu, do you sweat profusely when you eat? Or when you simply think about a meal? You may have a unique and distinct form of...

Read more

 

International Hyperhidrosis Society has received the GuideStar Exchange Seal a leading symbol of transparency and accountability provided by GuideStar, the premier source of nonprofit information.

 


 

International Hyperhidrosis Society is a 2013 Top-Rated Nonprofit!