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.

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.

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.

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:

• Blurred eyesight
• Larger pupils
• High body temperature
• Heatstroke
• Fast or abnormal heartbeat
• Signs of allergic reactions 
• Passing urine more often
• Trouble passing urine
• Urinating in a weak stream or drips
• Full bladder or difficulty emptying your bladder
• Less sweating in other areas apart from the underarm

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.

Dosage: How Much Qbrexza Should I Take?

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.

Precautions

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:

• Anticholinergic agents
• Atrovent HFA (ipratropium)
• Klor-Con (potassium chloride)
• Urocit-K (potassium citrate)
• Spiriva (tiotropium)
• Incruse Ellipta (umeclidinium)

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.

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.