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Medications for Hyperhidrosis

Other names: Excessive Perspiration; polyhidrosis; polyidrosis; Sweating

What is Hyperhidrosis?

Hyperhidrosis is another name for excessive or uncontrollable sweating. Although the condition is not life-threatening, it can cause a lot of embarrassment and discomfort and impact on school, work, or social relationships.

Hyperhidrosis affects approximately 2-3% of the population, and most commonly affects the armpits, although it can also affect the palms, feet, or the groin.
 

What Causes Hyperhidrosis?

Hyperhidrosis occurs from over-stimulation of our sweat glands, mostly our eccrine sweat glands.

We have two types of sweat glands in our bodies:

  • Apocrine glands: these are present from birth but only mature at puberty and start manufacturing sweat at that time. They produce a milky type sweat and sweat production is increased during times of heightened emotional state (stress or fear)
  • Eccrine sweat glands: these secrete a watery salty solution in response to heart, exercise or stress. Evaporation of this sweat from the skin provides a cooling effect. We have more than two million eccrine sweat glands and these are concentrated in the soles of the feet, palms, armpits, groin, and forehead.

Hyperhidrosis is classified as either primary or secondary, depending on whether there is an underlying medical condition or not.

Primary hyperhidrosis is the most common type. Although the exact cause is unknown, experts believe it may be due to overactivity of the hypothalamus (the area of the brain that maintains body temperature) which stimulates our nervous system to release sweat from eccrine sweat glands. Sweat production can occur without the effects of heat or physical activity, but certain triggers, such as anxiety, emotion, spicy foods can make it worse. It usually begins in adolescence; however, it can begin in childhood or even in infancy. The condition is particularly common among Japanese people suggesting some hereditary components. People with primary hyperhidrosis rarely sweat during their sleep.

Secondary hyperhidrosis occurs due to an underlying medical condition, such as:

  • Alcohol abuse
  • Anxiety
  • Diabetes
  • Heart disease
  • Hyperthyroidism
  • Menopause
  • Nerve damage
  • Obesity
  • Parkinson’s disease
  • Respiratory failure
  • Shingles
  • Some medications (eg, nortriptyline)
  • Some tumors
  • Spinal cord injury
  • Stroke
  • Substance abuse
  • Tuberculosis, malaria, or other infections.

What are the Symptoms of Hyperhidrosis?

Symptoms can vary in severity among people and even in the same person. Symptoms may include:

  • Wet, clammy palms
  • Wet, sticky, soles of the feet
  • Visible sweat patches in your armpits
  • Frequent sweating
  • An increased prevalence of fungal skin infections
  • Stained clothing
  • Self-consciousness or low self-esteem
  • Changing clothes frequently throughout the day
  • Problems with body odor.

How is Hyperhidrosis Treated?

Antiperspirants usually contain an aluminum salt which at concentrations >20% cause a long-lasting closure and shrinkage of the sweat gland. These are usually applied at night for a set period for the best results. If antiperspirants are not effective, referral to a doctor may be necessary to exclude a secondary cause of the hyperhidrosis and to try other types of treatment which may include:

  • Iontophoresis: This uses a gentle current of electricity to temporarily turn off the sweat gland
  • Botulinum toxin: This blocks the nerves that stimulate sweating
  • Anticholinergic drugs: these inhibit the transmission of nerve impulses
  • Endoscopic thoracic sympathectomy: this is a surgical procedure that involves cutting of the nerve that stimulates sweat production
  • Removal of the sweat glands by thermolysis, surgery, or other procedures.

Drugs Used to Treat Hyperhidrosis

The following list of medications are in some way related to, or used in the treatment of this condition.

Drug name Rx / OTC Pregnancy CSA Alcohol Reviews Rating Popularity
oxybutynin Off Label B N X 90 reviews
8.4

Generic name: oxybutynin systemic

Drug class: urinary antispasmodics

For consumers: dosage, interactions,

For professionals: A-Z Drug Facts, AHFS DI Monograph, Prescribing Information

Off Label: Yes

Drysol C N 279 reviews
8.9

Generic name: aluminum chloride hexahydrate topical

Drug class: miscellaneous topical agents

For consumers: side effects

Hypercare C N 211 reviews
8.9

Generic name: aluminum chloride hexahydrate topical

Drug class: miscellaneous topical agents

For consumers: dosage, side effects

For professionals: Prescribing Information

aluminum chloride hexahydrate C N 532 reviews
8.8

Generic name: aluminum chloride hexahydrate topical

Brand names:  Drysol, Hypercare, Xerac AC

Drug class: miscellaneous topical agents

For consumers:

