Oxybutynin for plantar hyperhidrosis

NewsBot · Feb 16, 2014

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Randomized trial - oxybutynin for treatment of persistent plantar hyperhidrosis in women after sympathectomy
Altair da Silva Costa Jr, Luiz Eduardo Villaça Leão, José Ernesto Succi, Joao Aléssio Juliano Perfeito, Adauto Castelo Filho, Erika Rymkiewicz, Marco Aurelio Marchetti Filho
Clinics vol.69 no.2 São Paulo Feb. 2014

OBJECTIVE:
Hyperhidrosis is a common disease, and thoracoscopic sympathectomy improves its symptoms in up to 95% of cases. Unfortunately, after surgery, plantar hyperhidrosis may remain in 50% of patients, and compensatory sweating may be observed in 70%. This clinical scenario remains a challenge. Our objective was to evaluate the effectiveness of oxybutynin in the treatment of persistent plantar hyperhidrosis and compensatory sweating and its effects on quality of life in women after thoracoscopic sympathectomy.

METHOD:
We conducted a prospective, randomized study to compare the effects of oxybutynin at 10 mg daily and placebo in women with persistent plantar hyperhidrosis. The assessment was performed using a quality-of-life questionnaire for hyperhidrosis and sweating measurement with a device for quantifying transepidermal water loss. Clinicaltrials.gov: NCT01328015.

RESULTS:
Sixteen patients were included in each group (placebo and oxybutynin). There were no significant differences between the groups prior to treatment. After oxybutynin treatment, there was a decrease in symptoms and clinical improvement based on the quality-of-life questionnaire (before treatment, 40.4 vs. after treatment, 17.5; p = 0.001). The placebo group showed modest improvement (p = 0.09). The outcomes of the transepidermal water loss measurements in the placebo group showed no differences (p = 0.95), whereas the oxybutynin group revealed a significant decrease (p = 0.001). The most common side effect was dry mouth (100% in the oxybutynin group vs. 43.8% in the placebo group; p = 0.001).

CONCLUSION:
Oxybutynin was effective in the treatment of persistent plantar hyperhidrosis, resulting in a better quality of life in women who had undergone thoracoscopic sympathectomy.
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Admin2 · Feb 16, 2014

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Admin2 · Feb 16, 2014

Oxybutynin

Medication for overactive bladder

Oxybutynin, sold as under the brand name Ditropan among others, is an anticholinergic drug primarily used to treat overactive bladder. It is widely considered a first-line therapy for overactive bladder due to its well-studied side effect profile, broad applicability, and continued efficacy over long periods of time. It works similar to tolterodine, darifenacin, and solifenacin, although it is usually preferred over these medications. It is sometimes used off-label for treatment of hyperhidrosis, or excessive sweating. It has also been used off-label to treat bed wetting in children, but this use has declined, as it is most likely ineffective in this role. It is taken by mouth or applied to the skin.
Common side effects include dry mouth, constipation, dizziness, trouble sleeping, and urinary tract infections.^[1] Serious side effects may include urinary retention and an increased risk of heat stroke.^[1] Use in pregnancy appears safe but has not been well studied while use in breastfeeding is of unclear safety.^[2] It is an antimuscarinic and works by blocking the effects of acetylcholine on smooth muscle.^[1]
Oxybutynin was approved for medical use in the US in 1975.^[1] It is available as a generic medication.^[3] In 2021, it was the 102nd most commonly prescribed medication in the US, with more than 6 million prescriptions.^[4]^[5]

^ ^a ^b ^c ^d "Oxybutynin Chloride Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Retrieved March 3, 2019.

^ "Oxybutynin Pregnancy and Breastfeeding Warnings". Drugs.com. Retrieved March 3, 2019.

^ British National Formulary: BNF 76 (76th ed.). Pharmaceutical Press. 2018. ISBN 978-0-85711-338-2.

^ "The Top 300 of 2021". ClinCalc.com. Archived from the original on January 15, 2024. Retrieved January 14, 2024.

^ "Oxybutynin - Drug Usage Statistics". ClinCalc.com. Retrieved January 14, 2024.

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NewsBot · Dec 16, 2014

Long-Term Efficacy of Oxybutynin for Palmar and Plantar Hyperhidrosis in Children Younger than 14 Years
Nelson Wolosker et al
Pediatric Dermatology; Early View

Oxybutynin for treating hyperhidrosis in children has been evaluated only in short-term studies. We aimed to investigate the long-term effects of oxybutynin in treating children with palmar and plantar hyperhidrosis who had not undergone surgery and who were monitored for at least 6 months (median 19.6 mos). A cohort of 97 patients was evaluated retrospectively, with particular attention to 59 children (ages 4–14 yrs) who were treated for longer than 6 months. Their quality of life (QOL) was evaluated using a validated clinical questionnaire before and after 6 weeks of pharmacologic therapy. A self-assessment of hyperhidrosis was performed after 6 weeks and after the last consultation. By their final office visit, more than 91% of the children with hyperhidrosis treated with oxybutynin experienced moderate or great improvement in their level of sweating and 94.9% experienced improvement in QOL. More than 90% of children reported improvement of hyperhidrosis at other sites. Dry mouth was the most common side effect. Oxybutynin appears to be an effective treatment option for children with hyperhidrosis, and positive results are maintained over the long term (median 19.6 mos).
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NewsBot · Jan 25, 2015

Long-term results of the use of oxybutynin for the treatment of plantar hyperhidrosis
Nelson Wolosker et al
International Journal of Dermatology; Early View

Background
Plantar hyperhidrosis is a common illness with significant impact on quality of life. Oxybutynin presents good short-term results, but longer follow-up results are lacking. We evaluated oxybutynin effectiveness in patients who were not surgically treated and who had at least six months of follow-up.

