From the Guidelines
Chlorpromazine for hiccups is typically administered at a dose of 25-50 mg orally three to four times daily, as needed, and for a short duration, usually until the hiccups resolve or for up to a few days 1.
Dosing Frequency
The dosing frequency of chlorpromazine for treating hiccups is usually three to four times daily, with a dose range of 25-50 mg orally.
- The treatment duration is generally short-term, continuing until the hiccups resolve or for up to a few days.
- In more severe or persistent cases, chlorpromazine can be given as an intramuscular injection of 25-50 mg, which may be repeated in 3-4 hours if needed.
Mechanism of Action and Side Effects
Chlorpromazine works by acting on dopamine receptors in the brain's chemoreceptor trigger zone and may help interrupt the hiccup reflex arc.
- Patients should be monitored for side effects, including sedation, orthostatic hypotension, and extrapyramidal symptoms.
- This medication should be used cautiously in elderly patients and those with cardiovascular disease, and it's typically considered after simpler interventions for hiccups have failed.
Precautions and Interactions
Patients should avoid alcohol while taking chlorpromazine and should not drive or operate machinery until they know how the medication affects them.
- Chlorpromazine may have potential interactions with other medications, including QT-interval-prolonging medications, which should be considered when prescribing this medication 1.
From the FDA Drug Label
INTRACTABLE HICCUPS 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.
The dosing frequency of chlorpromazine for treating hiccups is not explicitly stated, but the dosage is given as 25 to 50 mg IM if symptoms persist for 2-3 days after trial with oral therapy. If symptoms persist, a slow IV infusion may be used. 2
From the Research
Dosing Frequency of Chlorpromazine for Hiccups
- The dosing frequency of chlorpromazine for treating hiccups is not explicitly stated in the provided studies 3, 4, 5, 6, 7.
- Chlorpromazine is mentioned as a treatment option for hiccups in several studies, including a systematic review of pharmacologic interventions for intractable and persistent hiccups 3.
- However, the review does not provide specific information on the dosing frequency of chlorpromazine for this indication.
- Another study discusses the use of chlorpromazine as a treatment for hiccups, but also does not provide information on dosing frequency 4.
- A case report mentions that a patient used chlorpromazine for a short time to treat hiccups, but the dosing frequency is not specified 5.
- The other studies provided do not mention the use of chlorpromazine for hiccups or its dosing frequency 6, 7.
Alternative Treatment Options
- Other treatment options for hiccups are discussed in the provided studies, including baclofen 4, 5, 7, gabapentin 4, 5, and metoclopramide 3.
- The dosing frequencies of these alternative treatment options are also not explicitly stated in the provided studies.
- However, one study reports that gabapentin 300 mg bid was effective in treating persistent hiccups in a case report 5.
- Another study found that baclofen produced a long-term complete resolution or considerable decrease of hiccups in 28 of 37 patients with chronic hiccup 7.