A plain-language place to start
Glycopyrrolate can feel like a big step if you have only used antiperspirants, wipes, clothing tricks, or bathroom resets. It is a prescription medication, and that can make it feel serious. At the same time, if hyperhidrosis is affecting your work, school, dating, touch, clothing, sleep, errands, or ability to relax in public, it makes sense to want something that works beyond the surface.
The simplest way to understand glycopyrrolate is this: it turns down one of the body’s sweat signals. It does not cure hyperhidrosis, and it does not permanently change your sweat glands. But for some people, it can lower the amount of sweating enough to make daily life feel less like constant damage control.
This article focuses on glycopyrrolate as it applies to hyperhidrosis. It is not meant to replace medical advice, and it should not be used to self-prescribe or change your dose. It is meant to help you understand what the medication is, how people use it, what to watch for, and how to have a better conversation with your clinician.
If you have spent years feeling like sweating controls the room before you even get to participate in it, wanting more information is completely reasonable.
What glycopyrrolate is
Glycopyrrolate is an anticholinergic medication. You may also see the word glycopyrronium, especially with topical products. In everyday hyperhidrosis conversations, people often use these names loosely, but they refer to closely related forms of the same active anticholinergic drug family.
In the United States, oral glycopyrrolate tablets are FDA-labeled for reducing symptoms of peptic ulcer disease as an adjunct treatment, not specifically for hyperhidrosis. When oral glycopyrrolate is prescribed for excessive sweating, that is considered off-label use.1
Off-label does not automatically mean unsafe or unusual. It means the medication is being used for a condition outside the exact wording of its FDA-labeled indication. In hyperhidrosis care, oral anticholinergics such as glycopyrrolate and oxybutynin have been used for years, especially when sweating affects multiple areas or when other treatments are not enough.2
There is also an FDA-labeled topical glycopyrronium product, Qbrexza, which is a prescription cloth used for primary axillary hyperhidrosis, meaning underarm sweating, in adults and children age 9 and older.3
How it helps with sweating
Sweat glands are activated by nerve signals. One important chemical messenger involved in that process is acetylcholine. Glycopyrrolate blocks muscarinic acetylcholine receptors, which helps reduce the signal telling eccrine sweat glands to produce sweat.4
That is why glycopyrrolate can help with sweating, but it is also why it can cause side effects. Acetylcholine is not only involved with sweat. Similar receptor systems are involved in saliva, digestion, urination, eye focusing, tear production, heart rate, and other body functions. So when the medication turns down sweating, it can also turn down saliva, slow the gut, dry the eyes, blur vision, or make urination harder.
That does not mean the medication is bad. It means the balance matters. The goal is not “as dry as humanly possible at any cost.” The goal is enough sweat reduction to make life easier, with side effects you can actually tolerate.
Forms used for hyperhidrosis
Glycopyrrolate can come up in hyperhidrosis care in several different ways.
| Form | How it is used | Common hyperhidrosis role | Important note |
|---|---|---|---|
| Oral tablets | Swallowed by mouth as prescribed | Multi-area sweating, generalized sweating, craniofacial sweating, situational sweating, or sweating not controlled by local treatments | Use for hyperhidrosis is off-label. It affects the whole body, not just one sweat area. |
| Oral liquid | Measured and swallowed by mouth | Sometimes considered when pills are hard to swallow, especially in pediatric or special situations | FDA-labeled oral solution products are for chronic severe drooling in certain pediatric neurologic conditions, not hyperhidrosis.5 |
| Topical cloth | Applied to underarms once daily as prescribed | Primary underarm hyperhidrosis | Qbrexza is FDA-labeled for primary axillary hyperhidrosis age 9 and older.3 |
| Compounded topical solution, cream, or wipe | Applied to a specific area, often face/scalp or other localized sweating areas | Craniofacial sweating, gustatory sweating, or localized sweating when a clinician thinks it fits | Usually compounded and off-label. Must be kept away from eyes and used carefully. |
| Added to iontophoresis trays | Used with iontophoresis under clinician direction | Stubborn hand or foot sweating that does not respond enough to plain tap-water iontophoresis | This is off-label and should be clinician-guided, not casual DIY experimentation. |
Who it may help most
Glycopyrrolate can be especially worth discussing if your sweating is not limited to one easy-to-treat area.
