From the FDA Drug Label
For relief of intractable hiccups 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.
The treatment option for hiccups is Chlorpromazine (PO) with a dosage of 25 mg to 50 mg taken three to four times a day. If symptoms persist for 2 to 3 days, parenteral therapy is indicated 1.
From the Research
Hiccups can usually be treated with simple home remedies, but for persistent cases, medications like baclofen, gabapentin, or lidocaine may be necessary, as evidenced by recent studies 2, 3. When considering treatment options for hiccups, it's essential to differentiate between self-limiting and persistent cases. For most people, hiccups resolve on their own within a short period. However, for those with persistent hiccups lasting more than 48 hours, medical intervention may be required.
Home Remedies
Simple home remedies can often interrupt the hiccup reflex or stimulate the vagus nerve, providing relief. These include:
- Holding your breath for 10-20 seconds
- Drinking a glass of cold water quickly
- Gargling with ice water
- Breathing into a paper bag for a few minutes
- Pulling on your tongue
Medical Treatment
For persistent hiccups, medications can help. Baclofen (5-10mg three times daily) and gabapentin (300-600mg three times daily) are potential options, as they affect the central nervous system pathways involved in hiccups 4, 5. Additionally, lidocaine, applied orally, has shown promise in treating intractable hiccups 3.
Identifying Underlying Causes
It's crucial to identify and treat any underlying causes of persistent hiccups, such as gastroesophageal reflux disease (GERD), which may require specific treatment like proton pump inhibitors.
Rare Cases
In rare cases of intractable hiccups lasting months, nerve blocks or surgical interventions, including vagus nerve stimulation, might be considered, as reported in a case study from 2021 2.
Given the most recent and highest quality evidence, the use of baclofen or gabapentin, alongside the identification and treatment of underlying causes, appears to be a reasonable approach for managing persistent hiccups 4, 2.