There are 2 – 4 million sweat glands distributed all over our bodies. The majority on the soles of the feet, palm of the hands, the forehead, cheek and underarms. Sweat is essential for human survival as it serves as the body’s cooling system, protecting us from over heating . In some people the cooling mechanism is overactive. These people may sweat 4 – 5 times more than necessary. This excessive sweating is a medical condition known as hyperhidrosis.
Messages from the brain, Hormones, Emotions, Activity or exercise.
What is Hyperhidrosis?
We all sweat. Each of us typically has between 3 and 4 million sweat gland covering our bodies and amazingly, we can produce around 11 litres of sweat during a 24hr period. The body produces two types of fluid when we sweat: : eccrine, which is a clear, odourless fluid that appears all over our bodies and regulates our body temperature and keeps us cool (Thermoregulation); and apocrine, a more viscous substance that is produced by glands in areas such as the underarm and groin areas. Like eccrine fluids, apocrine fluids are odourless, at least until bacteria on the skin’s surface acts upon it, breaking down enzymes within the fluid and producing the offensive smell that we all associate with sweating. An estimated 40% of the population will experience some form of excessive sweating or problem odour at some point during their lives. Sweat problems can manifest themselves in specific areas of the body and be caused by many different factors, including age, diet, lifestyle, stress, medication, hormone imbalances, etc. Approximately 3% of the world’s population will suffer with severe excessive sweating, which is clinically identified as ‘Hyperhidrosis’ and can affect any adult, in any area of the body and during any stage of life. Excessive sweating or Hyperhidrosis rarely affects pre-pubescent minors. Axillae (underarms), Palmar (palms of the hands), Plantar (soles of the feet), Cranial-facial (head, face and neck) are all areas commonly affected by excess sweating.
Types of Hyperhidrosis
There are two types of hyperhidrosis, understanding the difference is the start of understanding your condition.
Primary focal hyperhidrosis this refers to excessive sweating that is not caused by a medical condition or the side effects of medicines taken by the sufferer.This type of sweating occurs on a specific area of the body, (discribed as “focal” areas) and is usually both the left and right hand side of the body is affected. The most common areas are the hands, feet, under arms, head and face.
Secondary generalised hyperhidrosis refers to excessive sweating caused by a medical condition or the side effects of medicines being consumed by the sufferer. Unlike primary hyperhidrosis, secondary hyperhidrosis is normally larger amounts of sweat in other areas such as back, groin and thighs. Sufferers often experience sweating during the night while asleep. Secondary normally only starts later in life and is not associated with stress. It is important to see a health care professional to establish what the cause of the sweating could be.
Drugs/Medications Known to Cause Hyperhidrosis
Certain prescriptions and non-prescription medications can cause hyperhidrosis (excess perspiration or sweating) as a side effect. A list of potentially sweat-inducing medications is provided below. Medications are listed alphabetically by generic name. U.S. brand names are given in parentheses, if applicable. This list is provided as a resource and a service. It is not exhaustive and is in no way meant to replace consultation with a medical professional. Although sweating is a known side effect of the medications listed below, in most cases only a small percentage of people using the medicines experience undue sweating (in some cases less than 1%). Medications noted with an “*” and in bold are the most likely to cause sweating and the frequency of sweating as a side effect from these medications may be as high as 50%. Medications noted with an “†” are commonly-prescribed drugs; and those with a “P” are often used for pediatrics.
