From the Research
To manage hiccups caused by prednisone use, the most effective approach is to try simple remedies first, such as sipping cold water, holding your breath for 10-20 seconds, breathing into a paper bag for a few minutes, or eating a teaspoon of granulated sugar, as these methods are non-invasive and can provide quick relief. If these remedies do not work, consider over-the-counter medications like simethicone (Gas-X, 80-125 mg) to reduce gas or low-dose baclofen (5-10 mg three times daily) which can help relax the diaphragm 1. For persistent hiccups, consulting a doctor is crucial, as they might prescribe medications such as chlorpromazine (25-50 mg), metoclopramide (10 mg three times daily), or gabapentin (300 mg three times daily) 2. It's essential not to stop taking prednisone without medical guidance, as the doctor might need to adjust the dosage or switch to another corticosteroid. Hiccups occur when prednisone irritates the phrenic nerve that controls the diaphragm, causing involuntary contractions. Staying well-hydrated and taking prednisone with food may help prevent this side effect. If hiccups persist for more than 48 hours or interfere with eating or sleeping, seeking medical attention promptly is recommended.
Some key points to consider in managing hiccups caused by prednisone use include:
- The importance of trying simple, non-invasive remedies first
- The potential effectiveness of over-the-counter medications for gas reduction or diaphragm relaxation
- The need for medical consultation for persistent hiccups to explore prescription medication options
- The avoidance of stopping prednisone without medical advice to ensure proper management of the underlying condition for which prednisone is prescribed
Given the potential for corticosteroids like prednisone to cause hiccups, as highlighted in cases involving dexamethasone 1, 3, and considering the pathophysiology of hiccup reflex arcs and the effects of steroids on the brainstem 4, a cautious and step-wise approach to managing hiccups is prudent. This approach balances the need to alleviate the discomfort of hiccups with the necessity of maintaining therapeutic efficacy of the corticosteroid regimen.