Persistent Hiccups Associated With Intravenous Corticosteroid Therapy

Abstract

Singulata, commonly known as hiccups, have many causes and are most often idiopathic and short-lived. Occasionally, hiccups can be persistent and becoming quite bothersome, distracting, and even disabling. Many medications have been implicated as a cause of hiccups. Although uncommon, corticosteroids and benzodiazepines are 2 classes of drugs most frequently associated with the development of hiccups. The following case series describes 5 patients with intravenous corticosteroid-associated hiccups reported to our adverse drug reaction reporting system between January 1998 and December 2000. Physicians using intravenous corticosteroids should be aware of this potential complication.

Persistent Hiccups After an Epidural Steroid Injection Successfully Treated With Baclofen: A Case Report

“…Systemic corticosteroids have been associated with development of hiccups [10]. It is believed that steroids may trigger hiccups through steroid receptors on the reflex arc [11].…”

Transient Hiccups Associated with Oral Dexamethasone

“…Other cases of corticosteroid-induced hiccups have been reported [1, 25], and Dickerman et al have described the first cases of anabolic steroid-induced hiccups [16, 17]. The only other adverse reaction to steroids found in the dental literature was a case of episodic psychiatric disturbance (cognitive dysfunction) in an 18-year-old female who had taken dexamethasone briefly [26].…”

“…They are usually brief and self-limiting but may become prolonged in some patients [1]. Hiccups that linger on for some time may become worrisome to the postoperative patient, thus hindering their nutritional and sleep needs [2, 3].…”

“…Using a strict standard, drugs have not been proven to be a common cause of hiccups [7, 14]. Nevertheless, many clinicians have alluded to various medications as triggering the hiccup reflex [1, 3, 6, 13, 15–24]. The following case describes a patient who experienced transient hiccups following oral presurgical administration of dexamethasone.…”

Annoying Hiccups following Intra-Articular Corticosteroid Injection of Betamethasone Acetate/Betamethasone Sodium Phosphate at the Knee Joint

“…Hiccups could be induced by different etiologies including drugs, especially steroids [2]. It is believed that steroids trigger this reflex through steroid receptors on the reflex arc [3].…”