It may be considered for people who deal with:
- craniofacial sweating, including face, scalp, forehead, or upper lip sweating
- multi-focal sweating, such as hands plus feet plus underarms
- large-area sweating, such as back, chest, trunk, groin, or generalized sweating
- situational sweating before events, presentations, performances, dates, or high-pressure moments
- sweating that has not responded enough to antiperspirants, iontophoresis, Botox, topical wipes, or other local treatments
- people who want to reduce their overall sweating enough that local treatments become easier to manage
The International Hyperhidrosis Society notes that systemic medications such as glycopyrrolate are often used for generalized or focal hyperhidrosis, including craniofacial sweating, large-area focal sweating, multi-focal sweating, cases not adequately controlled by other methods, and short-term event-specific management.2
The important thing to understand is that oral glycopyrrolate does not know which sweat gland is bothering you. If you take it by mouth, it works systemically. That can be helpful if you sweat in multiple places, but it also means it can reduce sweating in places where your body actually needs sweat for cooling.
How it fits different body areas
| Body area | How glycopyrrolate may fit | Practical reality |
|---|---|---|
| Underarms | Topical Qbrexza may be used directly for primary axillary hyperhidrosis. Oral glycopyrrolate may also help if underarms are part of broader sweating. | If underarms are the only issue, topical or local treatments may be preferred before systemic medication. |
| Hands | Oral glycopyrrolate can reduce sweating, and glycopyrrolate may sometimes be added to iontophoresis under medical guidance. | Hand sweating often responds well to iontophoresis or Botox too, so glycopyrrolate may be one part of a larger plan. |
| Feet | Oral glycopyrrolate may help. Glycopyrrolate-assisted iontophoresis may be considered in some stubborn palmoplantar cases. | Foot sweating often needs practical support too: socks, shoes, drying routines, and antifungal awareness. |
| Face and scalp | Oral glycopyrrolate and compounded topical glycopyrrolate are both commonly discussed for craniofacial sweating. | This is one of the areas where topical glycopyrrolate may be especially useful, but eye exposure must be avoided. |
| Back, chest, trunk, groin, or large areas | Oral glycopyrrolate may be more practical than trying to treat a large area topically. | Systemic side effects and heat tolerance become especially important. |
| Generalized sweating | Oral glycopyrrolate may be considered, but generalized sweating should also raise the question of secondary causes. | New, severe, or whole-body sweating deserves medical evaluation before assuming it is primary hyperhidrosis. |
What the evidence says
The evidence for glycopyrrolate in hyperhidrosis is real, but it is not perfect. Oral glycopyrrolate has supportive studies, retrospective data, and long clinical experience, but not the same kind of large, modern randomized controlled trial base that some FDA-labeled topical products have.
Oral glycopyrrolate in adults
A 2012 study by Lee and colleagues reviewed 36 patients with primary hyperhidrosis and found improvements in sweating severity, anxiety scores, and quality-of-life measures after oral glycopyrrolate treatment.6
Another retrospective study by Walling reviewed systemic therapy in 59 patients with primary hyperhidrosis. Glycopyrrolate was prescribed to 45 patients, generally at 1 to 2 mg once or twice daily, and 67% responded. Treatment failures included nonresponse and adverse effects such as dry mouth and gastrointestinal symptoms.7
Oral glycopyrrolate in children and teens
A pediatric retrospective study by Paller and colleagues reviewed 31 children who took oral glycopyrrolate for primary focal hyperhidrosis. At a mean dose of 2 mg daily, 90% experienced improvement, with major improvement in 71% of responders. Side effects occurred in 29%, most commonly dry mouth and dry eyes, and were dose-related.8
Pediatric use should always be handled by a clinician comfortable treating hyperhidrosis in children or teens. Children may not always describe side effects clearly, and sports, heat, hydration, and school accommodations matter.
