From the Research
Yes, prednisone and other corticosteroids can cause hiccups as a side effect, as evidenced by a case series reported in the Journal of clinical rheumatology, where 5 patients developed hiccups associated with intravenous corticosteroid therapy 1. This occurs more commonly with higher doses and longer durations of treatment, though it can happen at any dose. Hiccups related to prednisone may be persistent and troublesome for some patients. The mechanism behind steroid-induced hiccups isn't fully understood, but it likely involves the medication's effects on the central nervous system and the pathways that control the diaphragm. Specifically, steroids may affect neurotransmitters that regulate the hiccup reflex arc. If you develop persistent hiccups while taking prednisone, you should consult your healthcare provider rather than stopping the medication abruptly. Your doctor might adjust your dosage, change the timing of doses (taking it earlier in the day may help), or prescribe medications to manage the hiccups if they're severe. Some key points to consider when managing hiccups include:
- Staying hydrated and avoiding carbonated beverages may also help reduce the frequency of hiccups while on corticosteroid therapy.
- The use of other medications such as baclofen, metoclopramide, and gabapentin may be considered for the treatment of persistent and intractable hiccups, as suggested by a systematic review published in Alimentary pharmacology & therapeutics 2.
- However, the most recent and highest quality study, a prospective double-blind randomized clinical trial published in Neurological sciences, found that dexamethasone, a corticosteroid, was effective in pain relief and prevention of recurrence in migraine headache, but did not specifically address hiccups as a side effect 3. It's essential to weigh the benefits and risks of corticosteroid therapy and to discuss any concerns with your healthcare provider. In terms of treatment options for hiccups, some studies suggest that:
- Baclofen and gabapentin may be considered as first-line therapy for persistent and intractable hiccups, with metoclopramide and chlorpromazine in reserve 2.
- Chlorpromazine is the only drug approved by the US Food and Drug Administration for the treatment of hiccups, but it may not be acceptable for every patient 4, 5. Overall, while the evidence is not entirely clear, it is essential to be aware of the potential for corticosteroids like prednisone to cause hiccups and to manage them appropriately to minimize morbidity, mortality, and impact on quality of life.