Glycopyrronium Cantabria: Uses, Dosage & Side Effects
A topical anticholinergic cream for the treatment of primary axillary hyperhidrosis (excessive underarm sweating) in adults
Glycopyrronium Cantabria is a prescription topical cream containing glycopyrronium bromide, an anticholinergic (muscarinic receptor antagonist) agent used for the treatment of primary axillary hyperhidrosis (excessive underarm sweating) in adults. The cream is applied once daily to the underarm area using a metered-dose pump that delivers 2.2 mg of active ingredient per actuation. Glycopyrronium bromide works by blocking the acetylcholine-mediated activation of eccrine sweat glands, thereby reducing sweat production locally at the site of application. Clinical studies have shown that topical glycopyrronium significantly reduces sweat production, improves quality of life scores, and is well-tolerated with a favourable safety profile characterized mainly by mild local application site reactions and occasional dry mouth.
Quick Facts: Glycopyrronium Cantabria
Key Takeaways
- Glycopyrronium Cantabria is a topical anticholinergic cream specifically formulated for the treatment of primary axillary hyperhidrosis (excessive underarm sweating) in adults, offering a non-invasive alternative to botulinum toxin injections and oral anticholinergics.
- The cream is applied once daily using a metered-dose pump (2.2 mg per actuation to each underarm), ideally at bedtime on clean, dry skin, with noticeable reduction in sweating typically observed within the first week of use.
- Clinical trials have demonstrated that topical glycopyrronium significantly reduces gravimetric sweat production and improves patient-reported quality of life scores, with sustained efficacy over long-term treatment.
- The most common side effects are mild local reactions (dryness, redness, itching at the application site) and dry mouth; serious systemic anticholinergic effects are uncommon due to limited systemic absorption.
- Patients should avoid contact with eyes, mouth, and broken skin, wash hands thoroughly after application, and inform their doctor if they have conditions such as angle-closure glaucoma, urinary retention, or gastrointestinal obstruction before starting treatment.
What Is Glycopyrronium Cantabria and What Is It Used For?
Glycopyrronium Cantabria contains the active substance glycopyrronium bromide, a synthetic quaternary ammonium compound that belongs to the class of anticholinergic (antimuscarinic) agents. Glycopyrronium bromide has been used in medicine for decades in oral and injectable forms for various indications, including reduction of secretions during surgery, treatment of peptic ulcers, and management of chronic obstructive pulmonary disease (COPD). However, Glycopyrronium Cantabria represents a novel topical formulation specifically developed by Cantabria Labs for the dermatological treatment of primary axillary hyperhidrosis.
Primary axillary hyperhidrosis is a chronic condition characterized by excessive sweating from the eccrine sweat glands in the underarm (axillary) area that goes beyond what is physiologically necessary for thermoregulation. This condition affects an estimated 1–5% of the global population, with significant regional variation. It typically begins during adolescence or early adulthood and can persist throughout life. The sweating occurs bilaterally (affecting both underarms equally), is often unpredictable, and can be triggered or worsened by emotional stress, physical activity, or warm environments. Primary hyperhidrosis is distinguished from secondary hyperhidrosis in that it is not caused by an underlying medical condition, medication, or hormonal imbalance.
The impact of axillary hyperhidrosis on quality of life is substantial and often underappreciated. Patients frequently report embarrassment, social anxiety, occupational limitations, difficulty with clothing choices, and skin maceration or irritation in the affected area. The Hyperhidrosis Disease Severity Scale (HDSS) is commonly used to grade the severity of the condition, ranging from 1 (never noticeable, never interferes with daily activities) to 4 (intolerable, always interferes with daily activities). Studies have shown that the psychological burden of hyperhidrosis can be comparable to that of severe psoriasis or other chronic dermatological conditions, with higher rates of anxiety and depression among affected individuals.
