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Other Related Names or Treatments

Glycopyrrolate, Robinul-Forte

About Axhidrox

Axhidrox contains glycopyrronium bromide as the active ingredient. Glycopyrronium is a muscarinic acetylcholine receptor antagonist — it works by blocking the nerve signals that stimulate the sweat glands, thereby reducing excessive sweating.

Axhidrox is a prescription-only cream indicated for the topical treatment of severe primary axillary hyperhidrosis (excessive underarm sweating) in adults. It is applied directly to the underarm area using the pump-pack applicator.

Key facts of Axhidrox

• Axhidrox is a white glossy cream containing 2.2 mg of glycopyrronium per pump actuation.
• The recommended dose is two pump actuations per armpit (4.4 mg glycopyrronium), applied once daily in the evening for the first four weeks.
• From week five onwards, application may be reduced to twice a week depending on how well sweating is controlled.
• Continuous treatment is required to maintain the effect — symptoms may return if treatment is stopped.
• Axhidrox is for use in the underarm area only and must not be applied to hands, feet, face, or other body areas.
• After applying, wash your hands and the applicator cap thoroughly with soap and water immediately.
• Clinical studies showed Axhidrox produced approximately twice the sweat reduction of placebo after four weeks, with continued improvement over up to 72 weeks of treatment.
• Axhidrox is not currently established for use in children or adolescents under 18 years, or in adults over 65 years.

Who is Axhidrox suitable for?

Axhidrox is suitable for adults aged 18 and over with severe primary axillary hyperhidrosis — that is, excessive underarm sweating that is not caused by another underlying medical condition or medication, and that significantly impacts daily life. It is intended for patients whose condition has not been adequately controlled by standard antiperspirant treatments.

Who is Axhidrox not suitable for?

Axhidrox may not be suitable for some people. To make sure it is safe for you, speak to the prescribing clinician before starting treatment if you:

• Have a known hypersensitivity to glycopyrronium bromide or any of the excipients (including benzyl alcohol, cetostearyl alcohol, or propylene glycol).
• Have glaucoma, paralytic ileus, myasthenia gravis, Sjögren syndrome, severe ulcerative colitis, or toxic megacolon.
• Have an unstable cardiovascular condition, including coronary artery disease, congestive heart failure, cardiac arrhythmias, or hypertension.
• Have severe prostatic hyperplasia, bladder-neck obstruction, or a history of urinary retention.
• Have severe renal impairment (eGFR below 30 ml/min/1.73 m²) or end-stage renal disease requiring dialysis.
• Have had a recent traumatic brain injury, head surgery or radiation, or are an intravenous drug user (conditions affecting the blood-brain barrier).
• Are pregnant or breastfeeding — discuss the risks and benefits with your clinician before use.
• Have visibly inflamed or broken skin in the underarm area — do not apply until the skin has fully recovered.

How and where to get Axhidrox?

Axhidrox is a prescription-only medicine (Rx) and cannot be purchased over the counter. You can start a consultation with a certified prescribing pharmacist, nurse, or doctor at NowPatient to determine whether Axhidrox is the right treatment for you. Our service is certified, safe and effective, and we only treat conditions where it is clinically appropriate to do so. If the clinician determines that Axhidrox is suitable following your consultation, a prescription will be issued and your treatment dispatched directly to you.

Dosage and strength for Axhidrox for hyperhidrosis

Axhidrox is available as a pump-pack cream delivering 2.2 mg of glycopyrronium per actuation (270 mg of cream per pump). Each container holds 50 g of cream, corresponding to 124 actuations or 31 complete treatments (both armpits). The recommended dose is two pump actuations per armpit per application.

Information about how to take Axhidrox for hyperhidrosis

Before using Axhidrox for the first time, the pump must be primed to remove trapped air. Hold the pump at an angle and press down repeatedly until cream appears, then slowly press down fully a further 10 times, discarding the primed cream. The pump is then ready for use and does not need to be primed again.

To apply: hold the pump over the removed cap and press down twice to dispense the cream onto the cap. Use the cap to spread the cream evenly across one armpit, then repeat for the other armpit. Immediately afterwards, wash the cap and your hands thoroughly with soap and water to avoid accidental contact with eyes, nose, or mouth, and to prevent transfer to other people. Cover the treated area with clothing. Apply once daily, preferably in the evening, for the first four weeks. From week five, frequency may be reduced to twice weekly if sweating is well controlled.

How does Axhidrox work?

