Qbrexza (Glycopyrronium Tosylate) – Topical

What Is Qbrexza?

Qbrexza (glycopyrronium tosylate) is a topical prescription drug used to reduce excessive underarm sweating. Healthcare providers can prescribe it to adults and children 9 years or older.

Specific molecules in the body trigger sweating. Too much triggering of these molecules can cause excessive sweating in some people, especially in the armpits. Qbrexza belongs to a class of drugs called anticholinergics. It works by blocking communication to the sweat glands, which helps to reduce sweating.

Qbrexza is applied to the skin with a single-use cloth premoistened with a solution.

Drug Facts

Generic Name: Glycopyrronium tosylate

Brand Name(s): Qbrexza

Administration Route: Topical

Drug Availability: Prescription

Therapeutic Classification: Cholinergic antagonist

Available Generically:

Controlled Substance: N/A

Active Ingredient: Glycopyrronium tosylate

Dosage Form(s): Cloth

What Is Qbrexza Used For?

The Food and Drug Administration (FDA) approved Qbrexza to treat a condition called axillary hyperhidrosis, which causes excessive sweating in the armpits. It can be used in adults and children aged 9 years and older.

Qbrexza (Glycopyrronium Tosylate) Drug Information - Illustration by Zoe Hansen

Verywell / Zoe Hansen

How to Take Qbrexza

Qbrexza is applied with a single-use cloth that is premoistened with a 2.4% glycopyrronium solution. Apply to clean dry skin on your underarm once a day only.

Follow these steps to apply Qbrexza:

  • First, wash your hands. Clean and dry your underarms. 
  • Open the pouch that contains the Qbrexza single-use premoistened wipes and get the cloth out. 
  • Unfold and wipe across each underarm once with the same cloth.
  • After wiping, throw out the cloth; then wash your hands with soap and water.

Applying this drug consistently helps control your symptoms.

When using Qbrexza, do not:

  • Take by mouth
  • Get in the nose, mouth, and eyes, where exposure can cause such reactions as large pupils and blurred vision
  • Use coverings such as bandages or dressings, unless directed by your provider
  • Use if you have sores, cuts, or broken skin in your underarm
  • Use near a fire or heat since glycopyrronium is flammable
  • Use more than once every 24 hours

Storage

Store Qbrexza in a dry place at room temperature (68–77 degrees Fahrenheit). Do not keep it in your bathroom. Store your medicines away from children and pets and keep them away from flames and heat. Discard any unused or expired drugs. Ask your pharmacist about the best ways to discard your medicines. Check out drug take-back programs in your area.

How Long Does Qbrexza Take to Work?

In clinical studies, Qbrexza improved sweating symptoms as soon as one week after starting the regimen.

What Are the Side Effects of Qbrexza?

This is not a complete list of side effects, and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

People have different reactions to drugs. Some may have little to no side effects. Let your healthcare provider know of any side effects that you have, especially if it bothers you or does not go away. 

Some common side effects of Qbrexza are:

  • Sore throat
  • Headache 
  • Skin redness, burning/stinging, or itching in the underarm area
  • Constipation
  • Dry nose, skin, eyes, or mouth
  • Urination problems
  • Blurred vision
  • Dilated pupils of your eyes

This is not a full list of the side effects that can happen. Contact your doctor or pharmacist if you have any questions about side effects.

Severe Side Effects

It is uncommon to have serious side effects with Qbrexza. However, some people may have severe reactions while on this drug. Serious side effects and their symptoms include the following:

Call your healthcare provider as soon as possible if you have any serious side effects due to Qbrexza. Call 911 if your symptoms feel life-threatening or if you think you have a medical emergency.

Report Side Effects

Qbrexza may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Qbrexza Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For topical dosage form (cloth):
    • For excessive sweating of the underarms:
      • Adults and children 9 years of age and older—Apply 1 cloth to both underarm areas once every 24 hours.
      • Children younger than 9 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose, use it as soon as you find out. If it is too close to your next dose, skip the missed dose and return to your regular schedule. Do not use more than one dose of Qbrexza in 24 hours.

Overdose: What Happens If I Take Too Much Qbrexza?

Overdose symptoms from excessive anticholinergic exposure may include a fast or abnormal heartbeat, rapid or shallow breathing, and larger pupils. Topical overdosing of Qbrexza can cause severe local skin reactions.

What Happens If I Overdose on Qbrexza?

If you think you or someone else may have overdosed on Qbrexza, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Qbrexza, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your or your child's progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

Do not use this medicine to treat a skin problem your doctor has not examined.

Check with your doctor right away if you or your child have a decrease in urine volume, a decrease in the frequency of urination, difficulty in passing urine, or painful urination.

This medicine may make it more difficult for your body to cool down. It might reduce how much you sweat. Your body could get too hot if you do not sweat enough. If your body gets too hot, you might feel dizzy, weak, tired, or confused. Avoid places that are very hot. Call your doctor if drinking cool water and moving away from the heat does not cool you down.

