glycopyrronium bromide cream for treating severe primary axillary hyperhidrosis

Anticholinergic substances like Glycopyrronium bromide functions as a competitive inhibitor of acetylcholine receptors and can be used as an oral or topical treatment of hyperhidrosis (1):

• oral use is associated with reductions in clinical symptoms and improved quality of life, but at the expense of significant systemic adverse events
• topical glycopyrronium bromide significantly reduces sweat production
• topical glycopyrronium bromide has limited absorption and a low risk of anticholinergic adverse events
  • adverse events may occur when it is administered incorrectly
    • possible adverse events include dry mouth and anticholinergic effects
    • is important for patients to follow specific instructions, which include applying the cream using the pump's cap rather than the fingers, dispensing exactly two pump actuations per armpit, washing both the pump cap and hands with soap and water immediately after application, and avoiding eye, nose, or mouth contact with the drug to prevent systemic effects like blurred vision and temporary dilation of the pupil

NICE state (2):

Glycopyrronium bromide cream can be used as an option to treat severe primary axillary hyperhidrosis in adults, if lifestyle advice, topical aluminium-based antiperspirants and oral antimuscarinics:

• have not controlled underarm sweating, or
• are contraindicated or not tolerated.

Reference:

1. Elrosasy A, Zeid MA, Samha R, Alkousheh H, Cadri S, Cadri N, Mashaly D, Ehab A, Abdullah L, AlEdani EM. Efficacy and safety of topical glycopyrronium bromide in treating axillary hyperhidrosis: systematic review and meta-analysis. Sci Rep. 2024 Oct 19;14(1):24537.
2. NICE (July 2026). Glycopyrronium bromide cream for treating severe primary axillary hyperhidrosis.