Axhidrox works by blocking muscarinic acetylcholine receptors in the sweat glands. Acetylcholine is the chemical messenger that normally stimulates the sweat glands to produce sweat. By competitively antagonising these receptors, glycopyrronium prevents this signal from being received, resulting in a significant reduction in perspiration in the treated area. Although its action is primarily local, some systemic absorption does occur through the skin.

What happens if you take too much Axhidrox?

Overdosage is considered unlikely when Axhidrox is applied correctly to the underarm area only. However, if the cream is applied to other parts of the body such as the palms, feet, or face, or to large areas of skin, the risk of side effects or overdose increases. Signs of overdose from systemic exposure to glycopyrronium can include redness and a sensation of heat in the skin, overheating of the body, life-threatening heatstroke, dryness of the skin and mucous membranes, dilated pupils with loss of accommodation, changes in mental status and fever, a rapid heart rate (sinus tachycardia), reduced bowel sounds, urinary retention, high blood pressure, tremors, and myoclonic twitching. In case of severe or life-threatening symptoms, treatment with a quaternary ammonium anticholinesterase such as neostigmine should be considered. Contact emergency services (911) or your doctor immediately if you are concerned.

What are the side effects of Axhidrox?

Side effects of Axhidrox are split into very common, common, and uncommon. The most frequently reported side effects (occurring in more than 1 in 10 patients) include:

• Dry mouth.
• Application site reactions (dermatitis, eczema, rash, papules, erythema, irritation, pain, or itching).

Common side effects (affecting between 1 in 100 and 1 in 10 patients) include dry eye, blurred vision, nasal dryness, headache, dry skin, and constipation.

Uncommon side effects include dizziness, drowsiness, anxiety, sleep disturbance, restlessness, vertigo, tachycardia (increased heart rate), urinary difficulties, application site folliculitis or pustules, and in rare cases hypersensitivity reactions including angioedema and thrombocytopenia.

Because Axhidrox can cause dry mouth, there is an increased risk of dental caries from reduced saliva production. Careful dental hygiene and regular dental check-ups are recommended. If the cream comes into contact with the eyes, rinse immediately with plenty of water. If you experience any serious side effects, contact your doctor or seek emergency medical attention if required. Suspected adverse reactions should be reported via the FDA MedWatch program at fda.gov/medwatch.

Information about taking Axhidrox at the same time as other medications or herbal supplements

No formal drug interaction studies have been performed with Axhidrox. However, because glycopyrronium has anticholinergic properties, using it alongside other anticholinergic medicines may increase the risk of anticholinergic side effects. Tell your healthcare provider if you are taking any of the following before starting Axhidrox:

• Topiramate (for epilepsy or migraine)
• Sedative antihistamines
• Tricyclic antidepressants (such as amitriptyline)
• Monoamine oxidase inhibitors (MAOIs)
• Neuroleptics or antipsychotics
• Opioid pain medicines

Always tell your prescriber about all medicines, supplements, and herbal remedies you are taking before starting treatment.

Why might Axhidrox not work for hyperhidrosis?

Axhidrox is specifically indicated for severe primary axillary hyperhidrosis only. It may not be effective for secondary hyperhidrosis (where sweating is caused by another medical condition or medication), or for sweating in areas other than the underarms. Continuous treatment is required to maintain the therapeutic effect — if applications are missed or stopped, sweating is likely to return. For some patients, four weeks of daily treatment may be needed before the full benefit is seen. Patients who do not respond adequately should speak to their clinician about alternative or additional treatments.

Will Axhidrox affect my contraception?

There is no evidence that Axhidrox affects hormonal contraception. However, due to the very limited data on glycopyrronium in pregnancy, women of childbearing age should discuss their contraceptive needs with their clinician before starting treatment. The use of Axhidrox during pregnancy may be considered only if clearly necessary, and breastfeeding mothers should seek clinical advice as glycopyrronium has been found to distribute into breast milk in animal studies.

Should I avoid any particular food or drink when taking Axhidrox?

There are no specific dietary restrictions associated with Axhidrox. However, as the condition being treated can be triggered or worsened by caffeine, alcohol, and spicy foods, avoiding these may help to manage symptoms alongside treatment. Maintaining good general health, hydration, and a balanced diet supports overall skin health and treatment effectiveness.

Sources

• medicines.org.uk – Axhidrox Summary of Product Characteristics (SmPC), Dr. August Wolff GmbH & Co. KG Arzneimittel, first authorised 09/06/2025
• FDA MedWatch
• NHS – Hyperhidrosis
• British Association of Dermatologists – Hyperhidrosis