Glycopyrronium bromide exerts its therapeutic effect by competitively and reversibly inhibiting acetylcholine at the muscarinic receptors (primarily the M3 subtype) located on eccrine sweat glands. Under normal physiological conditions, the sympathetic nervous system releases acetylcholine at the neuroeffector junction with eccrine sweat glands. This acetylcholine binds to muscarinic receptors on the sweat gland cells, triggering a cascade of intracellular signalling events that result in the production and secretion of sweat. By blocking this acetylcholine-muscarinic receptor interaction, glycopyrronium bromide effectively reduces the stimulation of sweat glands and thereby decreases sweat production in the treated area.
The topical formulation of Glycopyrronium Cantabria is designed to deliver the active ingredient directly to the site of action — the eccrine sweat glands in the dermis of the axillary skin. This targeted delivery approach aims to maximize local efficacy while minimizing systemic absorption and the associated risk of systemic anticholinergic side effects (such as blurred vision, urinary retention, constipation, and tachycardia) that are more commonly observed with oral anticholinergic medications. The quaternary ammonium structure of glycopyrronium bromide further limits its ability to cross biological membranes, including the blood–brain barrier, which reduces the likelihood of central nervous system side effects.
In randomized, double-blind, vehicle-controlled clinical trials, topical glycopyrronium demonstrated statistically significant reductions in gravimetric sweat production compared with vehicle cream. A substantial proportion of patients achieved at least a 50% reduction in axillary sweating, and significant improvements were reported on the HDSS scale and dermatology-specific quality of life measures. The onset of action was rapid, with many patients noticing improvement within the first few days of treatment.
What Should You Know Before Using Glycopyrronium Cantabria?
Before starting treatment with Glycopyrronium Cantabria, it is essential that your healthcare provider has a complete understanding of your medical history, current medications, and any allergies you may have. Although topical application results in significantly lower systemic exposure compared with oral or injectable glycopyrronium, some systemic absorption can occur, and this may be clinically relevant in patients with certain pre-existing conditions. Your doctor will weigh the benefits of treatment against potential risks based on your individual health profile.
Contraindications
Glycopyrronium Cantabria should not be used in the following situations:
- Known hypersensitivity: Do not use this medication if you are allergic to glycopyrronium bromide, other anticholinergic agents, or any of the excipients (inactive ingredients) in the cream formulation. Signs of an allergic reaction may include rash, itching, swelling, severe dizziness, or difficulty breathing.
- Uncontrolled narrow-angle (angle-closure) glaucoma: Anticholinergic agents can increase intraocular pressure by causing mydriasis (pupil dilation), which may precipitate an acute glaucoma attack in susceptible individuals. While the risk is lower with topical application than with systemic administration, this remains a contraindication.
- Urinary retention: Patients with existing urinary retention or severe bladder outlet obstruction should not use anticholinergic medications, as these agents can worsen urinary retention by relaxing the detrusor muscle and reducing bladder contractility.
- Severe gastrointestinal obstruction: Anticholinergics reduce gastrointestinal motility and can exacerbate obstructive conditions of the gastrointestinal tract, including paralytic ileus and toxic megacolon.
- Myasthenia gravis: Anticholinergic agents may interfere with the action of acetylcholine at the neuromuscular junction, potentially worsening muscle weakness in patients with myasthenia gravis.
Warnings and Precautions
While Glycopyrronium Cantabria is generally well-tolerated as a topical treatment, several important precautions should be observed during use. Even though systemic absorption is limited, the anticholinergic properties of the active ingredient warrant careful consideration in certain patient populations and clinical scenarios.
- Avoid contact with eyes: If the cream accidentally comes into contact with the eyes, it may cause blurred vision, eye pain, and mydriasis (dilated pupils). Wash hands thoroughly with soap and water after each application to prevent inadvertent transfer of the medication to the eyes or other sensitive areas.
- Heat-related illness: Anticholinergics can inhibit the body’s ability to sweat, which is a critical mechanism for thermoregulation. Patients using Glycopyrronium Cantabria should exercise caution during hot weather, vigorous physical activity, or exposure to high ambient temperatures, as reduced sweating capacity may increase the risk of heat exhaustion or heat stroke.
- Do not apply to broken or irritated skin: Application to skin that is cut, abraded, sunburned, or otherwise compromised may result in increased systemic absorption and a higher likelihood of local irritation or adverse reactions.
