Which medications in the drug class Anticholinergic Agents are used in the treatment of Hyperhidrosis?

Updated: Mar 23, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD  more...
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Anticholinergic Agents

Topical glycopyrronium tosylate for primary axillary hyperhidrosis is available, allowing for a more tolerable route of administration. Orally administered anticholinergics are usually avoided because they are poorly tolerated at the required doses when given systemically. Acetylcholine is the preglandular neurotransmitter for sweat secretion. These drugs inhibit the binding of acetylcholine to the cholinergic receptor. Clinical effects usually occur within days.

Glycopyrronium tosylate topical (Qbrexza)

This is a topically applied anticholinergic agent that inhibits the action of acetylcholine on sweat glands. It is indicated for primary axillary hyperhidrosis in adults and children aged 9 years or older. It is applied using single-use, premoistened cloth to clean, dry skin on the underarm areas only, no more frequently than once every 24 hours.

Propantheline (Pro-Banthine)

Propantheline blocks the action of acetylcholine at postganglionic parasympathetic receptor sites.

Glycopyrrolate (Robinul)

Glycopyrrolate acts in the smooth muscle, CNS, and secretory glands to block the action of acetylcholine at parasympathetic sites.

Benztropine (Cogentin)

Benztropine blocks striatal cholinergic receptors; it may help balance cholinergic and dopaminergic activity in the striatum.

Oxybutynin (Ditropan)

Oxybutynin inhibits the action of acetylcholine on smooth muscle and has direct antispasmodic effects on smooth muscles. Although usually an oral preparation, its transdermal use for hyperhidrosis may be beneficial in selected patients.

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