Oxybutynin As An Alternative Treatment For Hyperhidrosis
Hyperhidrosis can be treated either surgically or clinically. Surgical treatments include microwave therapy, sweat gland removal and nerve surgery. In microwave surgery, the sweat glands are destroyed using microwave energy every three months and the sessions last up to 30 minutes. Clinical treatment of the condition involves using medication such as
- Antiperspirant prescription (for example Drysol)
- Creams containing glycopyrrolate
- Medication that block the nerves
- Iontophoresis (with iontophoretic drug delivery devices)
- Botulinum toxin injections
Some of these medications have side effects such as eye and skin irritation, blurred vision, bladder problems, dry mouth and muscle weakness.
Oxybutynin As An Alternative Treatment For Hyperhidrosis
The treatments above have proved to be less effective and work only in the short-term. As a result, Oxybutynin is often used as an alternative treatment method. Oxybutynin is a relatively cheap medication that is often used in the treatment of bladder and urinary difficulties such as the inability to control urination. It decreases the spasming of the bladder muscles. The drug gets quickly absorbed in the system within an hour of oral administration. When ingested with food, the absorption is delayed.
Oxybutynin was first used as an alternative treatment for hyperhidrosis in 1988. It is the most preferred treatment for the condition for those suffering from primary hyperhidrosis and the elderly who can’t undergo surgery. Studies that have been conducted on several patients indicated they usually responded well to the treatment and showed great improvement. 70% of the patients showed improvement after a 6-week treatment period with only 35% indicating moderate or severe side effects to the drug. Another study showed that 60% experienced improved quality of life after being placed on the medication.
An oral prescription of oxybutynin sees a patient take a daily dose of between 5 and 10mg. However, for more severe cases of hyperhidrosis, a prescription of up to 20mgs can be recommended. The drug is also available in other forms such as a transdermal patch, topical gel, and a slow-release tablet. It penetrates easily into the central nervous system from where it is distributed within the body.
In children between the ages of 7 and 14 years, 85% showed improvement of the condition. However, more than half of them suffered adverse side effects which were managed and it wasn’t necessary to discontinue treatment.
Tests were also conducted on obese and overweight patients. Their body usually produces excessive sweat as a way of maintaining normal body temperatures. The results showed that for the same dosage, the improvement of obese and overweight people varied slightly from that of people with normal weights. This proved that regardless of body weight, the dosage worked the same.
Reports indicate that the drug works effectively across the different age groups and genders. The variations are small and nonsignificant. It was also successfully administered to women who are past menopause. Notable improvement in the quality of life was noted in patients suffering from both primary and secondary hyperhidrosis. Majority of the patients didn’t need more than a dose of 10mg a day.
In the test studies, the use of the drug was compared to placebo. It therefore remains unclear how oxybutynin would compare to the other available treatments for hyperhidrosis. However, most people indicated that they would prefer it to surgery.
Side effects of oxybutynin
When used with other drugs, Oxybutynin can increase the severity and frequency of the side effects of those drugs. The drugs can also hinder its absorption into the system.
The most common side effect that has been noted with usage of the drug is dry mouth. Over 70% of the patients experienced this side effect. However, this only occurred with prolonged use of the drug. Very few patients discontinued treatment within the 12 weeks when the tests were conducted.
Other adverse effects experienced by the patients included drowsiness and constipation. These have largely affected the patients’ adherence to long-term prescription of the drug. Dry eyes, dizziness, mydriasis, diarrhea, flushing, and mild urinary retention were noted as minor side effects and were rarely experienced by the test patients. They were mostly experienced by patients who were on a dosage of 15mg and above. Long-term tolerance to the drug is still being examined. It is feared that long-term use of the drug could make patients develop resistance to it.
Oxybutynin has been reported as a safe drug for use in the treatment of hyperhidrosis. To lower the chances of suffering from the side effects, it is recommended that patients should stick to a maximum dosage of 10mg per day. Should there be a need for increase in dosage, it should be done slowly and progressively with the advice of a qualified medical practitioner.
In elderly patients using oxybutynin, there is the risk of contracting dental caries, oral candidiasis and parodontosis due to a reduction in the secretion of saliva. They can also cause cognitive impairment in the elderly.
The Canadian Hyperhidrosis Advisory Committee recommends the use of topical treatment with aluminium chloride as the first treatment for hyperhidrosis. Oxybutynin can be used as a secondary treatment. However, due to its affordability and convenience, besides numerous studies indicating its efficiency as an alternative treatment for hyperhidrosis, it could be on a fast rise as the preferred method of treatment. Other forms of treatment are recommended for patients who don’t notice any improvements within 6 weeks.
Insurance companies still do not have a provision for the oxybutynin treatment though. While the drug is licensed for use in treating urinary difficulties, it is yet to get a green light for use in the treatment of hyperhidrosis.