Antiemetic Corticosteroid Rotation from Dexamethasone to Methylprednisolone to Prevent Dexamethasone-Induced Hiccup in Cancer Patients Treated with Chemotherapy: A Randomized, Single-Blind, Crossover Phase III Trial

Go, Se Il; Koo, Dong Hoe; Kim, Seung Tae; Song, Haa‐Na; Kim, Rock Bum; Jang, Joung Soon; Oh, Sung Yong; Lee, Kyung Hee; Lee, Soon Il; Kim, Seong Geun; Park, Lee Chun; Lee, Sang Cheol; Park, Byeong Bae; Ji, Jun Ho; Yi, Seong Yoon; Lee, Yun Gyoo; Yun, Jina; Bruera, Éduardo; Hwang, In Gyu; Kang, Jung Hun

doi:10.1634/theoncologist.2017-0129

Cited by 27 publications

(15 citation statements)

References 32 publications

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“…Factors associated with steroid-induced severe persistent hiccups remain unclear. Although they are rare, hiccups are much more frequent with dexamethasone than with other corticosteroids [4]. Hiccups can be almost intolerable and significantly diminish the quality of life in these patients.…”

Section: Discussionmentioning

confidence: 99%

Persistent Severe Hiccups After Dexamethasone Intravenous Administration

et al. 2019

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Patient: Male, 49 Final Diagnosis: Hiccups Symptoms: Hiccups Medication: Dexamethasone Clinical Procedure: Drug termination Specialty: General and Internal Medicine Objective: Adverse events of drug therapy Background: Hiccups induced by steroids administration is not common. Although it is not life-threatening and is always recognized as a transient and minor complication, it can be severely uncomfortable and significantly diminished patient quality of life. In this case report, persistent hiccups were observed in 2 middle-aged Thai men receiving low-dose intravenous dexamethasone. This case report highlights the awareness of severe dexamethasone-induced hiccups. Case Report: A 49-year-old man and a 38-year-old man were admitted to our hospital and received IV dexamethasone. The hiccups started after each patient received a single dose of dexamethasone. The frequency and severity of their hiccups increased over time during dexamethasone treatment. Hiccups still continued to occur despite the discontinuation of dexamethasone and lasted for 72 h after drug termination. Conclusions: Dexamethasone can cause persistent hiccups. Although hiccups are not life-threatening, it should not be neglected since it can be severely uncomfortable and significantly diminish patient quality of life. Termination of dexamethasone can gradually relieve hiccups. Dexamethasone should be used cautiously and clinicians must be aware of this undesirable effect.

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Section: Discussionmentioning

confidence: 99%

Persistent Severe Hiccups After Dexamethasone Intravenous Administration

et al. 2019

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“…55 Another randomised cross-over study states that antiemetic corticosteroid rotation from dexamethasone to methylprednisolone prevents dexamethasone-induced hiccup. 71…”

Section: Practice Recommendationsmentioning

confidence: 99%

Practice review: Evidence-based quality use of corticosteroids in the palliative care of patients with advanced cancer

et al. 2021

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Background: It would be unusual for a patient with advanced cancer not to be prescribed corticosteroids at some stage of their disease course for a variety of specific and non-specific indications. Aim: The aim of this practice review was to provide a pragmatic overview of the evidence supporting current practice and to identify areas in which further research is indicated. Design: A ‘state-of-the-art’ review approach was used to examine the evidence supporting the use of corticosteroids for the management of cancer-related complications and in symptom control, in the context of known risks and harms to inform quality use of this medicine. We developed ‘Do’, ‘Do not’, and ‘Don’t know’ recommendations based on current literature and identified areas for future investigation and research. Data sources: We searched MEDLINE, EMBASE and the Cochrane library from inception to 14th October 2020. Our initial search limited to reviews, reviews of reviews, randomised controlled trials (RCTs) and controlled trials was supplemented by supporting literature as appropriate. Results: Evidence to support common practice in the use of corticosteroids is lacking for most indications. This is in the context of strong evidence for the potential for significant toxicity and poor quality use of medicine. Conclusion: Guidelines recommending the widespread use of corticosteroids should acknowledge the poor evidence base supporting much current dogma. Quality research is essential not only to define the role of corticosteroids in this context but to ensure good prescribing practice.

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“…In a randomised, multicentre, phase III trial, hiccup intensity was significantly lower when the antiemetic corticosteroid was rotated from dexamethasone to methylprednisolone without a change in emesis intensity. 101 It has been demonstrated in different case series that switching dexamethasone to an equipotent dosage of either methylprednisolone or prednisolone resolved the hiccups while maintaining adequate control of CINV.…”

Section: Steroid Rotationmentioning

confidence: 99%

Section: Hiccupmentioning

confidence: 99%