Low Dose Oxybutin in Primary Hyperhydrosis: A Prospective Study from a Tertiary Care Center in Nepal

Abstract

Introduction: Hyperhydrosis is a clinical condition where  there is excessive sweating beyond the physiological need of the patient’s body. This can  directly or indirectly affect the quality of patients life. Oxybutin is widely used in urology as anticholinergic medication for bladder urge incontinence. It can be used safely at a high doses (over 15 mg/day) to treat urological disorder. It also acts against excessive sweating and can be used in cases of hyperhidrosis.

Objectives:  To evaluate effectiveness of oxybutin at low dose and to assess the Hyperhidrosis Disease Severity Scale (HDSS) .

Materials and Methods: This is a hospital based cross-sectional study in primary hyperhydrosis. Oxybutin  was prescribed to all patients of primary hyperhydrosis with gradual increment of dosage of 2.5 mg orally once a day to 5 mg twice a day. Patients were evaluated  at zero wk (baseline), 4 wk, 8 wk, 12 wk and follow-up in 16 wks with  Hyperhidrosis Disease Severity Scale (HDSS) along with adverse effects were noted. 

Results: There was a significant difference in HDSS at zero wk (baseline) and  4^th wk (p=0.001) at a dose of 2.5 mg once a day of oxybutynin. Also, a significant difference was noted (p=0.022) in HDSS between zero wk (baseline) and 12 wk. Similarly, a significant difference between HDSS at zero wk (baseline) versus the 16^th wk was also noted. 

Conclusion: Oxybutin is an anticholinergic drug  with an emerging  role in hyperhydrosis. Low doses have shown significant results with minimal side effects. The dose requirement varies among authors. Studies  with long-term follow-ups  with ideal protocol  need to be established in the future.