It turns out, the human sweating response is influenced by a number of drugs. Here are some common medications that have a sweaty side, and why.
1) Antidepressants
All classes of antidepressants may cause excessive sweating. Bupropion (Wellbutrin) causes excess sweating in approximately one in five people taking it, slightly more often than the typical SSRI antidepressants like escitalopram, paroxetine, fluvoxamine and sertraline. Why? SSRIs (selective serotonin reuptake inhibitors) increase serotonin levels of serotonin in the brain. Serotonin effects both the hypothalamus, which sets our core temperature at which sweating occurs, and the spinal cord which may lead to excessive sweating.
Tricyclic antidepressants like amitriptyline and nortriptyline and SNRIs like duloxetine and venlafaxine also cause excess sweating. Why? Tricyclic and SNRI antidepressants cause more norepinephrine to float around the brain, which stimulates receptors (peripheral adrenergic receptors) that lead to sweating.
2) Migraine medications
Any triptan migraine medication—like sumatriptan, rizatriptan, frovatriptan (Frova) and eletriptan (Relpax)—may cause sweating within an hour of taking it. Why? The triptans boost serotonin level, which affects the way the body regulates its core temperature—and these changes in thermoregulation may lead to sweating.
3) Pain Relievers
- Over-the-counter pain medications: Taking Aspirin or NSAIDs like ibuprofen (Motrin) may lead to excessive sweating. Why? These medications work to lower fever by causing blood vessels to dilate so heat is lost through the skin, and this same mechanism may lead to sweating.
- Opioids: Opioids such as morphine, hydrocodone and Dilaudid are a well-known cause of excessive sweating. Why? Opioids stimulate a type of immune cell known as mast cells that release histamine, the same chemical involved in inflammation, and that in turn leads to sweating.
- Tramadol (Ultram): Tramadol, a narcotic-like pain reliever, causes sweating. Why? Because tramadol causes the release of serotonin and norepinephrine which lead to sweating.
4) Diabetes medications
Insulin, glyburide (Glynase), glipizide (Glucotrol) and pioglitazone (Actos) are common medications that may cause sweating. Why? Due to alterations in blood sugar with these medications, sweating is a reported side effect.
5) Asthma inhalers
Asthma inhalers which contain beta-agonist drugs dilate, or open up, the airways. They include albuterol (Ventolin, Proventil, Proair) and levalbuterol (Xopenex), and both can cause excessive sweating. Why? Beta-agonist drugs directly stimulate sweat glands to produce more sweat.
6) Heartburn and reflux medications
The popular acid reflux (GERD) medications known as proton-pump inhibitors (PPIs), which include omeprazole (Prilosec) and lansoprazole (Prevacid), have sweating as a reported side effect. Why? We don’t know yet why these cause excessive sweating, but the side effect seems to stop after the medication is discontinued.
7) Sildenafil (Viagra)
Sildenafil (Viagra) causes sweating and flushing. Why? Sildenafil helps with erections by causing blood vessels to dilate and increasing blood flow. This same mechanism may cause sweating and flushing.
8) Ropinirole (Requip)
Ropinirole (Requip), used in the treatment of restless leg syndrome and Parkinson’s disease, is a well-known cause of excessive sweating. Why? Ropinirole activates dopamine receptors, which leads to increased sweating.
9) Breast cancer medications
“Anti-estrogen” medications like anastrozole (Arimidex), exemestane (Aromasin), letrozole (Femara) and tamoxifen (Soltamox) are taken by breast cancer patients to prevent their the cancer from recurring. They can all lead to excessive sweating. Why? Due to their anti-estrogen properties, excessive sweating is a known side effect. It’s similar to why women going through menopause have hot flashes and night sweats.
10) Leuprolide (Lupron)
Leuprolide (Lupron) is a medication used to treat prostate cancer and endometriosis that can cause sweating as a side effect. Why? Lupron injections lower estrogen levels in women and testosterone levels in men, and those changes in hormones can cause excessive sweating and night sweats.
What can you do?
If your medication is causing excessive sweating, options include reducing the dosage, substituting the drug with a similar medication, or discontinuing the drug altogether. If you must take one of the above medications, there are also options to add medications that can reduce the side effect of sweating.
Dr O.
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