Sofdra (Sofpironium) for Excessive Underarm Sweating
Updated: Oct 24
Sofdra (sofpironium) topical gel, 12.45%, is an FDA-approved prescription treatment for primary axillary hyperhidrosis—excessive underarm sweating—in adults and children aged 9 years and older. It was approved in June 2024. This article has been updated to reflect the approved treatment.
Understanding the Impact of Hyperhidrosis
Excessive underarm sweating can interfere with clothing choices, work, and social activities. A clinician should confirm the diagnosis and consider medication effects or other causes when sweating is new, widespread, or associated with other symptoms.
How Sofpironium Works
Sofpironium is an anticholinergic medicine that reduces signals involved in sweating. It is applied to the underarms, but topical use can still cause systemic anticholinergic adverse effects.
Using the Approved Treatment
The approved instructions specify one pump per underarm once daily at bedtime. Use it only as prescribed, follow the application instructions, wash your hands afterward, and avoid the eyes or other unintended skin areas. Older experimental concentrations should not be substituted for the approved formulation.
What the Clinical Trials Found
The randomized CARDIGAN I and II trials compared sofpironium 12.45% gel with vehicle for six weeks in 701 participants. The pooled analysis found greater improvement in symptom scores and measured sweat production with sofpironium. The trials were short, and improvement does not mean everyone becomes sweat-free.
Side Effects and Precautions
Possible adverse effects include local irritation, dry mouth, blurred vision, dilated pupils, and difficulty urinating. Reduced sweating can impair cooling in hot conditions. The prescribing information lists contraindications and interactions; tell your clinician about your medical history and other medicines. Stop use and contact your clinician for urinary retention or blurred vision, and seek urgent help for symptoms of overheating.
Sofdra is one option among antiperspirants, other prescription treatments, injections, and procedures. Your dermatologist can help compare the likely benefits, adverse effects, cost, and convenience for your situation.
Need a dermatologist in St. Louis? Book your appointment online with Mid-County Dermatology or call (314) 994-0200 today.
Related reading
This article is for general educational purposes only and is not medical advice. If you have questions or concerns about your skin, talk with one of our dermatologists at Mid-County Dermatology.
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