Dexamethasone-induced
hiccup (DIH) is an underrecognized symptom in patients with
cancer, and little information is available about its treatment. The aims of this study were to investigate the feasibility of
methylprednisolone rotation as treatment and to confirm the male predominance among those with
cancer who experienced DIH during
chemotherapy. Methods. Persons with
cancer who experienced
hiccups during
chemotherapy treatment and who were receiving treatment with
dexamethasone were presumed to have DIH. The following algorithmic practice was implemented for
antiemetic corticosteroid use: rotation from
dexamethasone to
methylprednisolone in the next cycle and
dexamethasone re-administration in the second cycle of
chemotherapy after recognition of
hiccups to confirm DIH. All other
antiemetics except
corticosteroid remained unchanged. Patients (n = 40) were recruited from eight
cancer centers in Korea from September 2012 to April 2013. Data were collected retrospectively. Results.
Hiccup intensity (numeric rating scale [NRS]: 5.38 vs. 0.53) and duration (68.44 minutes vs. 1.79 minutes) were significantly decreased after rotation to
methylprednisolone, while intensity of
emesis was not increased (NRS: 2.63 vs. 2.08). Median dose of
dexamethasone and
methylprednisolone were 10 mg and 50 mg, respectively. Thirty-four (85%) of 40 patients showed complete resolution of
hiccups after
methylprednisolone rotation in the next cycle. Of these 34 patients, 25 (73.5%) had recurrence of
hiccups after
dexamethasone re-administration. Compared with baseline values,
hiccup intensity (NRS: 5.24 vs. 2.44) and duration (66.43 minutes vs. 22.00 minutes) were significantly attenuated after
dexamethasone re-administration. Of the 40 eligible patients, 38 (95%) were male. Conclusion. DIH during
chemotherapy could be controlled without losing
antiemetic potential by replacing
dexamethasone with
methylprednisolone. We also identified a male predominance of DIH. Further prospective studies are warranted.