- Cognitive effects: Although glycopyrronium bromide is a quaternary ammonium compound with limited ability to cross the blood–brain barrier, elderly patients or those with pre-existing cognitive impairment should be monitored for any changes in cognition, confusion, or somnolence.
- Controlled narrow-angle glaucoma: Even patients with medically controlled glaucoma should have their intraocular pressure monitored regularly during treatment, and any visual changes should be promptly reported to an ophthalmologist.
Pregnancy and Breastfeeding
There is limited clinical data on the use of Glycopyrronium Cantabria during pregnancy. Animal reproductive toxicity studies with glycopyrronium bromide at doses significantly exceeding the recommended topical dose have not demonstrated teratogenic effects. However, as a precautionary measure, Glycopyrronium Cantabria should be avoided during pregnancy unless the potential benefit to the mother justifies the potential risk to the foetus. Women who become pregnant during treatment should consult their doctor about whether to continue use.
It is not known whether glycopyrronium bromide is excreted in human breast milk following topical application. Given the low systemic absorption from topical use, the risk to a breastfed infant is considered low, but a decision should be made by the treating physician weighing the benefit of breastfeeding for the child and the benefit of therapy for the mother. If breastfeeding is continued during treatment, the cream should not be applied to areas that the infant could come into direct contact with.
Women of childbearing potential should discuss contraceptive measures with their healthcare provider if starting treatment with Glycopyrronium Cantabria. There are no known effects on male or female fertility associated with topical glycopyrronium bromide at the recommended doses.
Always wash your hands thoroughly with soap and water immediately after applying Glycopyrronium Cantabria cream. This prevents inadvertent transfer of the medication to the eyes, mouth, or other sensitive areas, which could cause unwanted anticholinergic effects such as blurred vision or dry mouth.
How Does Glycopyrronium Cantabria Interact with Other Drugs?
Drug interactions with Glycopyrronium Cantabria are primarily of concern when other medications with anticholinergic properties are used concurrently. Because glycopyrronium bromide acts by blocking muscarinic acetylcholine receptors, combining it with other anticholinergic agents may result in additive effects, potentially increasing the risk of systemic anticholinergic side effects such as dry mouth, blurred vision, constipation, urinary retention, and tachycardia. While the systemic exposure from topical application is substantially lower than from oral administration, clinicians should exercise caution and monitor patients for signs of additive anticholinergic toxicity.
It is important to note that many commonly prescribed medications have anticholinergic properties, sometimes as secondary pharmacological effects that patients and even prescribers may not immediately recognize. The total anticholinergic burden of a patient’s medication regimen should be considered when prescribing Glycopyrronium Cantabria. This is particularly relevant in elderly patients, who are more susceptible to anticholinergic side effects and who may already be taking multiple medications with anticholinergic activity.
Major Interactions
| Drug / Drug Class | Interaction Type | Clinical Significance |
|---|---|---|
| Oral anticholinergics (oxybutynin, tolterodine, solifenacin) | Additive anticholinergic effects | Increased risk of dry mouth, blurred vision, urinary retention, constipation, and cognitive impairment. Monitor closely; dose adjustment may be needed. |
| Potassium chloride (oral solid dosage forms) | Increased GI ulceration risk | Anticholinergics reduce GI motility, potentially prolonging contact time of potassium chloride tablets with GI mucosa, increasing ulceration risk. |
| Tricyclic antidepressants (amitriptyline, nortriptyline) | Additive anticholinergic effects | TCAs have significant intrinsic anticholinergic activity. Combination may worsen dry mouth, constipation, urinary retention, and cause tachycardia. |
| Opioids (morphine, codeine, tramadol) | Enhanced GI motility reduction | Both drug classes reduce gastrointestinal motility. Concurrent use increases risk of severe constipation and paralytic ileus. |
Minor Interactions
| Drug / Drug Class | Interaction Type | Clinical Significance |
|---|---|---|
| First-generation antihistamines (diphenhydramine, chlorpheniramine) | Mild additive anticholinergic effects | May increase dry mouth and sedation. Generally manageable with dose awareness. |
| Antipsychotics (chlorpromazine, quetiapine) | Additive anticholinergic activity | Some antipsychotics have anticholinergic properties. Combination may increase side effects. Monitor for urinary retention and confusion. |
| Antiparkinsonian agents (trihexyphenidyl, benztropine) | Additive anticholinergic effects | Patients already taking antiparkinsonian anticholinergics should be monitored for increased anticholinergic burden. |
| Topical antiperspirants (aluminium chloride solutions) | Potential local irritation | Concurrent use of topical antiperspirants with Glycopyrronium Cantabria may increase local skin irritation. Stagger application times if both are used. |
Glycopyrronium bromide is not metabolized by cytochrome P450 (CYP) enzymes; therefore, pharmacokinetic interactions involving CYP-mediated drug metabolism are not expected. The drug is primarily eliminated renally as unchanged drug. This pharmacokinetic profile means that Glycopyrronium Cantabria is unlikely to affect the plasma levels or efficacy of other medications metabolized through hepatic pathways. However, the pharmacodynamic interactions described above (additive anticholinergic effects) remain clinically relevant regardless of the route of metabolism.
