From the FDA Drug Label
Intractable Hiccups– 25 mg to 50 mg t.i.d. or q.i.d. If symptoms persist for 2 to 3 days, parenteral therapy is indicated. If symptoms persist for 2-3 days after trial with oral therapy, give 25 to 50 mg (1-2 mL) IM. Should symptoms persist, use slow IV infusion with patient flat in bed: 25 to 50 mg (1-2 mL) in 500 to 1000 mL of saline.
Treatment for Intractable Hiccups:
- Oral dosage: 25 mg to 50 mg t.i.d. or q.i.d.
- If symptoms persist, parenteral therapy with 25 to 50 mg IM or slow IV infusion may be indicated 1 2. Key Considerations:
- Monitor patient closely for hypotension and neuromuscular reactions
- Adjust dosage according to individual response and severity of symptoms
- Use lowest effective maintenance level to minimize side effects
From the Research
For hiccups, the most effective treatment approach is to try simple remedies first, such as holding your breath for 10-20 seconds, drinking a glass of cold water quickly, gargling with ice water, or breathing into a paper bag for a few minutes, as these methods can help reset your diaphragm's normal rhythm 3.
Treatment Options
- For persistent hiccups (lasting hours), medications like baclofen (5-10 mg three times daily), metoclopramide (10 mg), or methylprednisolone may be prescribed, with baclofen being a commonly used option 4, 3.
- Non-pharmacological interventions, such as acupuncture, infrared therapy, rebreathing techniques, and cervical epidural block, may also be considered, especially for patients who do not respond to pharmacological treatments 3.
Diagnosis and Referral
- Hiccups occur when your diaphragm involuntarily contracts while your vocal cords simultaneously close, causing the characteristic "hic" sound, and most hiccups resolve spontaneously within minutes 5, 6.
- If hiccups persist for more than 48 hours, seek medical attention as this could indicate an underlying condition requiring treatment, such as gastroesophageal reflux disease (GERD) or other central or peripheral causes 6, 3.