New Treatment for Excessive Sweating: Sofpironium Bromide (Sofdra Gel)

Why study the effectiveness of sofpironium bromide against sweating?

Many people are very bothered by underarm excessive sweating (axillary hyperhidrosis).

There are several treatment options, but each comes with drawbacks, and some people struggle to find one that works for them:

👉 Deodorants and antiperspirants
👉 Anticholinergic medications (oxybutynin, glycopyrrolate)
👉 Botulinum toxin injections
👉 Iontophoresis
👉 Surgery: thoracic sympathectomy

That’s why it’s important to better evaluate existing treatments and explore new ones.

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What is sofpironium bromide?

Aluminum chloride is the first-line treatment for underarm sweating in the U.S. and Japan, but it can cause skin irritation.

🆕 Sofpironium bromide is a promising new alternative.

It’s a topical medication (gel) that reduces sweating by blocking sweat glands.
Unlike other anticholinergic treatments, it is designed to act locally with fewer systemic side effects.
It was recently approved by the FDA in the U.S., after initial approval in Japan.

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What are the benefits of sofpironium bromide for excessive sweating?

Researchers analyzed data from 5 studies including more than 700 people with underarm hyperhidrosis.

Participants applied a product containing 5% sofpironium bromide (except in one study that tested 3%, 10%, and 15%). The researchers measured sweating compared to a placebo (an antiperspirant without active ingredient).

✅ Depending on the study, between 1 in 2 and 1 in 4 people had sweating levels considered mild after treatment.
✅ Quality of life improved more in the treated group.
✅ The total amount of sweat decreased more significantly with sofpironium bromide (measured by weighing sweat output).

🚨 However, the effectiveness of sofpironium bromide has not been directly compared with that of aluminum chloride (20%), which remains more effective in other studies, with 8 out of 10 patients showing improvement.

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Known side effects about Sofdra

Side effects were generally mild or moderate in both groups.

📌 More side effects occurred in the sofpironium group than in the placebo group.
📌 One study reported 7 serious adverse events (urinary retention, heatstroke, blurred vision), but all mild to moderate effects disappeared after stopping treatment.
📌 Side effects were more common during the first 3 months of treatment (study duration: 1 year).
📌 Two studies noted more skin irritation at the application site compared to placebo.
📌 20 out of 225 patients discontinued treatment due to side effects (dry mouth, blurred vision, pain, redness, swelling, itching or irritation of the underarms, pupil dilation, urinary issues).
📌 One study reported no side effects at all.

✅ No deaths were reported.
✅ No concerning changes in medical tests or vital signs.

Researchers concluded that sofpironium bromide may cause fewer irritation-related side effects compared to aluminum chloride, making it a potential option for those who cannot tolerate aluminum chloride.

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When is sofpironium bromide contraindicated?

Do not use if you have conditions worsened by anticholinergic medications, such as:

• Glaucoma
• Severe ulcerative colitis or other serious intestinal problems
• Myasthenia gravis
• Sjögren’s syndrome

Before using Sofdra, tell your doctor if you have:

• Prostate, bladder, or kidney issues
• Difficulty urinating
• If you are pregnant, breastfeeding, or planning to be
• All other medications you take, including anticholinergics

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Can you get sofpironium bromide easily?

To my knowledge, sofpironium bromide is marketed only under the brand name Sofdra.

It does not appear to be available in France (please let me know in the comments if you’ve managed to get it, I’ll update the article accordingly!).

Here’s how it works in the United States:

1️⃣ Telemedicine consultation
Book an online appointment with a healthcare professional for $45 (⚠️ not covered by insurance).
The doctor will assess if Sofdra is appropriate for you.

2️⃣ Home delivery
If a prescription is issued, Sofdra will be shipped to your home free of charge.
Cost: $0 for patients with commercial insurance (⚠️ additional conditions apply).

You can also see a doctor in person, who can send the prescription to SendRx Pharmacy, which handles the delivery.

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My Personal Takeaway About Sofpironium Bromide For Hyperhidrosis

Personally, I never had problems with side effects from aluminum chloride. I share in my ebook how Etiaxil (which contains aluminum chloride) saved me at my first job.

But over time, my body got used to the substance.

I’m no longer looking for treatments, having accepted that I won’t find a long-term solution that works for me.

Still, I think sofpironium bromide is worth considering for people who cannot tolerate aluminum chloride (or who prefer not to use it).

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Do you have any comments or questions? Your comments are welcome 🙂 !

You may also like:

• My blog on hyperhidrosis

 📚 SOURCES

Odat RM, Yousef Aldalati A, Hammadeh BM, Mohammad Hussein A, Idrees M, Marzouk H, Alshwayyat S, Hanifa H. Efficacy and safety of sofpironium in treatment of primary hyperhidrosis: a systematic review. J Dermatolog Treat. 2025 Dec;36(1):2441258. doi: 10.1080/09546634.2024.2441258. Epub 2024 Dec 13. PMID: 39668771.