What Is the Correct Dosage of Glycopyrronium Cantabria?
Glycopyrronium Cantabria is supplied as a topical cream in a metered-dose pump bottle. Each full pump actuation delivers a consistent dose of 2.2 mg of glycopyrronium bromide. The formulation is designed to ensure uniform drug distribution across the application area, providing reliable and reproducible dosing with each use. Proper application technique is important for optimal therapeutic outcomes.
Adults
Standard Adult Dosage
Apply one pump actuation (2.2 mg) of Glycopyrronium Cantabria cream to each axilla (underarm) once daily. The total daily dose is two pump actuations (4.4 mg total), one per underarm.
- Apply to clean, dry, intact skin of the underarm area
- Preferably apply at bedtime to optimize overnight absorption
- Spread the cream gently and evenly across the entire underarm surface
- Allow the cream to dry completely before putting on clothing
- Wash hands thoroughly with soap and water immediately after application
- Do not shower, bathe, or swim for at least 4 hours after application
- Do not apply deodorants or antiperspirants to the treated area for at least 2 hours after application
Children and Adolescents
Paediatric Use
The safety and efficacy of Glycopyrronium Cantabria in children and adolescents under 18 years of age have not been established. This medication is not recommended for use in patients younger than 18 years. Primary hyperhidrosis can begin during adolescence, and affected young patients should be managed with conventional treatments (topical antiperspirants, iontophoresis) under the guidance of a dermatologist until further paediatric data are available.
Elderly Patients
Elderly Dosage Considerations
No dose adjustment is generally required for elderly patients based solely on age. However, elderly patients may be more susceptible to anticholinergic side effects and are more likely to be taking other medications with anticholinergic properties. Healthcare providers should:
- Assess the total anticholinergic burden before prescribing
- Monitor for signs of cognitive impairment, confusion, or urinary retention
- Consider renal function, as glycopyrronium bromide is primarily renally excreted
- Advise patients to stay well-hydrated and avoid excessive heat exposure
Missed Dose
If you forget to apply Glycopyrronium Cantabria at your usual time, apply it as soon as you remember on the same day. If you do not remember until the following day, skip the missed dose and apply your next dose at the regular scheduled time. Do not apply a double dose to make up for a forgotten application. Consistent daily use is recommended for optimal therapeutic effect, but missing a single dose is unlikely to result in a significant recurrence of symptoms, as the anticholinergic effect at the sweat gland level does not dissipate immediately.
Overdose
Due to the topical route of administration and the limited amount of glycopyrronium bromide delivered per actuation, overdose with Glycopyrronium Cantabria is unlikely under normal conditions of use. However, excessive application or accidental ingestion of the cream could theoretically result in systemic anticholinergic toxicity. Symptoms of anticholinergic overdose may include severely dry mouth and throat, difficulty swallowing, dilated pupils with blurred vision, flushing and dry hot skin, rapid heartbeat (tachycardia), elevated body temperature, urinary retention, confusion, agitation, and in severe cases, hallucinations or seizures.
