See the DrugPatentWatch profile for emend
Does Emend Cause Hiccups?
Yes, hiccups are a reported side effect of Emend (aprepitant), an anti-nausea drug used to prevent chemotherapy-induced vomiting. Clinical trials and post-marketing data list hiccups occurring in 4-11% of patients, more commonly with the intravenous form than oral capsules.[1][2]
How Common Are Hiccups with Emend?
In pivotal trials for the 3-day oral regimen:
- Hiccups affected 4.6% of patients on Emend plus standard therapy, versus 3.9% on standard therapy alone.
- Rates rose to 10.9% with IV Emend in some studies, often mild and self-resolving.[1][3]
Post-approval reports confirm hiccups as one of the top gastrointestinal side effects, alongside fatigue and constipation.[2]
Why Do Hiccups Happen with Emend?
Emend blocks substance P and neurokinin-1 receptors in the brain and gut, disrupting nausea signals. This can irritate the phrenic nerve or diaphragm control, triggering spasms that cause hiccups. IV administration may heighten risk due to faster bloodstream entry.[3][4]
How Long Do Emend Hiccups Last?
Most cases are transient, lasting minutes to hours and resolving without intervention. Persistent hiccups (beyond 48 hours) are rare but warrant medical review, as they may signal dehydration or electrolyte shifts from chemo.[2][5]
What If Hiccups Don't Stop?
Consult a doctor—options include:
- Holding Emend temporarily.
- Chlorpromazine or baclofen for severe cases.
- Hydration and breathing exercises for mild ones.
No long-term harm is typical, but report to FDA MedWatch if ongoing.[2][5]
Compared to Other Anti-Nausea Drugs?
Emend's hiccup rate exceeds Zofran (ondansetron, <1%) but matches or trails Akynzeo (netupitant combo, 4-5%). Sustol (IV granisetron) reports up to 7%.[1][3]
[1]: Emend Prescribing Information (Merck)
[2]: FDA Label for Aprepitant
[3]: Drugs.com - Emend Side Effects
[4]: Medscape - Aprepitant Mechanism
[5]: Mayo Clinic - Hiccups Management