Topical glycopyrronium for underarms
Qbrexza clinical trials enrolled patients with primary axillary hyperhidrosis and compared once-daily glycopyrronium cloths with vehicle cloths. In two trials, the percentage of patients with at least a 4-point improvement in the Axillary Sweating Daily Diary item at week 4 was 53% versus 28% in one trial and 66% versus 27% in the other trial.3
A 2024 systematic review and meta-analysis of topical glycopyrronium bromide for axillary hyperhidrosis included four randomized controlled trials with 1,401 patients. It found that topical glycopyrronium improved responder rates, symptom scores, sweat production measures, and dermatology quality-of-life scores, while adverse effects such as dry mouth and anticholinergic effects still required consideration.9
Topical glycopyrrolate for face and scalp
Facial and scalp sweating can be especially hard because it is so visible. Several studies and reports support topical glycopyrrolate for craniofacial or forehead sweating. In one split-face study of 25 patients with facial hyperhidrosis, 2% topical glycopyrrolate significantly reduced forehead sweat production compared with placebo, and 96% of patients were partially or fully satisfied with the effect.10
Another randomized, multicenter, double-blind, placebo-controlled split-face study in 39 patients found significant reductions in forehead sweat production after topical glycopyrrolate application, with no serious adverse events reported during the study.11
Glycopyrrolate with iontophoresis
Glycopyrrolate has also been studied as an add-on to iontophoresis for palmoplantar hyperhidrosis. A single-blinded right-left comparison study by Dolianitis and colleagues found glycopyrrolate iontophoresis more effective than tap-water iontophoresis for palmoplantar hyperhidrosis.12
This is not the same as just doing regular iontophoresis. Adding medication to iontophoresis changes the risk profile and should be discussed with a clinician.
Dosing, timing, and expectations
Dosing should come from your clinician. Glycopyrrolate is not a medication where it is smart to copy someone else’s dose from a forum, because the right balance depends on your body, other medications, kidney function, age, heat exposure, sports, job, other medical conditions, and side-effect tolerance.
That said, there are a few general patterns worth knowing.
“Start low, go slow” is common
Clinicians often start with a low dose and gradually adjust based on benefit and side effects. The International Hyperhidrosis Society notes that it can take time to find the level where the medication helps without causing unmanageable side effects, and that doses may be adjusted based on seasons or weather.13
Effects may be felt fairly quickly
Some people notice benefit within hours or within the first few doses. In the pediatric study by Paller and colleagues, improvement occurred within hours of administration and disappeared within a day of stopping the medication.8
That quick on/off quality can be useful. It also means that if the medication is helping, skipping it may be noticeable.
Timing may depend on your sweating pattern
Some people use oral glycopyrrolate daily. Others use it more strategically for predictable situations, such as presentations, long shifts, weddings, interviews, travel days, or dates. That decision should be made with your prescriber.
If your sweating is worst in the morning, before work, during a commute, or before social events, tell your clinician. The timing of doses can matter just as much as the total dose.
Food can matter, especially with oral solution
Glycopyrrolate oral solution labeling says it should be taken at least one hour before or two hours after meals because high-fat food can markedly reduce absorption.5 Tablet instructions may vary by prescriber and formulation, so ask your clinician or pharmacist how they want you to take it.
Do not chase total dryness
The best outcome is not necessarily being bone-dry. Sweat is part of temperature regulation. A safer goal is “dry enough that I can function and feel less controlled by sweating,” while still tolerating the medication and staying safe in heat.
Side effects
Glycopyrrolate side effects are usually anticholinergic side effects. Some are annoying. Some can be serious. The same mechanism that reduces sweat can also dry out or slow down other body systems.
| Side effect | What it may feel like | What to do |
|---|---|---|
| Dry mouth | Constant thirst, sticky mouth, trouble speaking comfortably, bad breath worries | Sip water, ask about saliva-support products, protect dental health, and tell your clinician if it is persistent. |
| Constipation | Slower bowel movements, bloating, discomfort | Do not ignore it. Ask about fiber, fluids, stool softeners, or dose adjustment. |
| Dry eyes | Burning, gritty feeling, contact lens discomfort | Consider lubricating drops and discuss with your clinician, especially if you wear contacts. |
| Blurred vision or dilated pupils | Trouble focusing, light sensitivity, unsafe driving | Stop hazardous activities and contact your clinician. Avoid touching eyes after topical use. |
| Urinary hesitation or retention | Difficulty starting urination, weak stream, feeling unable to empty bladder | This needs medical attention. Stop and call your clinician if instructed by the product label or prescriber. |
| Fast heart rate or palpitations | Racing heartbeat, pounding, fluttering | Contact your clinician, especially if you have heart disease or symptoms are new or intense. |
| Drowsiness, dizziness, or confusion | Feeling slowed down, unsafe driving, mental fog | Do not drive or operate machinery until you know how the medication affects you. |
| Reduced sweating too broadly | Feeling overheated, flushed, weak, dizzy, or unable to cool down | This is important. Stop activity, cool down, and contact medical help if heat illness symptoms appear. |
The oral glycopyrrolate label lists adverse reactions including blurred vision, drowsiness, decreased sweating, flushing, vomiting, constipation, dry mouth, tachycardia, and urinary retention.14 Qbrexza labeling lists common adverse reactions such as dry mouth, dilated pupils, sore throat, headache, urinary hesitation, blurred vision, nasal dryness, dry throat, dry eyes, dry skin, constipation, and local underarm reactions such as redness, burning, stinging, or itching.15
None of this means you should be afraid of the medication. It means you should respect it. If you know what to watch for, you are less likely to panic over mild dryness and less likely to ignore something important.
