Medical Oncologist
Side effects
Persistent hiccups during chemotherapy
Most often the steroids given alongside treatment, with some anti-sickness medicines, reflux and a few chemotherapy drugs also responsible. Hiccups lasting a few minutes are a nuisance; hiccups lasting days are exhausting and stop people sleeping and eating. They are treatable, and most people endure them silently because it feels too small a thing to raise at a cancer appointment.
NG
Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
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The short answer
Why has chemotherapy caused persistent hiccups?
Most often the steroids given alongside treatment, which are the commonest culprit by a distance. Some anti-sickness medicines cause them too, as do a full or irritated stomach, acid reflux and occasionally the chemotherapy drugs themselves.
Hiccups that last a few minutes are a nuisance. Hiccups that go on for days are genuinely exhausting — they stop people sleeping, eating and talking properly, and they are one of the more demoralising side effects precisely because they sound trivial to everyone else.
They are treatable, and worth reporting
This is the part most people do not know. Persistent hiccups can be treated with medicine, and your team can also look at whether the steroid timing or dose is driving them. Many people endure them silently because it feels too small a complaint to raise at a cancer appointment.
If hiccups have gone on for more than a day or two, mention them. There is no need to wait until the next scheduled visit.Where they come from
The usual causes during treatment
Often more than one at once, which is why they can be stubborn.
Steroids
The commonest cause during chemotherapy, and the one most often missed. Hiccups that start reliably on the days you take steroids point straight at them, and that pattern is worth reporting.
Notice
- Do they start after the steroid days?
- Do they ease when the steroids stop?
A full or irritated stomach
Large meals, fizzy drinks, eating quickly, or acid reflux all irritate the nerve that controls the diaphragm. Eating smaller amounts more slowly often reduces them noticeably.
Anti-sickness medicines
Some cause hiccups as a side effect, and switching to a different class often resolves them. This is a straightforward change to ask about rather than a difficult one.
Never stop an anti-sickness medicine on your own to test this.The chemotherapy itself
A few drugs are associated with hiccups directly. Where that is the case they usually follow a predictable pattern around each cycle, and your team can tell you whether yours is one of them.
Salts out of balance
Dehydration, vomiting and kidney changes can alter the salts in the blood, which sometimes shows up as persistent hiccups. This is one reason prolonged hiccups get a blood test rather than only a remedy.
Something needing investigation
Rarely, hiccups that do not settle point at irritation of the nerve or diaphragm from another cause. That is why very persistent hiccups are assessed rather than simply treated.
Not sure whether this applies to you?
Ask an oncologistWorth trying at home
Simple measures, while you arrange to be seen
- Sip cold water slowly, or suck small ice chips
- Hold your breath for a short period, or breathe into a paper bag briefly
- Eat smaller amounts, more slowly, and avoid large meals
- Stop fizzy drinks entirely, since the gas makes them worse
- Sit upright after eating rather than lying down
- Swallow a spoonful of sugar, or a little crushed ice, slowly
- Pull your knees to your chest and lean forward for a minute
- Deal with any acidity, which is a frequent underlying trigger
- Ask about the timing of your steroid dose, which often helps
!
Contact the team, and go in for these
Hiccups lasting more than a couple of days, or stopping you sleeping or eating, should be reported rather than endured. Go to the nearest emergency department the same day if they come with chest pain, breathlessness, vomiting where nothing stays down, severe stomach pain, difficulty swallowing, or a fever — and say clearly that the person is on chemotherapy. Prolonged hiccups with poor eating and drinking also lead to dehydration, which is a reason to be seen in itself.
What your team can do
How persistent hiccups are treated
The first step is usually to look for a cause that can be removed rather than reaching straight for a medicine. That means reviewing the steroid timing and dose, checking whether an anti-sickness medicine is responsible, treating any reflux, and taking blood to check the salts and kidney function.
Medicines that are used
Several medicines are used specifically for persistent hiccups, working through different mechanisms. They are prescribed rather than bought, partly because the choice depends on what else you are taking and partly because some cause drowsiness. If the first does not work, there are others.
What to say when you report them
How many days they have lasted. Whether they stop at night or continue through sleep. Whether they started on the steroid days. Whether they are affecting eating, drinking or sleeping. And what you have already tried. Those five answers shape what is done.
Do not let anyone dismiss it
Hiccups sound minor and are not, once they have gone on for days. If the response is that nothing can be done, ask again, because that is not accurate. Exhaustion from hiccups affects eating, mood and how well treatment is tolerated.
Nothing here should be used to start, stop or change a prescribed medicine.Leave a number, we will call you
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Being straight with you
What this page cannot tell you
It cannot tell you which of the possible causes is yours. Steroids are the most likely, but anti-sickness medicines, reflux, salt imbalances and the chemotherapy itself all produce the same symptom, and separating them usually needs a review of your medicine list and a blood test.
It also cannot tell you which medicine would suit you. The options differ in how they work and in their own side effects, and the choice depends on everything else you are taking. Nothing sold over the counter is the right answer for hiccups that have lasted days.
What to do next
Note when they started and whether they follow the steroid days. Try the simple measures, eat smaller amounts more slowly and stop fizzy drinks. Then contact your team rather than waiting for the next appointment, and say plainly if they are stopping you sleeping or eating.
Questions we are asked
Common questions about hiccups
Are hiccups a recognised side effect?
Yes, and they are commoner than most people realise. Steroids given alongside chemotherapy are the usual cause, with some anti-sickness medicines and a few chemotherapy drugs also responsible. They are a known effect rather than something odd, and they are treatable.
How long is too long to put up with them?
More than a couple of days is worth reporting, and sooner if they are stopping you sleeping or eating. There is no reason to wait for the next appointment. Persistent hiccups are exhausting and they lead to poor eating and drinking, which causes problems of its own.
Can the steroids be stopped if they are the cause?
Never stop or reduce them yourself, because they are tapered carefully and stopping abruptly is unsafe. But your team can look at the timing, the dose, or whether a different approach to sickness control is possible. That conversation is exactly why reporting the pattern matters.
Do the home tricks actually work?
For short-lived hiccups, often. For hiccups that have lasted days they rarely resolve things, though sipping cold water, eating slowly and avoiding fizzy drinks are all harmless and worth doing. Do not let trying them delay reporting hiccups that are not settling.
Why do they stop me sleeping?
Hiccups that continue through the night are particularly exhausting and are a strong reason to seek treatment. Hiccups that stop during sleep are generally less concerning. Either way, mention which pattern you have, because it helps your team judge what is going on.
Can hiccups be a sign of something serious?
Occasionally. Persistent hiccups can reflect salts out of balance, kidney changes, or irritation of the nerve controlling the diaphragm. That is why prolonged hiccups usually get a blood test and an examination rather than only a prescription for something to suppress them.
Will they come back with every cycle?
If steroids are the cause, they often follow the same pattern each cycle, which at least makes them predictable. Once reported, your team can plan for it — adjusting the timing, or prescribing something to take during those days rather than waiting for them to start.
Is it worth mentioning at a cancer appointment?
Yes. People routinely leave it out because it feels too small alongside the diagnosis, and then endure it for months. Teams would rather hear about it, because it is one of the more straightforwardly treatable problems on the list.
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Sources
- Cancer Research UK — Steroids and cancer treatment
- National Cancer Institute — Gastrointestinal Complications (PDQ)
- Macmillan Cancer Support — Side effects of cancer treatment
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