Key: */Bold — Known to commonly cause hyperhidrosis † — Commonly-prescribed drugs P — Pediatric use
Abciximab (ReoPro®) Acamprosate (Campral®) Acetaminophen and Tramadol (UltracetTM) Acetophenazine (NA) Acetylcholine (Miochol-E®) P Acetylcysteine (Acetadote®) P Acitretin (Soriatane®) Acrivastine and Pseudoephedrine (Semprex®-D) † Acyclovir (Zovirax®) P Adenosine (Adenocard®; Adenoscan®) † Albuterol (Proventil® HFA Inhalation Aerosol) Alemtuzumab (Campath®) Alizapride (NA) Almotriptan (AxertTM) Alosetron (Lotronex®) Amonafide (NA) Ambenonium (Mytelase®) Amitriptyline (Elavil®) † Amlodipine (Norvasc®) Amoxapine (NA) Amphotericin B (Liposomal) (AmBisome®) Anastrozole (Arimidex®) Anidulafungin (EraxisTM) Antihemophilic Factor (Recombinant) (Advate; Helixate® FS; Kogenate® FS; RecombinateTM; Antithymocyte Globulin (Equine) (Atgam®) Antithymocyte Globulin (Rabbit) (Thymoglobulin®) P Apomorphine (ApokynTM) Aprepitant (Emend®) Aripiprazole (Abilify®) Arsenic Trioxide (TrisenoxTM) Atazanavir (Reyataz®)
Atomoxetine (Strattera®) P † Atorvastatin (Lipitor® Tablets) Atovaquone (Mepron®) P Azacitidine (VidazaTM) Aztreonam (Azactam®) † Bacitracin (AK-Tracin®
Dextroamphetamine and Amphetamine (Adderall XR®; Adderall®) Diflunisal (Dolobid® [DSC]) † Digoxin (Digitek®; Lanoxicaps®; Lanoxin®) Dihydroergotamine (D.H.E. 45®; Migranal®)
Diphenoxylate and Atropine (Lomotil®; Lonox®) Dipyridamole (Persantine®) Dipyrone (NA) Dirithromycin (Dynabac® [DSC])
Divalproex Sodium (Depakote® ER) Dofetilide (TikosynTM) Dolasetron (Anzemet®) Donepezil (Aricept® ODT; Aricept®) Doxapram (Dopram®)
Doxazosin (Cardura®) Doxepin (PrudoxinTM; Sinequan® [DSC]; Zonalon®) Doxorubicin (Liposomal) (Doxil®) Dronabinol (Marinol®) Duloxetine (Cymbalta®) Echothiophate Iodide (Phospholine Iodide®) Edrophonium (Enlon®; Reversol®) Efavirenz (Sustiva®) Eletriptan (Relpax®) Enalapril (Vasotec®) Entacapone (Comtan®) Ephedrine (Pretz-D® [OTC]) Epinephrine (Adrenalin®; EpiPen® Jr; EpiPen®; Primatene® Mist [OTC]; Raphon [OTC]; S2® [OTC]; TwinjectTM) Epoprostenol (Flolan®) Eprosartan (Teveten®) Ergonovine (NA) Erythropoietin (NA) Escitalopram (Lexapro®) Esmolol (Brevibloc®) † Esomeprazole (Nexium®) Estazolam (ProSom®) Eszopiclone (LunestaTM) Etoposide (Toposar®; VePesid®) Etoposide Phosphate (Etopophos®) Exemestane (Aromasin®) Exenatide (ByettaTM) Fat Emulsion (Intralipid®; Liposyn® III) Femoxetine (NA) Fenofibrate (AntaraTM; LipofenTM; LofibraTM; TriCor®; TriglideTM) † Fentanyl (Actiq®; Duragesic®; Sublimaze®) Ferric Gluconate (Ferrlecit®) Filgrastim (Neupogen®) Fludrocortisone (Florinef®) Fludarabine (Fludara®) Flumazenil (Anexate®; Romazicon®) Flunisolide (AeroBid®-M; AeroBid®; Nasarel®) Fluoxetine (Prozac® WeeklyTM; Prozac®; Sarafem®) Flupenthixol (NA) Flurazepam (Dalmane®) Fluticasone and Salmeterol (Advair Diskus®) Fluvoxamine (NA)