Heat safety and overheating
This is the safety point people with hyperhidrosis most need to understand: sweating is annoying, but it is also part of how your body cools itself.
Glycopyrrolate can reduce sweating beyond the area that bothers you. In hot weather, during exercise, during outdoor work, in saunas, during sports, in crowded rooms, or during long shifts, that can increase the risk of overheating.
Qbrexza labeling warns that heat illness can occur with anticholinergic drugs in hot environments and advises patients to watch for generalized lack of sweating in hot or very warm temperatures.16 Oral glycopyrrolate tablet labeling also warns about heat prostration at high environmental temperatures due to decreased sweating.17
Be especially careful if you:
- play sports
- work outside
- work in hot kitchens, warehouses, factories, or outdoor jobs
- do intense workouts
- live somewhere very hot or humid
- use saunas, hot tubs, or hot yoga
- already have trouble sensing overheating
- are taking other medications that affect heat tolerance
Possible heat illness warning signs
- feeling unusually hot or flushed
- weakness or dizziness
- headache
- nausea
- muscle cramps
- confusion or decreased alertness
- fast, weak pulse
- fainting
- high body temperature
- strangely reduced sweating in heat
If you are using glycopyrrolate and you feel overheated, take it seriously. Get to a cooler place, stop exertion, drink fluids if safe, and seek medical help if symptoms are concerning.
Who needs extra caution
Glycopyrrolate is not a good fit for everyone. Some people should avoid it, and others need careful supervision.
Medical conditions to discuss before using oral glycopyrrolate
- glaucoma or risk of increased eye pressure
- urinary retention, prostate enlargement, or obstructive urinary problems
- intestinal obstruction or severe gut motility problems
- severe constipation
- ulcerative colitis, toxic megacolon, or serious inflammatory bowel concerns
- myasthenia gravis
- heart disease, arrhythmias, or tachycardia
- autonomic neuropathy
- hyperthyroidism
- kidney impairment
- pregnancy, trying to become pregnant, or breastfeeding
- age 65 or older
Oral glycopyrrolate tablet labeling lists contraindications related to risk of anticholinergic toxicity, including glaucoma, obstructive uropathies, gastrointestinal obstruction or motility disorders, bleeding gastrointestinal ulcer, active inflammatory or infectious colitis that can lead to toxic megacolon, history of or current toxic megacolon, myasthenia gravis, and hypersensitivity to glycopyrrolate.18
The same label also notes that older adults may be more sensitive to anticholinergic adverse reactions, including urinary retention, bowel obstruction, heat prostration, arrhythmias, delirium, and falls or fractures.19
Medication interactions to discuss
Tell your clinician and pharmacist about all medications and supplements you take. Glycopyrrolate can stack with other anticholinergic medications, which may increase side effects. This includes some medications used for bladder symptoms, allergies, sleep, nausea, depression, motion sickness, respiratory conditions, and gastrointestinal problems.
Oral glycopyrrolate labeling says concomitant use with other anticholinergic drugs is not recommended, and Qbrexza labeling also warns against coadministration with other anticholinergic-containing drugs because of additive adverse effects.20
Real-life tips for taking it
Medication success is not just about the prescription. It is also about how it fits into your actual day.
Track benefit and side effects
For the first few weeks, write down:
- dose and timing
- how much sweating improved
- which body areas improved
- dry mouth level
- constipation
- urination changes
- eye dryness or blurred vision
- exercise or heat tolerance
- any headaches, dizziness, palpitations, or unusual symptoms
This helps your clinician adjust the plan based on evidence from your own life, not vague memory.
