The Surrey Heartlands Integrated Care System Area Prescribing Committee agree the traffic light status of the antimuscarinic preparations as follows:

Note that advice provided in CKS should be followed prior to initiation of the treatments below:

Oxybutynin (off label for hyperhidrosis)
BLUE on recommendation by the specialist team 

• Immediate release (IR) preferred choice antimuscarinic treatment option 
• Modified release (MR) preparation may be used for patients with intolerable side effects to IR preparation.

All other oxybutynin formulations (Liquid and patches) for hyperhidrosis

• Non-formulary

Propantheline (licensed for hyperhidrosis)
BLUE on recommendation from the specialist team 

• Offered after oxybutynin if intolerable side effects or inefficacy to that treatment

Glycopyrronium oral (off label for hyperhidrosis)
RED traffic light status

• Treatment choice after oxybutynin and propantheline if they have not been tolerated or have not been effective
• More expensive than other treatment options in primary care, although significantly less costly in secondary care