If overdose is suspected, treatment is supportive and symptomatic. In cases of significant systemic anticholinergic toxicity, physostigmine salicylate may be considered as a specific antidote under close medical supervision in a hospital setting. Patients or caregivers should contact their local poison control centre or emergency department immediately if accidental ingestion of a large quantity of the cream occurs.
If Glycopyrronium Cantabria is accidentally swallowed or if you experience severe anticholinergic symptoms such as rapid heartbeat, high fever, confusion, or difficulty breathing, seek emergency medical attention immediately. Contact your local poison control centre for guidance.
What Are the Side Effects of Glycopyrronium Cantabria?
Like all medicines, Glycopyrronium Cantabria can cause side effects, although not everybody gets them. The side effect profile of topical glycopyrronium is generally favourable compared with oral anticholinergic agents, owing to the significantly lower systemic exposure achieved through topical application. Most reported side effects are mild to moderate in intensity and are localized to the site of application. Systemic anticholinergic side effects, while possible, occur at a substantially lower rate than with oral formulations of the same active ingredient.
In clinical trials evaluating topical glycopyrronium for axillary hyperhidrosis, the overall incidence of adverse events in the treatment group was modestly higher than in the vehicle (placebo) group, with the majority of events being application site reactions that did not require discontinuation of treatment. Fewer than 5% of patients in clinical studies discontinued treatment due to adverse events. The following side effects have been reported, organized by frequency of occurrence:
Common
May affect up to 1 in 10 people
- Application site dryness
- Application site erythema (redness)
- Application site pruritus (itching)
- Dry mouth (xerostomia)
- Application site burning or stinging sensation
Uncommon
May affect up to 1 in 100 people
- Blurred vision
- Mydriasis (dilated pupils) – usually from inadvertent eye contact
- Dry eyes
- Constipation
- Urinary hesitancy
- Headache
- Nasal dryness
- Oropharyngeal pain (sore throat)
Rare
May affect up to 1 in 1,000 people
- Urinary retention
- Tachycardia (rapid heartbeat)
- Palpitations
- Allergic contact dermatitis at application site
- Dizziness
- Flushing
Not Known
Frequency cannot be estimated from available data
- Hypersensitivity reactions (rash, angioedema)
- Anhidrosis (complete absence of sweating) at application site
- Heat intolerance or hyperthermia in rare cases of widespread application
Most application site reactions are transient, typically resolving within the first one to two weeks of treatment as the skin adapts to the medication. If any side effect becomes severe, persistent, or significantly bothersome, you should consult your healthcare provider. In particular, seek prompt medical attention if you experience symptoms of a serious allergic reaction (such as swelling of the face, lips, tongue, or throat, difficulty breathing, or severe skin rash), acute eye pain with vision changes (which may indicate angle-closure glaucoma), inability to urinate, or severe abdominal pain and distension (which may indicate gastrointestinal obstruction).
Patients should be aware that certain side effects, particularly dry mouth, can be managed with supportive measures such as drinking water regularly, using sugar-free gum or lozenges to stimulate saliva production, and maintaining good oral hygiene. If dry mouth persists and becomes troublesome, your doctor may recommend saliva substitutes or consider adjusting the treatment regimen.
You can help ensure the ongoing safety of this medicine by reporting any side effects you experience. In the EU, side effects can be reported through your national pharmacovigilance authority (e.g., the Yellow Card Scheme in the UK, or the national reporting systems listed on the EMA website). In the US, adverse events can be reported to the FDA MedWatch program. Your reports contribute to the continuous monitoring of the benefit–risk balance of this medicine.
How Should You Store Glycopyrronium Cantabria?
Proper storage of Glycopyrronium Cantabria is important to maintain the stability, efficacy, and safety of the medication throughout its shelf life. The cream formulation contains specific excipients that ensure the stability of glycopyrronium bromide and maintain the appropriate consistency and drug release properties of the product. Exposure to extreme temperatures, direct sunlight, or moisture can compromise these properties.