Protect your mouth
Dry mouth is not just uncomfortable. Over time, it can affect breath, speaking comfort, and dental health. Consider asking your dentist or clinician about saliva-support products, fluoride, sugar-free gum or lozenges, and oral rinses.
Do not ignore constipation
Constipation is easier to prevent than rescue. If you notice your bowel movements slowing down, mention it early. Ask about fluids, fiber, diet changes, stool softeners, or dose changes before it becomes miserable.
Be careful with your eyes
Blurred vision and dilated pupils can happen, especially if topical medication gets near the eyes. If you use Qbrexza or compounded topical glycopyrrolate, wash your hands after application and avoid touching your eyes.
Plan for heat
- Carry water.
- Know when you will be outside or physically active.
- Tell coaches, trainers, or supervisors if heat risk matters.
- Use cooling breaks before you feel awful.
- Do not push through dizziness, weakness, confusion, or overheating.
Use the lowest effective approach
Some people need daily systemic medication. Others do better with lower doses, situational use, topical options, or combination therapy. The best plan is the one that reduces sweating while keeping side effects tolerable.
Combining glycopyrrolate with other treatments
Glycopyrrolate does not have to be the whole plan. In fact, it often works best as part of a practical treatment strategy.
The International Hyperhidrosis Society notes that systemic medications are often used in combination with other treatments such as antiperspirants, Botox, iontophoresis, and other approaches. Combination therapy may allow a lower oral medication dose, which may reduce side effects.13
| Combination | Why it may help | Example |
|---|---|---|
| Oral glycopyrrolate + antiperspirant | Systemic reduction plus local support | Useful for underarms or feet when oral medication alone is not enough. |
| Oral glycopyrrolate + iontophoresis | Systemic support plus focused hand/foot treatment | Can be useful when hands and feet are still the hardest areas. |
| Oral glycopyrrolate + Botox | Botox targets one severe area while oral medication lowers overall sweating | Example: Botox for underarms, oral glycopyrrolate for face/scalp or trunk sweating. |
| Qbrexza + non-drug routines | Topical underarm treatment plus clothing and reset strategies | Useful when underarm sweat marks are the main issue. |
| Compounded topical glycopyrrolate + oral medication | May target a visible area while reducing broader sweating | Needs clinician oversight to avoid excessive anticholinergic burden. |
Be careful about stacking treatments without telling your clinician. Combining multiple anticholinergic products can increase side effects, especially dry mouth, blurred vision, urinary problems, constipation, and overheating risk.
When to call your clinician
Call your clinician or pharmacist if you are not sure whether a side effect is expected, dangerous, or dose-related. It is better to ask early than to quietly suffer through something fixable.
Contact your clinician soon if you notice:
- dry mouth that is hard to tolerate
- constipation that does not improve
- new or worsening dry eyes
- blurred vision
- urinary hesitation or trouble emptying your bladder
- heart palpitations or racing heart
- dizziness, confusion, or unusual drowsiness
- reduced ability to tolerate exercise or heat
- side effects after dose changes
Seek urgent help if you have:
- symptoms of heat illness, especially confusion, fainting, high fever, or fast weak pulse
- inability to urinate
- severe eye pain, red eye, dilated pupil, or sudden vision changes
- severe abdominal pain, bloating, or signs of bowel obstruction
- chest pain or severe palpitations
- allergic reaction symptoms such as hives, swelling, or trouble breathing
If your sweating suddenly becomes generalized, night-heavy, new, or very different from your usual pattern, that is also worth medical attention. Hyperhidrosis can be primary, but sweating can also be secondary to medications, thyroid disease, infection, low blood sugar, hormonal changes, neurologic conditions, and other causes.21
Questions to ask before starting
A good appointment is easier when you know what to ask. Bring your real life into the conversation, not just the medical terms.
- Is my sweating pattern consistent with primary hyperhidrosis, or should we check for secondary causes?
- Would oral, topical, or compounded glycopyrrolate make the most sense for my sweating pattern?
- Is this daily use, situational use, or both?
- What dose would we start with, and how would we adjust it?
- How quickly should I expect to notice an effect?
- Should I take it with food or away from meals?
- What side effects should make me stop and call you?
- How should I handle exercise, sports, hot weather, saunas, or outdoor work?
