From the Research
Steroids can cause hiccups as a side effect, and the most effective treatment approach is to try non-medication methods first, followed by pharmacological interventions such as baclofen or metoclopramide if necessary. The relationship between steroids and hiccups is supported by several studies, including a case report of anabolic steroid-induced hiccups 1 and a study on persistent severe hiccups after dexamethasone intravenous administration 2.
Pathophysiology and Risk Factors
The exact mechanism of steroid-induced hiccups is not fully understood, but it is thought to be related to the irritation of the vagus or phrenic nerves that control the diaphragm, disrupting normal breathing patterns 3. The risk of developing hiccups increases with higher doses and longer treatment durations of steroids.
Treatment Options
For persistent hiccups, the following treatment options may be considered:
- Baclofen (5-10mg three times daily) or chlorpromazine (25-50mg) may be prescribed 4
- Gabapentin (300mg three times daily) or metoclopramide (10mg three times daily) are other medication options 5
- Alternatively, the doctor might switch to a different steroid or adjust the dosage
Important Considerations
If hiccups persist beyond 48 hours or significantly affect eating, sleeping, or breathing, it is essential to contact a healthcare provider promptly, as prolonged hiccups can lead to complications like exhaustion, weight loss, or dehydration 2. The treatment approach should be individualized, taking into account the underlying cause of the hiccups, comorbidities, and the properties of the medications used.