Metoclopramide for Hiccups

Clinical Considerations

Metoclopramide is particularly useful when hiccups are associated with gastrointestinal disorders or gastroparesis, as it improves gastric motility, according to the American Diabetes Association 1, 2

The FDA has issued warnings about serious adverse effects with prolonged use (>12 weeks) of metoclopramide, including extrapyramidal symptoms such as tardive dyskinesia, which is supported by evidence from the American Academy of Pediatrics and the American Diabetes Association 1, 2, 3
Metoclopramide should be used cautiously in patients with seizure disorders, GI bleeding, or GI obstruction, as recommended by the American Academy of Family Physicians 4
Use of metoclopramide with caution is advised in elderly patients and those with renal or hepatic impairment, according to the American Academy of Pediatrics 5
Monitoring for drowsiness, diarrhea, and muscle weakness is necessary when using metoclopramide, as suggested by the American Academy of Family Physicians 4

Gabapentin is an alternative pharmacologic option with some evidence of efficacy for hiccups, according to the American Academy of Family Physicians 4
Haloperidol and midazolam are other alternative options, as recommended by the American Academy of Pediatrics 5