The short version
Axhidrox is a prescription cream. NICE technology appraisal TA1175, published on 9 July 2026, recommends it only for a narrow group.
Glycopyrronium bromide cream (Axhidrox, Axunio) can be used on the NHS as an option for severe primary axillary hyperhidrosis in adults when:
- lifestyle advice,
- topical aluminium-based antiperspirants, and
- oral antimuscarinic medicines
have not controlled underarm sweating, or those treatments are contraindicated or not tolerated.
It is not a first-line product, it is not for hands or feet, and you cannot pick it up beside Driclor at the pharmacy counter.
This page summarises the public NICE and NHS documents. It is not a prescribing guide. The dose is in the summary of product characteristics, and a prescriber decides whether it is appropriate.
What TA1175 actually is
NICE has still not published a full clinical guideline on hyperhidrosis. TA1175 is a technology appraisal of one medicine. That is why treatment for hands, feet, iontophoresis and surgery still varies by area. The appraisal does not replace the NICE clinical knowledge summary, which remains the primary-care starting point: lifestyle measures and a 20% aluminium chloride antiperspirant.
NICE describes the licensed use as the topical treatment of severe primary axillary hyperhidrosis in adults. "Primary" means no separate disease is driving the sweating. "Axillary" means the underarms. "Severe", in the committee discussion, is the sort of sweating that is barely tolerable or intolerable and frequently or always interferes with daily life, often scored 3 or 4 on the Hyperhidrosis Disease Severity Scale. Our severity check uses that wording if you want a note to take to an appointment. It is not a diagnosis.
Where it sits in treatment
NICE's own "why the committee made these recommendations" section sets the order:
- Lifestyle advice and topical aluminium-based antiperspirants.
- If those are not enough, oral antimuscarinics. In the UK that conversation is usually about propantheline, which is licensed for hyperhidrosis, or oxybutynin, which is often used off-label. See prescription medications.
- Botulinum toxin is sometimes available in secondary care, with long waits and patchy funding. See Botox for sweating.
- Glycopyrronium bromide cream is an option after lifestyle measures, aluminium antiperspirants and oral antimuscarinics have failed or cannot be used.
The committee heard that clinicians often prefer a topical treatment before a tablet, because tablets cause dry mouth, constipation and blurred vision. NICE still positioned the cream after oral antimuscarinics for NHS funding. The company had asked for it to be considered only in that later position, which is narrower than the licence. If your GP suggests a different order, that is a clinical decision. The funding recommendation in TA1175 is the sequence above.
Driclor, Anhydrol Forte, Odaban and, for people who cannot tolerate those, Perspirex are the aluminium antiperspirants this site points to before anyone talks about a prescription cream. The NHS treatment guide explains how to have that conversation.
What NICE says about the evidence
NICE says clinical trial evidence shows that people using the cream have less underarm sweat, and may have a better quality of life, than people using a placebo.
The cream has not been compared head-to-head in a trial with oral antimuscarinics or botulinum toxin. Indirect comparisons suggested it may not be as effective as some of those usual treatments, including botulinum toxin. NICE's cost-effectiveness case for recommending it was against botulinum toxin: the cream may do less, and it costs less, and the estimates were acceptable to NICE only in the group who had already tried lifestyle measures, aluminium antiperspirants and oral antimuscarinics.
The summary of product characteristics, as cited by NICE, reports that common unwanted effects include reactions where the cream is applied, and dry mouth. That is not a full side-effect list. Read the leaflet you are given, and report suspected side effects via the Yellow Card scheme.
Price and funding
NICE records a list price of £69.50 per tube from the company submission. Costs can be lower where the NHS has a procurement discount. That figure is not a price you will see on a shop shelf, and this site does not sell the cream.
In England, integrated care boards and NHS England must make funding available for the recommended group within 90 days of 9 July 2026, if the clinician responsible for your care thinks the cream is the right option. A positive NICE technology appraisal is not a promise that every GP will prescribe it on the first visit. In Wales, ministers' directions usually require funding within 60 days of final draft guidance when NICE recommends a treatment.
People already using the cream before the guidance was published can continue under the arrangements they already had, until they and their clinician decide to stop.
What it is not
- Not Qbrexza. Those are glycopyrronium wipes licensed in the United States. They are not the product in TA1175, and they are not routinely available on the NHS. See Qbrexza for the US distinction.
- Not oral glycopyrronium. Tablets and the cream are different products. Oral glycopyrronium for sweating in the UK is a separate, usually off-label, conversation. See glycopyrrolate for sweating.
- Not a compounded cream. NICE notes that some glycopyrronium creams are specially made, unlicensed and often costly. Axhidrox is the licensed product the appraisal is about.
- Not Sofdra. Sofpironium gel is a different drug and, as of our Sofdra page, not a UK-licensed option.
- Not for palms, soles or the face under this appraisal.
What to do if you think it might apply
- Use a 20% aluminium chloride antiperspirant properly for a few weeks, unless a pharmacist or GP has told you not to. Night, dry skin, wash off in the morning.
- If that fails, see a GP and say how sweating affects work and daily life. Take a short record of what you used.
- Ask whether an oral antimuscarinic is appropriate. TA1175 expects that step, or a reason it is unsuitable, before the cream is an NHS option.
- If you are referred, ask whether Axhidrox or botulinum toxin is what the local service actually provides. Funding for injections still varies. The cream recommendation is national for the group NICE defined; the appointment pathway is not instant.
If sweating is new, one-sided, or happens at night, the GP visit is about finding a cause, not about jumping to a cream. The NHS page on excessive sweating is the public overview.
