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.
The treatment for intractable hiccups is chlorpromazine (PO) 25 mg to 50 mg t.i.d. or q.i.d. If symptoms persist for 2 to 3 days, parenteral therapy is indicated 1.
From the Research
For hiccups, the most effective treatment approach is to try simple remedies first, and if persistent, consider medication such as metoclopramide, as suggested by the most recent study 2. The treatment of hiccups should prioritize simple remedies, including drinking a glass of cold water quickly, holding your breath for 10-20 seconds, breathing into a paper bag for a few minutes, or gargling with ice water, as these methods can help reset the diaphragm's normal rhythm by interrupting the hiccup reflex.
- Persistent hiccups lasting more than 48 hours may require medication, with metoclopramide being a viable option, as it has been reported to have effects on intractable hiccup 2.
- Other medications such as baclofen and chlorpromazine may also be considered, but the evidence for their use is less recent and of lower quality compared to metoclopramide 3, 4, 5.
- For severe cases lasting days or weeks, it is essential to consult a doctor, as this could indicate an underlying condition requiring specific treatment, and the treatment should be directed at the underlying cause whenever possible 6.
- The pathophysiology of hiccups involves the involuntary contraction of the diaphragm and the simultaneous closure of the vocal cords, causing the characteristic "hic" sound, and understanding this can help guide treatment decisions 6.