Persistent Hiccups — SCE Medical Oncology MCQ

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EasySupportive & Palliative OncologyPersistent HiccupsSCE Medical Oncology

A 62-year-old man with metastatic oesophageal adenocarcinoma on cisplatin develops severe hiccups that are persistent and distressing, interfering with eating and sleeping. What pharmacological treatment is most appropriate?

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Correct answer: E — Metoclopramide or chlorpromazine

Persistent hiccups in cancer patients can be debilitating. Pharmacological options include chlorpromazine (the only drug licensed for hiccups in many countries), metoclopramide (particularly if related to gastric distension from chemotherapy), baclofen (GABA-B agonist), gabapentin and nifedipine. Cisplatin-induced hiccups may be related to vagal irritation or direct CNS effects. Non-pharmacological approaches include breathing techniques and nasopharyngeal stimulation.

Reference: ESMO 2024 Supportive Care Guidelines; BNF; Steger et al J Pain Symptom Manage 2015