STEPS

New Drug Reviews

Glycopyrronium (Qbrexza) Topical Wipes for Hyperhidrosis

 

Am Fam Physician. 2019 Sep 15;100(6):372-373.

Glycopyrronium (Qbrexza) topical wipes are labeled for the treatment of hyperhidrosis. Glycopyrronium wipes contain a topically-dosed anticholinergic. When applied to the axillae, they reduce sweating in patients nine years and older with hyperhidrosis.1

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DrugDosageDose formCost*

Glycopyrronium (Qbrexza) topical wipes, 2.4%

Topical application once daily to each axilla

Single cloth

$580 for 30 wipes


*—Estimated retail price based on information obtained at https://www.goodrx.com (accessed August 9, 2019).

DrugDosageDose formCost*

Glycopyrronium (Qbrexza) topical wipes, 2.4%

Topical application once daily to each axilla

Single cloth

$580 for 30 wipes


*—Estimated retail price based on information obtained at https://www.goodrx.com (accessed August 9, 2019).

Safety

Systemic anticholinergic absorption may occur with use of glycopyrronium wipes. The most serious adverse effects of glycopyrronium wipes are blurred vision and dehydration. In a study of more than 450 patients, nearly one in 25 patients experienced blurred vision. Dehydration occurred in only one patient.1 There is a theoretic risk of worsening narrow-angle glaucoma, paralytic ileus, urinary retention, and myasthenia gravis, as well as an increased risk of heat injury.2 Coadministration of glycopyrronium wipes and other anticholinergic medications should be avoided. Safety of glycopyrronium wipes has not been studied in children younger than nine years, women who are pregnant or breastfeeding, or patients with significant renal impairment.

Tolerability

Minor adverse effects are common. In two clinical trials of 459 patients treated with glycopyrronium over four weeks, more than one-third experienced minor adverse effects.1 The most common is dry mouth, reported by one in four patients.1 Dilated pupils are less common (7%) but can be unilateral, falsely raising concern for neurologic injury.1,2 With long-term use of glycopyrronium, adverse effects will be reported by 59% of patients, leading to 8% of patients discontinuing treatment.3

Effectiveness

Glycopyrronium wipes decrease symptoms of hyperhidrosis more effectively than control wipes, with one additional person benefiting after four weeks of use compared with placebo (number

Address correspondence to Michael J. Arnold, MD, at michael.arnold@usuhs.edu. Reprints are not available from the authors.

Author disclosure: No relevant financial affiliations.

References

show all references

1. DailyMed. Drug label information: Qbrexza—glycopyrronium cloth. Accessed January 29, 2019. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6b985380-1256-4fb3-b89a-6df2c6a6d12e...

2. Reviewers of Multi-Disciplinary Review and Evaluation. Center for Drug Evaluation and Research. Application number: 210361Orig1s000. NDA Multi-disciplinary review and evaluation, NDA 210361. Qbrexza (glycopyrronium) cloth, 2.4%. Accessed February 25, 2019. https://www.accessdata.fda.gov/drugsatfda_docs/nda/2018/210361Orig1s000MultidisciplineR.pdf

3. Glaser DA, Hebert AA, Nast A, et al. Open-label study (ARIDO) evaluating long-term safety of topical glycopyrronium tosylate (GT) in patients with primary axillary hyperhidrosis. MauiDerm for dermatologists: selected abstracts from the 2018 meeting. J Clin Aesthet Dermatol. 2018;11(5 suppl):S8–S31.

4. Grabell DA, Hebert AA. Current and emerging medical therapies for primary hyperhidrosis. Dermatol Ther (Heidelb). 2017;7(1):25–36.

5. Qbrexza (glycopyrronium) cloth. Applying Qbrexza wipes. Accessed February 27, 2019. https://www.qbrexza.com/applying-qbrexza

STEPS new drug reviews cover Safety, Tolerability, Effectiveness, Price, and Simplicity. Each independent review is provided by authors who have no financial association with the drug manufacturer.

This series is coordinated by Allen F. Shaughnessy, PharmD, MMedEd, Assistant Medical Editor.

A collection of STEPS published in AFP is available at https://www.aafp.org/afp/steps.

 

 

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