This medicine may cause blurred vision. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn't Take Qbrexza?

Qbrexza can worsen certain medical conditions. Do not take Qbrexza if you have:

  • Severe ulcerative colitis (chronic inflammatory bowel disease causing inflammation and sores on the lining of the intestines)
  • Myasthenia gravis (chronic autoimmune disorder that interferes with nerve and muscle communication, causing muscle weakness)
  • Glaucoma (group of eye conditions that damage the optic nerve, which can cause vision loss and blindness)
  • Toxic megacolon  (life-threatening complication of a colon disease)
  • Paralytic ileus (temporary paralyzation of the muscles moving food through the intestines)
  • Unstable heart issues with acute hemorrhage (bleeding)
  • Sjögren's syndrome (autoimmune disease affecting the glands that make tears and saliva)

What Other Medications Interact With Qbrexza?

Some medications do not go very well with Qbrexza. Taking them together may increase drug side effects. While on Qbrexza, avoid taking:

What Medications Are Similar?

Other drugs used to treat excessive sweating, like Qbrexza, are:

  • Drysol (aluminum chloride)
  • Botox (onabotulinumtoxin A) injections
  • Oxytrol (oxybutynin) 
  • Ditropan (oxybutynin)
  • Gelnique (oxybutynin)

Drysol 

Drysol is a topical skin product available with a prescription. It is a high-grade antiperspirant. It contains 20% aluminum chloride, which is higher than aluminum chloride in regular deodorants. Drysol is also dosed once daily like Qbrexza. It has minimal side effects and no drug-drug interactions.

Botox

Botox can be used when other topical agents fail to control sweating. Botox treats excessive sweating by paralyzing muscles that can cause sweat glands to produce too much sweat. Botox injections take about 15 minutes to give, and their effects last up to 28 weeks. So, doses are repeated every four to six months.

Getting injections can be uncomfortable for some patients when compared with using a topical cloth, like Qbrexza. Botox also has more severe side effects, like trouble swallowing, in some people.

Oxybutynin

Oxybutynin is also used to treat excessive sweating. It works very well. Oxybutynin is available as a patch (Oxytrol), a gel (Gelnique), and a tablet (Ditropan). It has frequent but tolerable side effects. However, it has more side effects than Qbrexza. Oxybutynin may cause serious side effects in some people, like heart palpitations, dry mouth, a change in mental state, and constipation.

This is a list of drugs also prescribed for heart failure. It is not a list of drugs recommended to take with Qbrexza. You should not take these drugs together. Ask your pharmacist or healthcare provider if you have any questions.

Frequently Asked Questions

  • What is Qbrexza used for?

    Qbrexza is used to treat excessive underarm (armpit) sweating.

  • What should I do if I miss a dose of Qbrexza?

    If you miss a dose of Qbrexza, apply it as soon as you think of it. If it is too close to the next dose, skip the missed dose. Resume using your medicine at your regular time.

  • How does Qbrexza work?

    Qbrexza works by blocking communication to the nerves that trigger sweating. Therefore, reducing too much sweating.

  • What are some side effects of Qbrexza?

    Some common side effects are:

    • Burning
    • Itching
    • Sore throat
    • Headache 
    • Redness
    • Constipation
    • Stinging
    • Dry nose, skin, eyes, or mouth
  • How long does it take for Qbrexza to work?

    Qbrexza starts to work about one to 1.5 hours once applied. You may see improvement in your sweating symptoms as early as one week after you start your regimen.

How Can I Stay Healthy While Taking Qbrexza?

Excessive sweating is a very controllable health problem. Specific health issues can cause too much sweating, like menopause, hyperthyroidism, or malaria. You may also experience it when you are stressed out or nervous. 

If you suffer from too much underarm sweating, you can reduce it by applying Qbrexza consistently, according to the instructions. The more consistent you are with this medicine, the more successful you will be at controlling your symptoms.

Be careful in hot weather and while exercising. Drink plenty of fluids. Qbrexza can cause you to have decreased sweating in areas other than the underarm area. This could cause you to become overheated and to develop heat illness. If you are not sweating in warm temperatures or during activities, tell your provider immediately and stop using Qbrexza. Listen to your healthcare team, pay attention to your body, and talk to your provider if you have any concerns.

Medical Disclaimer

Verywell Health's drug information is meant for education purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Lamb YN. Topical glycopyrronium tosylate in primary axillary hyperhidrosis: A profile of its use. Clinical Drug Investigation. 2019. doi: 10.1007/s40261-019-00853-x

  3. American Osteopathic College of Dermatology. Hyperhidrosis.

  4. Food and Drug Administration. Botox label.

  5. Wolosker N, Kauffman P, de Campos JRM, et al. Long-term results of the treatment of primary hyperhidrosis with oxybutynin: follow-up of 1,658 cases. International Journal of Dermatology. 2020;59(6):709-715. doi:10.1111/ijd.14872