Wednesday, February 07, 2007

Treating Hiccups

I didn't really know how to treat hiccups, besides what we all normally do. But this is a very useful article on how to medically treat hiccups.

Should I treat?
  • If the person has not already tried them, suggest some simple physical manoeuvres to try and stop the hiccups.
  • If physical manoeuvres are ineffective, consider drug treatment while the person is waiting to see a specialist or in the palliative care situation.
  • If a person has symptoms suggestive of gastro-oesophageal reflux and has no alarm symptoms, it is reasonable to first try a course of proton-pump inhibitor (see PRODIGY guidance on Dyspepsia - symptoms (uninvestigated by endoscopy) .

Table 2. Oral drugs used in the treatment of hiccup and suggested dosage.
Drug Suggested dosages for use in primary care
Chlorpromazine* 25-50 mg three to four times a day
Haloperidol* 1.5 mg three times a day; usual maintenance dose 1.5-3 mg at night
Baclofen§ 5 mg three times a day, increased to 20 mg three to four times a day if necessary
Gabapentin§ 300-400 mg three times a day
Metoclopramide§ 10-20 mg three to four times a day
* Licensed dosage for treatment of hiccups
§ Dosages taken from case reports


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