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Drug-induced diaphoresis
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Drug-induced diaphoresis

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Contributors: Jonathan Webster, Susan Burgin MD
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Synopsis

Drug-induced diaphoresis is profuse, excessive, or increased sweating due to effects of medication or substance use. Medication groups that are known to cause sweating are cholinergic, hypoglycemic, antidepressant, antipyretic, and hormonal agents. Less commonly implicated medications include beta blockers, calcium channel blockers, protease inhibitors, sympathomimetics, and migraine medications. Substances such as opioids, alcohol, and cocaine, along with substance withdrawal syndromes, are known to cause diaphoresis.

The pathophysiology of drug-induced diaphoresis depends on the mechanism of action. Drugs that augment cholinergic transmission commonly cause hyperhidrosis by stimulating peripheral muscarinic receptors. This class of drugs include cholinesterase inhibitors and accidental poisoning caused by the organophosphate pesticides.

Antidepressants are a common cause of medication-induced hyperhidrosis. Although antidepressants cause generalized hyperhidrosis, patients may complain of night sweats.

Medication-induced hypoglycemia is another important cause of sweating. Sweating is a prominent clinical feature of hypoglycemia, especially in patients who are taking hypoglycemic agents such as insulin or sulfonylureas.

In addition to flushing, hormonal agents can also cause excessive sweating and medication-induced hot flashes. This includes aromatase inhibitors, antiestrogen medications and androgen receptor blockers.

Related topic: Drug-induced flushing reaction

Codes

ICD10CM:
T50.995A – Adverse effect of other drugs, medicaments and biological substances, initial encounter

SNOMEDCT:
52613005 – Excessive sweating

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Non-medication causes of diffuse diaphoresis: Physiologic:
  • Emotional factors
  • Hot environment
  • Over-clothing
  • Exercise
Febrile illnesses and infectious causes: Endocrine and metabolic disorders: Cardiovascular disorders: Neurologic: Other causes:

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 01/17/2019
Last Updated: 02/28/2019
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Drug-induced diaphoresis
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Drug-induced diaphoresis : Diaphoresis
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