For professionals: AHFS DI Monograph, Prescribing Information

clonidine Off Label C N X 5 reviews
7.8

Generic name: clonidine systemic

Drug class: antiadrenergic agents, centrally acting

For consumers: dosage, interactions,

For professionals: A-Z Drug Facts, AHFS DI Monograph, Prescribing Information

Off Label: Yes

Hytrin Off Label C N X 1 review
9.0

Generic name: terazosin systemic

Drug class: antiadrenergic agents, peripherally acting

For consumers: dosage, interactions, side effects

For professionals: Prescribing Information

Off Label: Yes

terazosin Off Label C N X 4 reviews
8.3

Generic name: terazosin systemic

Brand name:  Hytrin

Drug class: antiadrenergic agents, peripherally acting

For consumers: dosage, interactions,

For professionals: A-Z Drug Facts, AHFS DI Monograph, Prescribing Information

Off Label: Yes

benztropine Off Label N N X Add review
0.0

Generic name: benztropine systemic

Drug class: anticholinergic antiparkinson agents

For consumers: dosage, interactions,

For professionals: A-Z Drug Facts, AHFS DI Monograph, Prescribing Information

Off Label: Yes

gabapentin Off Label C N X Add review
0.0

Generic name: gabapentin systemic

Drug class: gamma-aminobutyric acid analogs

For consumers: dosage, interactions,

For professionals: A-Z Drug Facts, AHFS DI Monograph, Prescribing Information

Off Label: Yes

Xerac AC C N 9 reviews
9.2

Generic name: aluminum chloride hexahydrate topical

Drug class: miscellaneous topical agents

For consumers: side effects

amitriptyline Off Label C N X 3 reviews
4.0

Generic name: amitriptyline systemic

Drug class: tricyclic antidepressants

For consumers: dosage, interactions,

For professionals: A-Z Drug Facts, AHFS DI Monograph, Prescribing Information

Off Label: Yes

Botox C N 2 reviews
6.0

Generic name: onabotulinumtoxinA systemic

Drug class: skeletal muscle relaxants

For consumers: dosage, interactions, side effects

For professionals: AHFS DI Monograph, Prescribing Information

Qbrexza N 24 reviews
5.3

Generic name: glycopyrronium topical

Drug class: miscellaneous topical agents

For consumers: dosage, interactions, side effects

For professionals: AHFS DI Monograph, Prescribing Information

glycopyrronium N 24 reviews
5.3

Generic name: glycopyrronium topical

Brand name:  Qbrexza

Drug class: miscellaneous topical agents

For consumers: dosage, interactions,

For professionals: A-Z Drug Facts, AHFS DI Monograph

onabotulinumtoxinA C N 2 reviews
6.0

Generic name: onabotulinumtoxinA systemic

Brand name:  Botox

Drug class: skeletal muscle relaxants

For consumers: dosage, interactions,

For professionals: A-Z Drug Facts, AHFS DI Monograph

Learn more about Hyperhidrosis

Mayo Clinic Reference

ICD-10 CM Clinical Codes (External)

Legend

Rx Prescription Only
OTC Over the Counter
Rx/OTC Prescription or Over the Counter
Off Label This medication may not be approved by the FDA for the treatment of this condition.
Pregnancy Category
A Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).
B Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.
C Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
D There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
X Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use in pregnant women clearly outweigh potential benefits.
N FDA has not classified the drug.
Controlled Substances Act (CSA) Schedule
N Is not subject to the Controlled Substances Act.
1 Has a high potential for abuse. Has no currently accepted medical use in treatment in the United States. There is a lack of accepted safety for use under medical supervision.
2 Has a high potential for abuse. Has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. Abuse may lead to severe psychological or physical dependence.
3 Has a potential for abuse less than those in schedules 1 and 2. Has a currently accepted medical use in treatment in the United States. Abuse may lead to moderate or low physical dependence or high psychological dependence.
4 Has a low potential for abuse relative to those in schedule 3. It has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 3.
5 Has a low potential for abuse relative to those in schedule 4. Has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 4.
Alcohol
X Interacts with Alcohol.

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Further information

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