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Oral Medications for Hyperhidrosis

Several oral medications are used to treat excessive sweating, or hyperhidrosis. Each has different side effects and dosing recommendations.

Please talk to your your physician to find out if one of these medications for hyperhidrosis is right for you. 

Oral Robinul (glycopyrrolate)

Robinul is used primarily to treat peptic ulcer disease and to decrease excessive saliva production. To start taking Robinul for hyperhidrosis, clinicians will prescribe a large quantity of small pills. Small pills allow the patient to carefully adjust the dose according to specific directions to achieve maximal benefits and minimize side effects. The number of tablets you need to impact your sweating may be limited by the medication’s side effects, which are discussed below. You must determine how many tablets per day are needed to improve excessive sweating with mild or tolerable side effects. Decrease the dose to reduce mild side effects.

The most common side effect is dry mouth. Please be aware that this medicine has other significant potential side effects characteristic of this class of medications (called anticholinergics). These side effects include but are not limited to difficulty with urination, confusion, dizziness, drowsiness, blurred vision or sandy feeling in the eyes, eye sensitivity to light, increased bloated feeling, constipation, dry skin, rapid heartbeat. You should also know that this medicine can potentially put you in danger of overheating if you are unable to sweat during heat or exercise. Please stop using the medicine if you have significant side effects and notify our office. If you experience pronounced difficulty passing urine, or severe blurred vision or eye pain, you should seek urgent evaluation at an emergency room.

This medicine should not be used in patients with significant liver, kidney or unstable heart disease, patients with significant gastrointestinal disorders such as ulcerative colitis, patients with eye diseases like glaucoma, patients with a history of urinary retention or prostate enlargement, or patients diagnosed with myasthenia gravis. Please ask your physician about usage of this medicine if you have any of these medical problems. Usage of Robinul during pregnancy has not been studied, though animal studies have not found any fetal harm. The medication should be discontinued during pregnancy or breastfeeding.

Clonidine

Clonidine is used primarily to treat high blood pressure, and is also occasionally prescribed as treatment for attention deficit hyperactivity disorder and autism.

To start taking Clonidine, clinicians will prescribe a large quantity of small pills. Small pills allow the patient to carefully adjust the dose according to specific directions to achieve maximal benefits and minimize side effects. The number of tablets you need to impact your sweating may be limited by the medication’s side effects, which are discussed below. You must determine how many tablets per day are needed to improve excessive sweating with mild or tolerable side effects. Decrease the dose to reduce mild side effects. Please consult your physician for specific dosing recommendations. Once you reach an effective daily dosage, maintain that amount of medication. Many people do not find it necessary to increase the dosage.

The most common side effects are dry mouth, cloudy thinking, and a lowering of blood pressure which may cause lightheadedness especially when first standing. Please be aware that this medicine has other uncommon but significant potential side effects. These include but are not limited to drowsiness, dizziness, constipation, sedation, weakness, fatigue, headache, agitation, rash, nausea, loss of appetite, joint pain, impotence, leg cramps, swelling, dry eyes, slowed heart rate.

One potentially serious side effect is a marked increase in blood pressure with abrupt stopping of the medication. If you decide to stop taking Clonidine, you must decrease the dose by one pill each day and take ½ tablet for 2 days before discontinuation.

You may not take Clonidine if you are currently taking an MAOI antidepressant, a beta blocker blood pressure medication such as metoprolol, atenolol or propranolol, or Remeron (mirtazapine). Let your doctor know if you are taking any other blood pressure medication, since they may interact with Clonidine. It is not known if Clonidine causes fetal harm, so you should not take this medication if you are pregnant or breastfeeding. This medicine should not be used in patients with significant liver, kidney, or heart disease. Please ask your physician about usage of this medicine if you have any of these medical problems.

Propranolol

Propranolol is used primarily to treat high blood pressure, angina, irregular heartbeats, hand tremor, and to prevent migraine headaches. It can be useful to diminish performance anxiety, or tension that occurs with attending a social or work event. The reduction of anxiety may prevent onset of severe sweating in persons with hyperhidrosis.

For specific prescription recommendations, please consult your physician. To use propranolol, begin taking a small dose 30 to 60 minutes before the start of the event. In case of an adverse reaction, the first use should be prior to an event that allows you to rest if needed; for example, a family event at home. If you tolerate the medication, you may use it in other situations where performance anxiety may occur, taking a dose 30-60 minutes before the event. If taking with a meal, dose 60-90 minutes before the event. Do not repeat the dose within 24 hours.

Common side effects include fatigue, dizziness, slow heart rate, lowered blood pressure, constipation, and depression. Other possible adverse reactions can include insomnia, weakness, disorientation, nausea, diarrhea, allergic reactions, worsening of psoriasis, hair loss and impotency. Rare serious reactions may include congestive heart failure, very slow heartbeat, severe skin rash, asthma/shortness of breath. These side effects are unlikely to occur with the recommended low dose of medication.

Do not take this medication if you have a heart condition or asthma, unless approved by your primary care provider. Do not take this medication if you are taking thoridazine. Discontinue use if you become pregnant.

Please ask your primary care physician about usage of this medicine if you have high blood pressure, low blood pressure, heart disease or asthma.

Ditropan (oxybutynin)

Ditropan is used primarily to treat overactive bladder problems. Please consult your physician for specific prescription recommendations. To start taking Ditropan for hyperhidrosis, clinicians will prescribe a large quantity of small pills. Small pills allow the patient to carefully adjust the dose according to specific directions to achieve maximal benefits and minimize side effects. The number of tablets you need to impact your sweating may be limited by the medication’s side effects, which are discussed below. You must determine how many tablets per day are needed to improve excessive sweating with mild or tolerable side effects. Decrease the dose to reduce mild side effects.

The most common side effect is dry mouth. Please be aware that this medicine has other significant potential side effects characteristic of this class of medications (called anticholinergics). These side effects include but are not limited to difficulty with urination, confusion, dizziness, drowsiness, blurred vision or sandy feeling in the eyes, eye sensitivity to light, increased bloated feeling, constipation or diarrhea, dry skin, rapid heartbeat. You should also know that this medicine can potentially put you in danger of overheating if you are unable to sweat during heat or exercise. You must determine how many tablets per day are needed to improve excessive sweating with mild or tolerable side effects. Decrease the dose to reduce mild side effects. Please stop using the medicine if you have significant side effects and notify our office. If you experience pronounced difficulty passing urine, or severe blurred vision or eye pain, you should seek urgent evaluation at an emergency room.

This medicine should not be used in patients with significant liver, kidney or unstable heart disease, patients with significant gastrointestinal disorders such as ulcerative colitis, patients with eye diseases like glaucoma, patients with a history of urinary retention or prostate enlargement, or patients diagnosed with myasthenia gravis. Please ask your physician about usage of this medicine if you have any of these medical problems. Usage of Ditropan during pregnancy has not been found to cause fetal harm. However, you should discuss continued use with your obstetrician during pregnancy or breastfeeding.

Contact Us

For an appointment with the SLUCare Hyperhidrosis Clinic, call 314-977-9666.