Fomivirsen (VitraveneTM [DSC]) Foscarnet (Foscavir®) Frovatriptan (Frova®) Fulvestrant (Faslodex®) Gadopentetate Dimeglumine (Magnevist®) Gatifloxacin (Tequin®; ZymarTM)
Gepirone (NA) Glatiramer Acetate (Copaxone®) † Glipizide (Glucotrol® XL; Glucotrol®) Goserelin (Zoladex®) Guanfacine (Tenex®) Haloperidol (Haldol® Decanoate; Haldol®) Hepatitis A Inactivated and Hepatitis B (Recombinant) Vaccine (Twinrix®) Hepatitis B Vaccine (Engerix-B®; Recombivax HB®) Hexoprenaline (NA) Histrelin (VantasTM) Hydralazine (NA) † Hydrocodone (Anexsia®; Bancap HC®; Ceta-Plus®; Co-Gesic®; hycetTM; Lorcet® 10/650; Lorcet® Plus; Lorcet®-HD [DSC]; Lortab®; Margesic® H; MaxidoneTM; Norco®; Stagesic®; Vicodin® ES; Vicodin® HP; Vicodin®; Vicoprofen®, Zydone®) Ibritumomab (Zevalin®) Imipramine (Tofranil-PM®; Tofranil®) Immune Globulin (Intravenous) (CarimuneTM NF; Gammagard® Liquid; Gammagard® S/D; Gammar®-P I.V.; Gamunex®; Iveegam EN; Octagam®; Panglobulin® NF; Polygam® S/D) Indium IN 111 Pentetreotide (Octreoscan®) Indocyanine Green (IC-Green®) † Indomethacin (Indocin®) Infliximab (Remicade®) Insulin Inhalation (Exubera®) † Insulin Regular (Humulin® R (Concentrated) U-500; Humulin® R; Novolin® R) Interferon Alfa-2a (Roferon-A®) Interferon Alfa-2b (Intron® A) Interferon Alfa-n3 (Alferon® N) Interferon Alfacon-1 (Infergen®) Interferon Beta-1b (Betaseron®) Interleukin-3 (NA) Iodixanol (VisipaqueTM) Ipratropium and Albuterol (Combivent®; DuoNebTM) Irinotecan (Camptosar®) Iron Dextran Complex (Dexferrum®; INFeD®) Iron Supplements (Parenteral) (Dexferrum®; Ferrlecit®; INFeD®; Venofer®) P Isocarboxazid (Marplan® Tablets) Isoproterenol (Isuprel®) P Isosorbide Dinitrate and Hydralazine (BiDil®) Isotretinoin (Accutane®; AmnesteemTM; ClaravisTM; Sotret®) Ketorolac (Acular LSTM; Acular® PF; Acular®; Toradol®) Labetalol (Trandate®) Leflunomide (Arava®) Lenalidomide (Revlimid®) Lentinan (Better Cholestorol®) Letrozole (Femara®) Leuprolide (Eligard®; Lupron Depot-Ped®; Lupron Depot®; Lupron®; Viadur®) Levalbuterol (Xopenex HFATM; Xopenex®) Levobupivacaine (Chirocaine® [DSC]) Levodopa and Carbidopa (ParcopaTM; Sinemet® CR; Sinemet®)
† Levothyroxine (Levothroid®; Levoxyl®; Synthroid®; Unithroid®) † Lidocaine and Epinephrine (LidoSiteTM; Xylocaine® MPF With Epinephrine; Xylocaine® With Epinephrine) Liothyronine (Cytomel®; Triostat®) P Liotrix (Thyrolar®) Lisdexamfetamine (VyvanseTM) † Lisinopril (Prinivil®; Zestril®) Lodoxamide (Alomide®) Lofepramine (NA) Lopinavir and Ritonavir (Kaletra®) † Loratadine (Apo-Loratadine®; Claritin® Kids; Claritin®) Lorcainide (NA) Losartan (Cozaar®) Maprotiline (NA) Mechlorethamine (Mustargen®) P MedroxyPROGESTERone (Depo-Provera® Contraceptive; Depo-Provera®; depo-subQ provera 104TM; Provera®) Mefloquine (Lariam®) Megestrol (Megace® ES; Megace®) Melphalan (Alkeran®) P † Mepivacaine (Carbocaine®; Polocaine® Dental; Polocaine® MPF; Polocaine®) Mepivacaine (Dental) (Carbocaine®; Polocaine®) Mepivacaine and Levonordefrin (Carbocaine® 2% with Neo-Cobefrin®) Meptazinol (NA) Meropenem (Merrem® I.V) Mesalamine (Asacol®; CanasaTM; Pentasa®; Rowasa®) Metaproterenol (Alupent®) Methadone (Dolophine®; Methadone Diskets®; Methadone IntensolTM; Methadose®) Methotrimeprazine (NA) Methylene Blue (Urolene Blue®) Methylergonovine (Methergine®) Metoprolol and Hydrochlorothiazide (Lopressor HCT®) Mexiletine (Mexitil® [DSC]) Midodrine (ProAmatine®) Milnacipran (Savella) Misoprostol (Cytotec®) Moclobemide (NA) Modafinil (Alertec®; Provigil®) Morphine Sulfate (Astramorph/PFTM; Avinza®; DepoDurTM; Duramorph®; Infumorph®; Kadian®; MS Contin®; Oramorph SR®; RMS®; Roxanol 100TM; RoxanolTM-T [DSC]; RoxanolTM) † Moxifloxacin (Avelox® I.V.; Avelox®; VigamoxTM) Muromonab-CD3 (Orthoclone OKT® 3) Mycophenolate (CellCept®; Myfortic®) Nabumetone (Relafen®) Nadolol (Corgard® Tablets) Nalbuphine (Nubain®) Naloxone (Narcan® [DSC]) Naphazoline and Antazoline (Vasocon®-A [OTC] [DSC]) † Naproxen (Aleve® [OTC]; Anaprox® DS; Anaprox®; EC-Naprosyn®; Midol® Extended Relief; Naprelan®; Naprosyn®; Pamprin® Maximum Strength All Day Relief [OTC]) Naratriptan (Amerge®) Nefazodone (Serzone®) Nefopam (NA) Nelfinavir (Viracept®) Neostigmine (Prostigmin®) Nesiritide (Natrecor®)
Niacin (Niacor®; Niaspan®; Slo-Niacin® [OTC]) Nicardipine (Cardene® I.V.; Cardene® SR; Cardene®) † Nicotine (CommitTM [OTC]; NicoDerm® CQ® [OTC]; Nicorette® [OTC]; Nicotrol® Inhaler; Nicotrol® NS; Nicotrol® Patch [OTC]) † Nifedipine (Adalat® CC; AfeditabTM CR; NifediacTM CC; NifedicalTM XL; Procardia XL®; Procardia®) Nilutamide (Nilandron®) Nimesulide (NA) Nimodipine (Nimotop®) Nisoldipine (Sular®) Nitazoxanide (Alinia®) Nitroprusside (Nitropress®) Norepinephrine (Levophed®) P *Nortriptyline (Pamelor®) Octreotide (Sandostatin LAR®; Sandostatin®) Olanzapine (Zyprexa® Zydis®; Zyprexa®) † Omeprazole (Prilosec OTCTM [OTC]; Prilosec®) Omeprazole and Sodium Bicarbonate (Zegerid®) Oxprenolol (NA) † Oxycodone (OxyContin®; OxydoseTM; OxyFast®; OxyIR®; RoxicodoneTM IntensolTM; RoxicodoneTM) Oxycodone and Ibuprofen (CombunoxTM) Oxymetazoline (4-Way® 12 Hour [OTC]; Afrin® Extra Moisturizing [OTC]; Afrin® Original [OTC]; Afrin® Severe Congestion [OTC]; Afrin® Sinus [OTC]; Duramist® Plus [OTC]; Duration® [OTC]; Genasal [OTC]; Neo- Synephrine® 12 Hour Extra Moisturizing [OTC]; Neo-Synephrine® 12 Hour [OTC]; NRS® [OTC]; N_strilla® [OTC]; Vicks Sinex® 12 Hour Ultrafine Mist [OTC]; Vicks Sinex® 12 Hour [OTC]; Visine® L.R. [OTC]) P Papaverine (Para-Time SR®) † Paroxetine (Paxil CR®; Paxil®; Pexeva®) Peginterferon Alfa-2a (Pegasys®) Peginterferon Alfa-2b (PEG-Intron®) Pentazocine (Talwin® NX; Talwin®) Pentazocine and Acetaminophen (Talacen®) Perflutren Lipid Microspheres (Definity®) Pericyazine (Neuleptil®) Perindopril Erbumine (Aceon®) Perphenazine (NA) Phendimetrazine (Bontril PDM®; Bontril® Slow-Release; Melfiat®; Obezine® [DSC]; Prelu-2® [DSC]) Phenelzine (Nardil®) Phenyltoloxamine (Myogesic®) Physostigmine (NA) Phytonadione (Mephyton®) *Pilocarpine (Isopto® Carpine; Pilopine HS®; Salagen®) Pimozide (Orap®) Piperacillin and Tazobactam Sodium (Zosyn®) Pipotiazine (NA) Pirbuterol (MaxairTM AutohalerTM) P Piritramide (NA) Prazepam (NA) Praziquantel (Biltricide®) † Prednisolone (AK-Pred®; Bubbli-PredTM [DSC]; Econopred® Plus; Orapred®; Pediapred®; Pred Forte®; Pred Mild®; Prelone®) Prilocaine (Citanest® Plain) Prilocaine and Epinephrine (Citanest® Forte Dental) Prochlorperazine (ComproTM) Propafenone (Rythmol® SR; Rythmol®) Proparacaine (Alcaine®; Ophthetic®) Propoxyphene (Darvocet®; Darvon®
Protein C, Human (Ceprotin) Protirelin (Thyrel® TRH [DSC]) *Protriptyline (Vivactil®) Pseudoephedrine (Biofed [OTC]; Contact® Cold [OTC]; Dimetapp® 12-Hour Non-Drowsy Extentabs® [OTC]; Dimetapp® Decongestant Infant [OTC]; ElixSureTM Congestion [OTC]; Genaphed® [OTC]; Kidkare Decongestant [OTC]; Kodet SE [OTC]; Oranyl [OTC]; PediaCare® Decongestant Infants [OTC]; Silfedrine Children’s [OTC]; Simply StuffyTM [OTC]; Sudafed® 12 Hour [OTC]; Sudafed® 24 Hour [OTC]; Sudafed® Children’s [OTC]; Sudafed® [OTC]; Sudo-Tab® [OTC]; Sudodrin [OTC]; SudoGest [OTC]
Pyridostigmine (Mestinon® Timespan®; Mestinon®; Regonol®) Quetiapine (Seroquel®) Quinapril (Accupril®) Quinapril and Hydrochlorothiazide (Accuretic®; Quinaretic) Quinupristin and Dalfopristin (Synercid®)
Rabeprazole (AcipHex®) Raloxifene (Evista®) Raltegravir (Isentress) Raltitrexed (NA)
Ramipril (Altace®) Rasagiline (Azilect®) Reboxetine (NA) Rho(D) Immune Globulin (BayRho-D® Full-Dose; BayRho-D® Mini-Dose; MICRhoGAM®; RhoGAM®; Rhophylac®; WinRho® SDF)
Ribavirin (Copegus®; Rebetol®; RibasphereTM; Virazole®) Rimantadine (Flumadine®) Ritonavir (Norvir®) Rivastigmine (Exelon®)
Rizatriptan (Maxalt-MLT®; Maxalt®) Rofecoxib (Vioxx® [DSC]) Rolipram (NA) Ropinirole (Requip®)
Rotigotine (Neupro®) Satumomab Pendetide (Octreoscan®) Secretin (SecreFloTM) Selegiline (Eldepryl®; Emsam®) Selenium (Selenicaps [OTC]; Selenimin [OTC]; Selepen®) Selenium Sulfide (Exsel® [DSC]; Head & Shoulders® Intensive Treatment [OTC]; Selsun Blue® 2-in-1 Treatment [OTC]; Selsun Blue® Balanced Treatment [OTC]; Selsun Blue® Medicated Treatment [OTC]; Selsun Blue® Moisturizing Treatment [OTC]; Selsun®) † Sertraline (Zoloft®) Sibutramine (Meridia®) Sincalide UKinevac® Sirolimus (Rapamune®) Sodium Oxybate (Xyrem®) Somatropin (Genotropin Miniquick®; Genotropin®; Humatrope®; Norditropin® NordiFlex®; Norditropin®; Nutropin AQ®; Nutropin®; Saizen®; Serostim®; Tev-TropinTM; ZorbtiveTM) Sotalol (Betapace AF®; Betapace®; Sorine®) Streptokinase (Streptase®) Sulpiride (NA) † Sumatriptan (Imitrex®) Tacrine (Cognex®) Tacrolimus (Prograf®; Protopic®) † Tadalafil (Cialis®) Tamoxifen (Nolvadex® [DSC]; SoltamoxTM) Tegaserod (Zelnorm®) Telithromycin (Ketek®)
Telmisartan (Micardis®) Telmisartan and Hydrochlorothiazide (Micardis® HCT) Temazepam (Restoril®) Tenofovir (Viread®) Terbutaline (Brethine®) Testosterone (Androderm®; AndroGel®; Delatestryl®; Depo®-Testosterone; First® Testosterone MC; First® Testosterone; Striant®; Testim®; Testopel®) Thalidomide (Thalomid®) Thiothixene (Navane®) Thyroid (Armour® Thyroid; Nature-Throid® NT; Westhroid®) Tiagabine (Gabitril®) Tigecycline (TygacilTM) Tinidazole (TindamaxTM) Tirofiban (Aggrastat®) Tocainide (Tonocard® [DSC]) Tolcapone (Tasmar®) Topiramate (Topamax®) Toremifene (Fareston®) Tositumomab and Iodine I 131 Tositumomab (131 I Anti-B1 Antibody; 131 I-Anti-B1 Monoclonal Antibody; Anti- CD20-Murine Monoclonal Antibody I-131; B1 Antibody; B1; Iodine I 131 Tositumomab and Tositumomab; Tositumomab I-131) *Trace Metals (Iodopen®; M.T.E.-4®; M.T.E.-5®; M.T.E.-6®; M.T.E.-7®; Molypen®; MultitraceTM-4 Neonatal; MultitraceTM-4 Pediatric; MultitraceTM-4; MultitraceTM-5; Neotrace-4®; P.T.E.-4®; P.T.E.-5®; Pedtrace-4®; Selepen®) P Tramadol (Ultram® ER; Ultram®) Tranylcypromine (Parnate®) † Trazodone (Trialodine®; Desyrel®) Tretinoin (Oral) (Vesanoid®) Triamcinolone (Aristocort® A; Aristocort®; Aristospan®; Azmacort®; Kenalog-10®; Kenalog-40®; Kenalog®; Nasacort® AQ; Tri-Nasal®; Triderm®) Triprolidine and Pseudoephedrine (Actifed® Cold and Allergy [OTC]; Allerfrim® [OTC]; AphedridTM [OTC]; Aprodine® [OTC]; Genac® [OTC]; Silafed® [OTC]; Sudafed® Sinus Nighttime [OTC]; Tri-Sudo® [OTC]) Triprolidine, Pseudoephedrine, and Codeine (Triacin-C® [DSC]) Tulobuterol (NA) Urokinase (Abbokinase® [DSC]) Vaccinia Immune Globulin (Intravenous) (CNJ-016TM) † Vardenafil (Levitra®) Vasopressin (Pitressin®) Venlafaxine (Effexor® XR; Effexor®) Vasopressin (Pitressin®) † Verapamil (Calan® SR; Calan®; Covera-HS®; Isoptin® SR; Verelan® PM; Verelan®) Xylometazoline (Otrivin® Pediatric [OTC] [DSC]; Otrivin® [OTC] [DSC]) Yohimbine (Aphrodyne®; Yocon®) Ziconotide (Prialt®) Zidovudine (Retrovir®) *† Zinc Supplements (Cold-Eeze® [OTC; GalzinTM; Orazinc® [OTC]; Zincate®) P Ziprasidone (Geodon®) Zolmitriptan (Zomig-ZMTTM; Zomig®) † Zolpidem (Ambien CRTM; Ambien®) Zonisamide (Zonegran®) Zopiclone (NA) Zuclopenthixol (NA)