{
  "schema_version": 1,
  "kind": "condition",
  "id": "hyperhidrosis",
  "name": "Primary Focal Hyperhidrosis",
  "category": "chronic",
  "sources": "International Hyperhidrosis Society Guidelines 2019 · Anhydrol Forte 20% w/v cutaneous solution SmPC sections 4.1-4.4 (eMC product 3749)",
  "review_status": "reviewed",
  "verified_against": "Anhydrol Forte 20% w/v cutaneous solution SmPC sections 4.1-4.4 (eMC product 3749) · International Hyperhidrosis Society Guidelines 2019 · Primary Focal Hyperhidrosis - disease-level clinical article (hyperhidrosis-clinical.txt)",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 958,
      "generic": "Aluminium chloride",
      "line": 1,
      "is_adjunct": false,
      "form": "topical",
      "strength_mg": null,
      "adult_dose": "Apply 20% solution to clean, completely dry skin once daily at bedtime until sweating is controlled, then reduce frequency; wash off in morning",
      "adult_duration": "1-2 weeks nightly initiation, then 1-2 times weekly maintenance",
      "dose_source": "Anhydrol Forte 20% w/v cutaneous solution SmPC sections 4.1-4.4 (eMC product 3749)",
      "rationale": "Topical aluminium chloride hexahydrate solution acts as first-line antiperspirant/astringent barrier; available as standalone 20% preparation in Egypt.",
      "cautions": [
        "Apply only to completely dry skin to minimize skin irritation and burning.",
        "Do not apply to broken, inflamed, or recently shaved skin.",
        "Wash off thoroughly in the morning; may stain clothing.",
        "Wash it off in the morning - it is not left on through the day.",
        "No shaving and no depilatory within 12 hours either side of an application to the armpits, and do not bathe just before applying. Broken or freshly shaved skin is what turns this into a burn, and the burn is why people give up on a treatment that works."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Children >=12 years: apply sparingly at night",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [
        {
          "trade_name": "ABC MOCOTIVE TOPICAL SPRAY 70 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "> EGYSTAR PHARM",
          "price_egp": 30.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": "alcohol, chamomile, glycerin, tea tree oil, vit.e"
        }
      ],
      "condition_id": "hyperhidrosis"
    },
    {
      "id": 960,
      "generic": "Referral & safety-netting (no drug therapy)",
      "line": 1,
      "is_adjunct": false,
      "form": null,
      "strength_mg": null,
      "adult_dose": null,
      "adult_duration": null,
      "dose_source": "Hyperhidrosis - disease-level clinical article (hyperhidrosis-clinical.txt)",
      "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.",
      "cautions": [
        "RED FLAG - Work up and exclude secondary causes of hyperhidrosis (infection, malignancy, thyroid disease, diabetes mellitus)."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": null,
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [],
      "condition_id": "hyperhidrosis"
    },
    {
      "id": 959,
      "generic": "Glycopyrronium",
      "line": 2,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": 1.0,
      "adult_dose": "1-2 mg 1-2 times daily on an empty stomach",
      "adult_duration": "long-term under monitoring",
      "dose_source": "International Hyperhidrosis Society Guidelines 2019",
      "rationale": "Oral glycopyrronium is not registered in Egypt. Every glycopyrronium product in the register is an inhaled COPD device, so no brand and no price is shown - it is a real option a physician may import or compound, not one the pharmacy will hand over.",
      "cautions": [
        "CONTRAINDICATED in narrow-angle glaucoma, urinary retention, severe gastrointestinal obstruction, and severe ulcerative colitis.",
        "Systemic anticholinergic effects include dry mouth, blurred vision, dizziness, constipation, and tachycardia.",
        "Take on an empty stomach (1 hour before or 2 hours after meals).",
        "No oral glycopyrronium tablet is on sale in Egypt - the register carries only inhaled COPD capsules. Do not substitute one; it is the wrong route and the wrong dose."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Specialist dermatological advice required",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [],
      "condition_id": "hyperhidrosis"
    }
  ]
}