Methods
From September 2007 to September 2013, 85 consecutive patients were enrolled in our institutional protocol for the “pharmacological-first” treatment of primary plantar hyperhidrosis with oxybutynin. Eight patients were lost to follow-up, 15 patients have not yet been under treatment for six months, and data were available for 39 patients (all female) treated for at least six months. Data at the start of the protocol, six weeks after beginning treatment, and at their final visit were analyzed.

Results
Twenty-three of the 77 patients (29.87%) did not improve after pharmacological therapy. From the 39 patients with more than six months of follow-up (median 16.9 months, range 9–71), 79.5% reported moderate/great improvement in excessive plantar sweating after six weeks of treatment, and this rate increased to 84.7% in the last follow-up visit; 82.85% showed improvement in other sites presenting hyperhidrosis. Dry mouth was the most common side effect; 51.6% of patients reported it to be moderate/severe at the last visit.

Conclusion
In patients with good initial response to oxybutynin, more than 82% presented moderate or great improvement in plantar and other sites' excessive sweating; dry mouth was the most common side effect but was tolerable and did not lead any patient to interrupt treatment.
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NewsBot · Jun 30, 2015

Oxybutynin as a treatment for generalized hyperhidrosis: a randomized, placebo-controlled trial
M. Schollhammer et al
British Journal of Dermatology; Accepted Article

Background
Hyperhidrosis is a disorder that can impair quality of life. Localized treatments may be cumbersome and ineffective, and no systemic treatments have proven to be significantly beneficial.

Objectives
To evaluate the effectiveness and tolerance of low-dose oxybutynin for hyperhidrosis.

Methods
We conducted a prospective, randomized, placebo-controlled trial. From June 2013 to January 2014, 62 patients with localized or generalized hyperhidrosis were enrolled. Oxybutynin was started at a dose of 2.5 mg per day and increased gradually to 7.5 mg per day. The primary outcome was defined as improvement of at least one point on the Hyperhidrosis Disease Severity Scale (HDSS). Dermatology Life Quality Index (DLQI) and tolerance were also reported.

Results
Most patients (83%) in our study had generalized hyperhidrosis. Oxybutynin was superior to placebo in improving the HDSS: 60% of patients treated with oxybutynin, compared with 27% of patients treated with placebo, improved at least one point on the HDSS (P = 0.009). The mean improvement in quality of life measured by DLQI was significantly better in the oxybutynin arm (6.9) than in the placebo arm (2.3). The most frequent side-effect was dry mouth, which was observed in 43% of the patients in the oxybutynin arm, compared with 11% in the placebo arm.

Conclusions
Treatment with low-dose oxybutynin is effective in reducing symptoms of hyperhidrosis in generalized or localized forms. Side-effects were frequent but minor and mainly involved dry mouth.
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NewsBot · Jan 24, 2017

Initial study of transdermal oxybutynin for treating hyperhidrosis
José Francisco Millán-Cayetano, et al
The Journal of Dermatology

Oral oxybutynin for treating hyperhidrosis is effective and safe. Its side-effects are mild but frequent so we consider whether transdermal oxybutynin (considered to have a better side-effect profile) could be an alternative for treating hyperhidrosis. During 2015, a prospective study was conducted. Epidemiological variables, effectiveness (using the Hyperhidrosis Disease Severity Scale) and tolerance to transdermal oxybutynin were compiled concerning two different groups (patients previously treated or untreated with oral oxybutynin), at baseline, and at 3 and 12 months. Seven previously treated and six previously untreated patients were included. Five patients in the first group discontinued the treatment within 3 months. Of the two remaining patients, one reported ineffectiveness and the other obtained an excellent response but discontinued due to local irritation. Among the untreated patients, two showed no response and four experienced improvement (three with “partial response” and one with “excellent response”). All patients discontinued treatment within 12 months. No major adverse effects were observed. The absence of active metabolites after transdermal oxybutynin could result in less effectiveness than oral oxybutynin, although it is usually well tolerated. In conclusion, transdermal oxybutynin could have low effectiveness for the treatment of hyperhidrosis in patients following intolerance to oral oxybutynin but could provide good results in patients who have never tried systemic drugs.
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NewsBot · May 23, 2017

Oxybutynin as an alternative treatment for hyperhidrosis
Sergio Delort et al
An. Bras. Dermatol. vol.92 no.2 Rio de Janeiro Mar./Apr. 2017

Hyperhidrosis is the excessive production of sweating, which can be primary and focal or secondary to various pathologies. The exact cause of primary focal hyperhidrosis is still unknown, although a genetic basis is recognized, and its prevalence varies from 1% to 2.8%. The most affected sites are the armpits, palms, soles and face. It causes much discomfort, affects the quality of life, and is estimated to be undervalued by health professionals. Many treatment options are proposed, both clinical and surgical. The aim of this review is to focus on the treatment of hyperhidrosis with oxybutynin, an anticholinergic drug originally used to control overactive bladder.
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Oxybutynin

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