Glycopyrrolate-induced craniofacial compensatory hyperhidrosis successfully treated with oxybutynin: report of a novel adverse effect and subsequent successful treatment

Dermatol Online J. 2016 Oct 15;22(10):13030/qt4wp1g44b.

Abstract

Hyperhidrosis, or abnormally increased sweating, is a condition that may have a primary or secondary cause. Usually medication- induced secondary hyperhidrosis manifests with generalized, rather than focal sweating. We report a 32-year-old woman with a history of palmoplantar hyperhidrosis for 15 years who presented for treatment and was prescribed oral glycopyrrolate. One month later, the palmoplantar hyperhidrosis had resolved, but she developed new persistent craniofacial sweating. After an unsuccessful trial of clonidine, oxybutynin resolved the craniofacial hyperhidrosis. To our knowledge, this is the first case of compensatory hyperhidrosis secondary to glycopyrrolate reported in the literature. The case highlights the importance of reviewing medication changes that correlate with new onset or changing hyperhidrosis. It also demonstrates a rare drug adverse effect with successful treatment.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Adult
  • Deprescriptions
  • Female
  • Glycopyrrolate / adverse effects*
  • Humans
  • Hyperhidrosis / chemically induced
  • Hyperhidrosis / drug therapy*
  • Mandelic Acids / therapeutic use*
  • Muscarinic Antagonists / adverse effects*
  • Muscarinic Antagonists / therapeutic use
  • Treatment Outcome

Substances

  • Mandelic Acids
  • Muscarinic Antagonists
  • oxybutynin
  • Glycopyrrolate

Supplementary concepts

  • Hyperhidrosis Palmaris Et Plantaris