Effect of Antiemetic Agents on Hiccups during Chemotherapy in Patients with Lung Cancer

Abstract

Hiccups commonly occur in patients undergoing chemotherapy for lung cancer and may diminish their motivation for treatment. Therefore, it is important to characterize the hiccups and their risk factors. We examined the medical records of 120 patients with lung cancer during their initial chemotherapy and extracted data on the patients' profiles and the onset, duration, and severity of their hiccup episodes. We found the incidence of hiccups to be 19.2% among the patients. Hiccups appeared within 3 days of beginning the chemotherapy and disappeared within 4 days. Hiccups hindered sleep in two patients. The characteristics of the hiccups episodes in our study were not different from those of previous studies. We also investigated distinctive features of the patients who developed hiccups. The occurrence of hiccups was associated with gender, age, and the treatment with platinum agents. Antiemetic agents, dexamethasone and neurokinin-1 receptor antagonists, also showed significant effects on hiccup episodes. Although the dose-responsive effect of dexamethasone on hiccups was insignificant and the effects of two neurokinin-1 receptor antagonists, aprepitant and fosaprepitant, on hiccups appeared identical. From these results, we suggest that a high incidence of hiccups may be anticipated with a prophylactic use of antiemetic agents, dexamethasone and neurokinin-1 receptor antagonists.

Analysis of Factors Associated with Hiccups Using the FAERS Database

“…In this study, the steroids methylprednisolone and dexamethasone were identified as risk factors for hiccups in men. Many reports exist on the relationship between steroids and hiccups, yet the mechanism is not clear [9,11,33]. In a study using JADER, a Japanese database, dexamethasone was extracted among steroids as a strong inducer for hiccups [11].…”

“…Several studies have investigated drug-induced hiccups. In particular, cisplatin and dexamethasone-used in chemotherapy for cancer treatment-have been reported as important suspect drugs [7][8][9][10]. As there have been no comprehensive risk factor reports on the association between hiccups and medications, we analyzed the medications and patient information associated with hiccups using the Japanese Adverse Drug Event Report database, JADER, through a data mining approach.…”