- Could this interact with any of my other medications?
- What should I do if I get dry mouth, constipation, or blurred vision?
- Is there a safer local option I should try first?
- Can we combine this with iontophoresis, antiperspirants, Botox, or other treatments?
- How will we decide whether it is working well enough?
Final thought
Glycopyrrolate is not magic, and it is not harmless. It sits in the middle: useful, real, and worth respecting.
For some people, it can make daily life feel dramatically more manageable. It can make commutes, dates, work, school, errands, social events, and close moments less dominated by sweat. For others, the side effects are too much, or a more local treatment makes better sense.
The goal is not to prove you can tolerate anything just to be dry. The goal is to find a plan that gives you more freedom with fewer trade-offs.
If you are considering glycopyrrolate, go in informed. Know the forms, know the side effects, know the heat risks, know the off-label reality of oral use, and know what questions to ask. Then make the decision with a clinician who takes hyperhidrosis seriously.
You deserve treatment that respects both the sweating and the life you are trying to live around it.
Footnotes
- DailyMed. “Glycopyrrolate tablet.” The oral tablet label lists glycopyrrolate as an anticholinergic indicated in adults to reduce symptoms of peptic ulcer as an adjunct to treatment, not as a labeled hyperhidrosis treatment. Available at: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=bfccdb26-5047-4b54-9732-ffac2d78e4d1. Back
- International Hyperhidrosis Society. “Glycopyrrolate.” IHHS describes systemic medications such as glycopyrrolate as often used for generalized or focal hyperhidrosis, including craniofacial, large-area, multi-focal, inadequately controlled, and event-specific sweating. Available at: https://www.sweathelp.org/treatments-hcp/systemic-medications/glycopyrrolate.html. Back
- DailyMed. “Qbrexza — glycopyrronium cloth.” Qbrexza is indicated for topical treatment of primary axillary hyperhidrosis in adults and pediatric patients age 9 and older. The label also includes clinical trial data showing week-4 response rates and sweat production changes. Available at: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=5b372650-e56e-47a5-93e2-c0c292017059. Back
- International Hyperhidrosis Society. “Oral Medications.” IHHS explains that anticholinergics help block nerve signals that tell sweat glands to produce sweat and identifies glycopyrrolate as one of the anticholinergics used in excessive sweating care. Available at: https://www.sweathelp.org/hyperhidrosis-treatments/medications.html. Also see Gallanosa A, Stevens JB, Hendrix JM, Quick J. “Glycopyrrolate.” StatPearls, updated 2025. Available at: https://www.ncbi.nlm.nih.gov/books/NBK526035/. Back
- DailyMed. “CUVPOSA — glycopyrrolate oral solution.” The label states that Cuvposa is indicated to reduce chronic severe drooling in pediatric patients age 3 to 16 with neurologic conditions associated with problem drooling, and that it should be administered at least one hour before or two hours after meals because high-fat food markedly reduces bioavailability. Available at: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d200bd44-9856-4104-a29e-a4cca3db6737. Back
- Lee HH, Kim DW, Kim DW, Kim C. “Efficacy of glycopyrrolate in primary hyperhidrosis patients.” Korean Journal of Pain. 2012;25(1):28-32. DOI: 10.3344/kjp.2012.25.1.28. Available at: https://pubmed.ncbi.nlm.nih.gov/22259713/. Back
- Walling HW. “Systemic therapy for primary hyperhidrosis: A retrospective study of 59 patients treated with glycopyrrolate or clonidine.” Journal of the American Academy of Dermatology. 2012;66(3):387-392. DOI: 10.1016/j.jaad.2011.01.023. Available at: https://pubmed.ncbi.nlm.nih.gov/21820204/. Back
- Paller AS, Shah PR, Silverio AM, Wagner A, Chamlin SL, Mancini AJ. “Oral glycopyrrolate as second-line treatment for primary pediatric hyperhidrosis.” Journal of the American Academy of Dermatology. 2012;67(5):918-923. DOI: 10.1016/j.jaad.2012.02.012. Available at: https://pubmed.ncbi.nlm.nih.gov/22405644/. Back
- Elrosasy A, Abo Zeid M, Samha R, et al. “Efficacy and safety of topical glycopyrronium bromide in treating axillary hyperhidrosis: systematic review and meta-analysis.” Scientific Reports. 2024;14:24537. Available at: https://www.nature.com/articles/s41598-024-74430-4. Back
