Facial Edema Induced by Glycopyrrolate in a Patient With Metastatic Tongue Cancer: A Case Report

Glycopyrrolate, an anticholinergic medication, is commonly used for managing excessive secretions in palliative care, especially in patients with advanced head and neck cancers. However, its side effect profile, particularly in complex oncological cases, is not fully understood. This case report presents a 62-year-old male with metastatic squamous cell carcinoma (SCC) of the tongue, who was managed in a palliative care setting. Glycopyrrolate 0.2 mg subcutaneously (SC) or intravenously (IV) every six hours was initiated to control chest secretions. While the patient showed initial symptomatic improvement, he subsequently developed significant and unexpected facial edema extending to both lower eyelids. The edema did not respond to antibiotics or corticosteroids and only improved after discontinuation of glycopyrrolate, suggesting a potential adverse reaction, although the advanced stage of his illness may have also contributed to the development of edema. This case underscores the importance of monitoring for rare adverse effects like facial edema when using glycopyrrolate, particularly in patients with advanced metastatic cancers. Further research is warranted to explore the underlying mechanisms of this reaction and guide safer clinical practice.