What Medications Cause Chronic Hiccups? Drug Classes

Many patients do not realize that their existing medical treatments—ranging from oral pills to joint injections or anesthesia—can inadvertently trigger the hiccup reflex ^[1]. While medications are just one possible cause, they are an important factor to consider. Hiccups lasting more than 48 hours are medically considered “persistent,” while those lasting over a month are “chronic” or “intractable.”

If you develop persistent hiccups, your doctor will need to evaluate your medication list alongside other potential causes, such as gastrointestinal reflux, metabolic issues, or nerve irritation ^[2]. Identifying a suspected medicine can sometimes help guide treatment, provided you work carefully with your care team.

When to Seek Urgent Care

Before looking at medications, ensure your hiccups are not a sign of a medical emergency. Seek immediate medical attention if your hiccups are accompanied by:

• Difficulty breathing or swallowing
• Inability to keep fluids or food down (which increases the risk of dehydration)
• Severe chest or abdominal pain
• Confusion, weakness, severe headache, or new neurological symptoms

Medications Reported to Cause Hiccups

When looking for a root cause, your care team should review your entire medication timeline—including routine pills, over-the-counter supplements, recent dose changes, and recent procedures ^[2]. The strength of the evidence varies, but the following drug classes have been reported in the medical literature:

• Corticosteroids: Steroids have the strongest reported association with drug-induced hiccups based on adverse-event data ^[1]. Dexamethasone has a particularly notable pharmacovigilance signal ^[1][3]. These medications do not have to be taken orally to cause an issue; hiccups lasting more than 48 hours have been described in case reports following epidural, sacroiliac-joint, and facet-joint steroid injections ^[4][5].
• Benzodiazepines and Anesthetics: Medications used for sedation, such as midazolam, have been linked to hiccups starting during or after surgery ^[6]. General anesthetics are also sometimes associated with perioperative hiccups (hiccups occurring around the time of surgery) ^[7]. In isolated, monitored case reports, post-surgical hiccups stopped when the anesthesia team administered a reversal agent ^[6]. However, reversal is a strict clinical decision with its own risks (such as acute withdrawal or seizures in susceptible patients) and is not a routine treatment patients should request or expect.
• Chemotherapy and Supportive Care Drugs: Hiccups are frequently reported in adults undergoing cancer treatment ^[8]. While this is often associated with platinum-based chemotherapy drugs like oxaliplatin and cisplatin, pinpointing the exact cause is complex ^[9]. Cancer regimens frequently include dexamethasone and anti-nausea drugs (like aprepitant or fosaprepitant), which may also modify the risk of hiccups ^[9]. Do not alter your cancer regimen; instead, discuss these side effects with your oncology team.
• Other Medications: Some drugs have been linked to hiccups primarily through rare, individual case reports. These include certain psychiatric medications (like aripiprazole) ^[10], dopamine agonists used for Parkinson’s disease ^[11], and specific antibiotics (like cefotaxime) ^[12]. Case reports show a possible association but do not prove that the drug will cause hiccups in a wider population.

How Might Drugs Cause Hiccups?

The exact biological process behind medication-induced hiccups is not completely settled ^[13]. The hiccup reflex involves a complex network: sensory pathways (including the vagus, phrenic, and sympathetic nerves) feed signals into a central brainstem network. This network then sends motor output primarily through the phrenic nerves down to the diaphragm, accompanied by coordinated closure of the vocal cords.

Researchers propose that certain medications might cause chemical irritation of these nerve pathways ^[13], or they might alter how neurotransmitters (chemical messengers) function in the central brain network ^[14]. When this communication is disrupted, the diaphragm spasms, resulting in a hiccup.

A Crucial Warning: Do Not Stop Your Medications

If you suspect a medication is causing your hiccups, never stop taking it or change your dose without consulting your doctor first ^[2][13].

Abruptly stopping prescribed treatments can be dangerous:

• Interrupting chemotherapy or cancer treatments can reduce their lifesaving effectiveness.
• Stopping systemic corticosteroids abruptly can cause adrenal insufficiency, a potentially life-threatening condition.
• Halting psychiatric or neurological medications can trigger severe withdrawal symptoms or relapse.

Instead, present your concerns and a detailed medication timeline to your prescriber or pharmacist. A clinician can determine if it is safe to slowly taper the dose, substitute an alternative drug, or safely withdraw the suspected medicine under close medical supervision ^[2].