- Temperature: Store at room temperature, below 30°C (86°F). Do not refrigerate or freeze the cream, as freezing may alter the emulsion structure and affect drug distribution.
- Light: Protect from direct sunlight. Store in the original packaging to shield the product from light exposure.
- Closure: Keep the pump bottle tightly closed when not in use to prevent contamination and drying of the cream at the nozzle.
- Children: Keep out of the sight and reach of children. The metered-dose pump bottle should be stored in a secure location to prevent accidental ingestion.
- Expiry date: Do not use Glycopyrronium Cantabria after the expiry date stated on the label and carton (EXP). The expiry date refers to the last day of that month.
- After opening: Once opened, the cream should be used within the period specified on the label (typically within 6 months of first use). Write the date of opening on the packaging for reference.
- Disposal: Do not dispose of unused medication via household waste or wastewater. Return unused or expired products to your pharmacy for safe disposal in accordance with local regulations.
If you notice any change in the appearance, colour, odour, or consistency of the cream, do not use it and consult your pharmacist. A properly stored cream should be smooth, uniform in colour, and free from any visible particles or separation.
What Does Glycopyrronium Cantabria Contain?
Glycopyrronium Cantabria is formulated as a topical cream designed to deliver glycopyrronium bromide effectively to the eccrine sweat glands in the dermal layer of the axillary skin. The formulation has been optimized to balance drug stability, skin penetration, and cosmetic acceptability, ensuring that the product is easy to apply, absorbs well, and does not leave an excessively greasy or sticky residue on the skin.
Active Ingredient
The active substance is glycopyrronium bromide. Each metered-dose pump actuation delivers 2.2 mg of glycopyrronium bromide, equivalent to approximately 1.6 mg of glycopyrronium (the free base). Glycopyrronium bromide is a white to off-white crystalline powder that is freely soluble in water. Its quaternary ammonium structure is key to its pharmacological profile, as it confers permanent positive charge to the molecule, limiting its passage across lipid membranes and reducing the risk of central nervous system effects.
Inactive Ingredients (Excipients)
The cream base typically contains pharmaceutical-grade excipients that serve various functions in the formulation. While the exact excipient composition may vary slightly between manufacturers and between different national market authorizations, typical excipients in topical glycopyrronium cream formulations include:
- Emollients and moisturizers: Such as glycerol (glycerin) or propylene glycol, which help to maintain skin hydration and improve the cosmetic feel of the product
- Emulsifying agents: Such as cetyl alcohol, stearyl alcohol, or polysorbates, which stabilize the oil-in-water or water-in-oil emulsion structure of the cream
- Preservatives: Such as benzalkonium chloride or phenoxyethanol, which prevent microbial contamination during the in-use period
- pH adjusters: Such as citric acid or sodium hydroxide, which maintain the formulation at an optimal pH for drug stability and skin compatibility
- Purified water: The primary vehicle for the aqueous phase of the cream
If you have known allergies or sensitivities to any pharmaceutical excipients, review the full list of ingredients printed on the product packaging or the patient information leaflet before use. Your pharmacist can also provide this information. Patients with a history of contact dermatitis may wish to request a patch test before initiating regular treatment.
Frequently Asked Questions About Glycopyrronium Cantabria
Glycopyrronium Cantabria is a prescription topical cream used to treat primary axillary hyperhidrosis (excessive underarm sweating) in adults. It contains glycopyrronium bromide, an anticholinergic agent that blocks the nerve signals responsible for stimulating eccrine sweat glands. By reducing sweat gland activity locally at the application site, it decreases underarm sweating without requiring injections or systemic medication. It is typically prescribed for patients whose excessive sweating has not been adequately controlled by over-the-counter antiperspirants.
Many patients report a noticeable reduction in underarm sweating within the first few days of starting Glycopyrronium Cantabria. In clinical trials, significant improvements in sweat production were typically measured within the first week of daily application. However, the full therapeutic benefit may take 2 to 4 weeks to develop with consistent daily use. Your healthcare provider will usually evaluate the treatment response after approximately 4 weeks to determine whether the medication is providing adequate benefit.
