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Usage: Apply one pump of Sofdra to each underarm once daily at bedtime. When used as prescribed, Sofdra is a safe and effective treatment for hyperhidrosis. However, as with any medication, there may be potential side effects.

Precautions: Sofdra should not be used by individuals with certain medical conditions that could be worsened by its anticholinergic effects, such as: glaucoma, paralytic ileus, severe ulcerative colitis, myasthenia gravis, Sjögren’s syndrome.

Common side effects include dry mouth, blurred vision, dilated pupils, urinary retention and application site reactions such as pain, redness, irritation, rash and itching.

Clinical trials demonstrated a 2-point decrease in the Hyperhidrosis Disease Severity Measure (HDSM) in nearly half of the participants in one study and 64% in another. A similar reduction was observed in the placebo groups, but in a smaller percentage of individuals—29% in one study and 48% in the other. To help put this in perspective, a 2-point decrease, for example from a score of 4 to 2, means that the patient's hyperhidrosis symptoms have improved from being "intolerable and always interfering with daily activities" to being "tolerable and only sometimes interfering with daily activities." This level of improvement typically reflects a meaningful positive impact on the patient's quality of life and their ability to manage the condition.

20 Aug 2024

Sofpironium - a new topical gel for hyperhidrosis

Another option in the treatment of focal primary hyperhidrosis is coming soon. Sofpironium or Sofdra (brand name) was recently approved by the FDA. The following is an overview of the product:

Sofdra (sofpironium) Gel is a topical treatment designed to manage excessive underarm sweating, or hyperhidrosis, in adults and children aged 9 and older. Available as a 12.45% gel, Sofdra is an anticholinergic medication that works by blocking acetylcholine receptors in the sweat glands of the armpit. Since acetylcholine triggers sweat production, Sofdra effectively reduces sweating by preventing this stimulation.

Unfortunately, we do not have data on how sofpironium compares with other topical treatments like oxybutynin or aluminum chloride. Additionally, cost is a significant factor to consider, as hyperhidrosis requires ongoing management, making long-term treatments potentially expensive. As with most new treatment options, Sofdra is likely to be significantly more expensive than existing therapies. Stay tuned.

* Sofdra Product Monograph, Botanix SB Inc. **Hiroo, Y. et.al. J Dermatol 2021 Mar;48(3):279-288

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