glycopyrronium tosylate topical

Action and Spectrum

Actions and spectrum: 

glycopyrronium tosylate topical is an anticholinergic medication that acts by blocking the action of acetylcholine, a neurotransmitter responsible for sweat gland activation. It is formulated for the treatment of primary axillary hyperhidrosis.

By inhibiting sweat production, glycopyrronium tosylate helps to reduce sweating and improve quality of life for individuals with hyperhidrosis. Its spectrum of action is limited to the targeted area of application, primarily the underarms. 

Drug Interaction

Adverse Reaction

Frequency defined 

1-10% 

Constipation (2%) 

Pharyngitis (2.2%) 

Dry skin (2.2%) 

Erythema (2.4%) 

Dry eye (2.4%) 

Dry throat (2.6%) 

Urinary hesitation (3.5%) 

Blurred vision (3.5-6.7%) 

Pruritus (3.8%) 

Dermatitis (3.8%) 

Urinary hesitation (4.2%) 

Headache (5%) 

Oropharyngeal pain (5.7%) 

Nasopharyngitis (5.8%) 

application site Pain (6.4%) 

Mydriasis (5.3-6.8%) 

Pruritus (8.1%)  

>10% 

Erythema (17%) 

Dry mouth (16.9-24.2%) 

Burning/stinging (14.1%)  

Post marketing Reports 

Genitourinary system disorders: onset of urinary retention 

Black Box Warning

Black Box Warning: 

glycopyrronium tosylate topical does not have any black box warning 

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

glycopyrronium tosylate topical is contraindicated in individuals with a known hypersensitivity or allergy to glycopyrronium tosylate or any of its components. It is not advised to use in individuals with hypersensitivity reactions to anticholinergic drugs. Additionally, it is also not recommended to use in children below 6 years.  

Caution: 

• Avoid contact with eyes and mucous membranes: glycopyrronium tosylate topical is intended for external use only. Avoid getting the medication in sensitive areas of the body. 
• Skin irritation or allergic reactions: Some individuals may experience skin irritation, redness, itching, or allergic reactions to glycopyrronium tosylate topical.  
• Use in specific patient populations: The safety and effectiveness of glycopyrronium tosylate topical have not been established in pediatric patients below 6 years, pregnant women, and lactating women.  
• Concurrent use of other anticholinergic medications: The combined use of glycopyrronium tosylate topical with other anticholinergic medications may increase the risk of anticholinergic side effects.

Comorbidities: 

• Glaucoma: glycopyrronium tosylate topical should be used with caution in individuals with glaucoma or a history of increased intraocular pressure. It may cause dilation of the pupils and potentially worsen glaucoma symptoms. 
• Urinary retention: Individuals with a history of urinary retention or bladder dysfunction should use glycopyrronium tosylate topical with caution. Anticholinergic medications like glycopyrronium tosylate can affect bladder function and potentially worsen urinary retention. 
• Gastrointestinal disorders: Individuals with gastrointestinal disorders, such as severe constipation or obstruction, should exercise caution when using glycopyrronium tosylate topical. Anticholinergic medications can affect gastrointestinal motility and potentially worsen these conditions. 

Pregnancy / Lactation

Pregnancy consideration: US FDA pregnancy category: Not assigned. 

Lactation: it is unknown whether drug gets excreted into human milk.  

Pregnancy category: 

• Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 
• Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 
• Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   
• Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits. 
• Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women. 
• Category N: There is no data available for the drug under this category. 

Pharmacology

Pharmacology: 

glycopyrronium tosylate is an anticholinergic medication that acts by blocking the action of acetylcholine. When applied topically, glycopyrronium tosylate acts locally on the sweat glands in the skin. 

• Anticholinergic activity: glycopyrronium tosylate selectively blocks the muscarinic receptors in the sweat glands, reducing sweat production. This helps in the management of conditions characterized by excessive sweating, such as primary axillary hyperhidrosis. 
• Localized action: The topical formulation of glycopyrronium tosylate allows for targeted application directly on the affected skin areas. It minimizes systemic absorption and reduces the potential for systemic side effects. 
• Sweat gland inhibition: By blocking the action of acetylcholine, glycopyrronium tosylate inhibits the stimulation of sweat glands, leading to decreased sweat production. This helps in controlling excessive sweating and improving symptoms associated with hyperhidrosis.

Pharmacodynamics: 

The pharmacodynamics of glycopyrronium tosylate topical are primarily attributed to its anticholinergic activity. It acts as a competitive antagonist at muscarinic receptors, specifically the M1 and M3 subtypes, which are present in sweat glands. 

By blocking the acetylcholine, which is involved in sweat production, glycopyrronium tosylate reduces the stimulation of sweat glands. This results in a decrease in sweat production and helps to manage conditions characterized by excessive sweating, such as primary axillary hyperhidrosis. 

The localized application of glycopyrronium tosylate topical allows for targeted action on the sweat glands in the specific area of application. It is designed to have minimal systemic absorption, which reduces the risk of systemic anticholinergic side effects.  

Pharmacokinetics: 

Absorption 

When applied topically, glycopyrronium tosylate is primarily absorbed through the skin. It acts locally on the sweat glands, reducing sweat production. 

Distribution 

Since glycopyrronium tosylate topical is primarily designed for local action, it remains largely confined to the site of application and does not distribute extensively throughout the body. 

Metabolism 

Metabolism is not a significant concern for topical medications like glycopyrronium tosylate. However, if any systemic absorption occurs, the drug may undergo metabolism in the liver. 

Elimination and excretion 

The majority of glycopyrronium tosylate topical is not systemically absorbed, so excretion is not a major route of elimination. Any minimal systemic absorption that occurs may lead to the drug being excreted through urine or bile after undergoing metabolism. 

Adminstartion

Administration: 

• Clean the affected area: Start by cleaning and drying the area where the medication will be applied. This helps ensure optimal absorption and effectiveness. 
• Apply a thin layer: Take a sufficient amount of the cream or gel and gently spread it over the affected area. Use enough to cover the area completely but avoid applying excessive amounts. 
• Rub in gently: Use your fingertips to gently massage the medication into the skin. Ensure even distribution and absorption. 
• Wash hands after application: After applying glycopyrronium tosylate topical, wash your hands thoroughly to remove any residual medication and prevent accidental transfer to other areas. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: glycopyrronium tosylate topical 

Pronounced: (glie-koh-PIR-ro-nee-um toh-SIL-ate top-i-kal)  

Why do we use glycopyrronium tosylate topical? 

glycopyrronium tosylate topical is primarily used for the treatment of primary axillary hyperhidrosis, a condition characterized by excessive sweating in the underarm area. It helps to reduce sweating by blocking the activity of sweat glands.

The use of glycopyrronium tosylate topical can provide relief from excessive sweating and improves quality of life. It is usually prescribed in patients who have not responded adequately to other topical antiperspirants or treatments.