Baclofen Dosing for Hiccups

Dosing Guidelines

The recommended dose of baclofen for treating hiccups is 5-10 mg three times daily, with a typical effective total daily dose of 30-60 mg, as recommended by the Hepatology society 1
Total daily dose range is typically 15-60 mg, with most patients responding in the 30-60 mg range, according to the Hepatology society 1

Baclofen is a GABA-B receptor agonist that works as a muscle relaxant, as stated by the Clinical and Molecular Hepatology society 2

The American Geriatrics Society recommends monitoring for common side effects of baclofen, particularly in older adults, including sedation and drowsiness 3, 4
The American Geriatrics Society also recommends monitoring for cognitive impairment 4, muscle weakness 3, and urinary dysfunction 3 in older adults taking baclofen
Baclofen should be used with caution in patients with renal impairment, as dose adjustment may be needed, according to the American Geriatrics Society 4
The Hepatology society recommends using baclofen with caution in patients with hepatic encephalopathy, as it may worsen mental status 1
The American Geriatrics Society recommends avoiding abrupt discontinuation of baclofen, as it may cause central nervous system irritability 3
Older adults may require lower doses of baclofen (start at 5 mg twice daily) due to increased sensitivity to side effects, as recommended by the American Geriatrics Society 3, 4

The Clinical and Molecular Hepatology society and the Hepatology society note that baclofen is the only medication for alcohol abstinence that has been specifically studied in patients with alcoholic liver disease, which may be relevant if hiccups are related to alcohol use 1, 2

The titration of baclofen can be increased weekly by 10 mg/day up to 30 mg/day if needed, according to the Hepatology guideline 5

The treatment algorithm for intractable hiccups may involve increasing the dose of baclofen by 5-10 mg/day weekly up to 30 mg/day, as recommended by the Hepatology guideline 5