- Kim WO, Kil HK, Yoon KB, Yoon DM. “Topical glycopyrrolate for patients with facial hyperhidrosis.” British Journal of Dermatology. 2008;158(5):1094-1097. DOI: 10.1111/j.1365-2133.2008.08476.x. Available at: https://academic.oup.com/bjd/article/158/5/1094/6641525. Back
- Hyun MY, Son IP, Lee Y, et al. “Efficacy and safety of topical glycopyrrolate in patients with facial hyperhidrosis: a randomized, multicentre, double-blinded, placebo-controlled, split-face study.” Journal of the European Academy of Dermatology and Venereology. 2015;29(2):278-282. DOI: 10.1111/jdv.12518. Available at: https://pubmed.ncbi.nlm.nih.gov/24909188/. Back
- Dolianitis C, Scarff CE, Kelly J, Sinclair R. “Iontophoresis with glycopyrrolate for the treatment of palmoplantar hyperhidrosis.” Australasian Journal of Dermatology. 2004;45(4):208-212. DOI: 10.1111/j.1440-0960.2004.00098.x. Available at: https://pubmed.ncbi.nlm.nih.gov/15527429/. Back
- International Hyperhidrosis Society. “Oral Medications.” IHHS notes that oral medications are often used with other treatments, that clinicians may start low and adjust upward, and that side effects can often be managed through dose adjustment or treatment changes. Available at: https://www.sweathelp.org/hyperhidrosis-treatments/medications.html. Back
- DailyMed. “Glycopyrrolate tablet.” The label lists adverse reactions including blurred vision, drowsiness, decreased sweating, flushing, vomiting, constipation, dry mouth, tachycardia, and urinary retention. Available at: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=bfccdb26-5047-4b54-9732-ffac2d78e4d1. Back
- DailyMed. “Qbrexza — glycopyrronium cloth.” The label lists common adverse reactions including dry mouth, mydriasis, oropharyngeal pain, headache, urinary hesitation, blurred vision, nasal dryness, dry throat, dry eyes, dry skin, constipation, and local skin reactions. Available at: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=5b372650-e56e-47a5-93e2-c0c292017059. Back
- DailyMed. “Qbrexza — glycopyrronium cloth.” The label warns that heat illness can occur in high ambient temperatures because of decreased sweating and advises patients to watch for generalized lack of sweating in hot or very warm environments. Available at: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=5b372650-e56e-47a5-93e2-c0c292017059. Back
- DailyMed. “Glycopyrrolate tablet.” The oral tablet label warns that heat prostration resulting in fever and heatstroke can occur at high environmental temperatures due to decreased sweating. Available at: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=bfccdb26-5047-4b54-9732-ffac2d78e4d1. Back
- DailyMed. “Glycopyrrolate tablet.” Contraindications include glaucoma, obstructive uropathies, gastrointestinal obstruction or motility disorders, bleeding gastrointestinal ulcer, active inflammatory or infectious colitis that can lead to toxic megacolon, history of or current toxic megacolon, myasthenia gravis, and hypersensitivity. Available at: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=bfccdb26-5047-4b54-9732-ffac2d78e4d1. Back
- DailyMed. “Glycopyrrolate tablet.” The label states that geriatric patients may be more sensitive to anticholinergic adverse reactions, including urinary retention, bowel obstruction, heat prostration, arrhythmias, delirium, and falls or fractures. Available at: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=bfccdb26-5047-4b54-9732-ffac2d78e4d1. Back
- DailyMed. “Glycopyrrolate tablet” and “Qbrexza — glycopyrronium cloth.” Both labels warn about additive anticholinergic effects when used with other anticholinergic medications. Oral tablet label: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=bfccdb26-5047-4b54-9732-ffac2d78e4d1. Qbrexza label: https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=5b372650-e56e-47a5-93e2-c0c292017059. Back
- Mayo Clinic. “Hyperhidrosis — Diagnosis and treatment.” Mayo Clinic notes that evaluation may include history, exam, and tests to determine whether sweating is caused by another medical condition such as hyperthyroidism or hypoglycemia. Available at: https://www.mayoclinic.org/diseases-conditions/hyperhidrosis/diagnosis-treatment/drc-20367173. Back