Yes, you can use deodorant or antiperspirant alongside Glycopyrronium Cantabria, but it is recommended to stagger the application times. Apply Glycopyrronium Cantabria at bedtime and allow it to absorb overnight. You may then apply your regular deodorant or antiperspirant in the morning. Avoid applying both products simultaneously, as this may increase the risk of local skin irritation. If you experience significant skin dryness or irritation, you may find that Glycopyrronium Cantabria provides sufficient odour and moisture control on its own.
Glycopyrronium bromide (the active ingredient in Glycopyrronium Cantabria) and glycopyrrolate refer to the same active substance under different naming conventions. “Glycopyrronium” is the International Nonproprietary Name (INN) used in Europe and internationally, while “glycopyrrolate” is the United States Adopted Name (USAN). Glycopyrronium Cantabria is a specific branded topical cream formulation by Cantabria Labs, whereas glycopyrrolate is also available in oral and injectable forms for other medical indications such as reduction of secretions during surgery, COPD management, and chronic drooling.
Glycopyrronium Cantabria is specifically approved and formulated for the treatment of primary axillary (underarm) hyperhidrosis. While some healthcare providers may consider off-label use on other body areas affected by focal hyperhidrosis (such as the palms, soles, or face), such use should only be undertaken under careful medical supervision. The safety and efficacy of the product for use on non-axillary body regions have not been established in controlled clinical trials. Applying the cream to the face carries a higher risk of inadvertent contact with the eyes.
If Glycopyrronium Cantabria accidentally comes into contact with your eyes, rinse them immediately and thoroughly with cool, clean water for at least 15 minutes. The anticholinergic properties of the medication can cause temporary blurred vision and dilated pupils (mydriasis) if it contacts the eye. If symptoms of blurred vision, eye pain, or sensitivity to light persist after rinsing, seek prompt medical attention, particularly if you have a history of glaucoma. This is why thorough hand-washing immediately after application is strongly recommended.
References
- European Medicines Agency (EMA). Glycopyrronium bromide topical – Summary of Product Characteristics. Available from: www.ema.europa.eu. Accessed January 2026.
- Hornberger J, Grimes K, Naumann M, et al. Recognition, diagnosis, and treatment of primary focal hyperhidrosis. Journal of the American Academy of Dermatology. 2004;51(2):274–286. doi:10.1016/j.jaad.2003.12.029
- Lakraj AA, Moghimi N, Jabbari B. Hyperhidrosis: anatomy, pathophysiology and treatment with emphasis on the role of botulinum toxins. Toxins. 2013;5(4):821–840. doi:10.3390/toxins5040821
- Glaser DA, Hebert AA, Nast A, et al. Topical glycopyrronium tosylate for the treatment of primary axillary hyperhidrosis: Results from the ATMOS-1 and ATMOS-2 phase 3 randomized controlled trials. Journal of the American Academy of Dermatology. 2019;80(1):128–138.e2. doi:10.1016/j.jaad.2018.07.002
- Grabell DA, Hebert AA. Current and emerging medical therapies for primary hyperhidrosis. Dermatology and Therapy. 2017;7(1):25–36. doi:10.1007/s13555-016-0148-z
- Nawrocki S, Cha J. The etiology, diagnosis, and management of hyperhidrosis: A comprehensive review. Part II. Therapeutic options. Journal of the American Academy of Dermatology. 2019;81(3):669–680. doi:10.1016/j.jaad.2018.11.066
- British Association of Dermatologists (BAD). Guidelines for the management of primary hyperhidrosis. 2023. Available from: www.bad.org.uk.
- International Hyperhidrosis Society. Treatment algorithm for focal hyperhidrosis. 2024. Available from: www.sweathelp.org.
- World Health Organization (WHO). WHO Model List of Essential Medicines – 23rd List. Geneva: World Health Organization; 2023.
- Stolman LP. Treatment of excess sweating of the palms by iontophoresis. Archives of Dermatology. 1987;123(7):893–896.
Medical Editorial Team
Clinical Pharmacology Review
Content reviewed by specialist physicians in clinical pharmacology and dermatology with expertise in hyperhidrosis management and topical drug formulations.
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