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. Follow blood pressure closely. The treatment for intractable hiccups is:
- IM injection: 25 to 50 mg (1-2 mL) if symptoms persist for 2-3 days after trial with oral therapy
- Slow IV infusion: 25 to 50 mg (1-2 mL) in 500 to 1000 mL of saline if symptoms persist, with the patient flat in bed and blood pressure closely monitored 1
From the Research
For most cases of hiccups, simple home remedies are effective, but for persistent hiccups lasting more than 48 hours, medical treatment with medications such as baclofen or gabapentin may be necessary, as supported by the most recent and highest quality study 2.
Treatment Options
- Simple home remedies: holding breath for 10-20 seconds, drinking cold water quickly, gargling with ice water, breathing into a paper bag, or pulling gently on the tongue
- Medications for persistent hiccups:
- Baclofen (5-10mg three times daily)
- Gabapentin
- Metoclopramide (10mg orally or intravenously)
- Chlorpromazine (25-50mg orally or intramuscularly)
Underlying Causes
- Addressing underlying causes like acid reflux, medication side effects, or metabolic disorders may also be necessary for long-term resolution, as suggested by 3 and 2
Severe Cases
- In severe cases lasting months (intractable hiccups), nerve blocks or surgical interventions might be considered, as mentioned in 4 and 5