Can diazepam cause hiccups? Investigating the Link in Medications and Pharmacology

October 13, 2025 •

4 min read

While most hiccups are benign and short-lived, certain medications can, in rare instances, be a contributing factor. Although considered an uncommon side effect, medical literature and drug labeling suggest that can diazepam cause hiccups? for some individuals.

Quick Summary

Diazepam is a benzodiazepine that can, on rare occasions, trigger hiccups by affecting the brainstem hiccup reflex arc involving GABAergic and dopaminergic pathways. This effect is often paradoxical and may be dose-dependent.

Key Points

Possible but Rare Side Effect: Diazepam can cause hiccups, but it is an uncommon adverse reaction documented in medical literature and drug labeling.
Benzodiazepine Class Effect: Other benzodiazepines like midazolam and lorazepam are also associated with hiccups, suggesting it may be a class effect.
Mechanism Involves Brainstem Reflex: Benzodiazepines can trigger hiccups by modulating GABAergic and dopaminergic neurotransmitter pathways within the brainstem's hiccup reflex arc.
Paradoxical Dose-Response: At low doses, benzodiazepines can induce hiccups, while higher doses are sometimes used to treat them, highlighting a complex and not fully understood effect.
Consider Other Medications and Conditions: Hiccup risk can be influenced by dosage, co-administration with other drugs (e.g., steroids, aripiprazole), or pre-existing conditions like GERD.
Consult a Doctor for Persistent Hiccups: While often benign, persistent or severe hiccups warrant a medical evaluation. Do not stop or alter your medication without professional guidance.
Standard Remedies Often Effective: For mild, temporary hiccups, many traditional home remedies like drinking cold water or holding your breath can be effective.

The Direct Link Between Diazepam and Hiccups

Hiccups, or singultus, are involuntary contractions of the diaphragm followed by the rapid closure of the glottis. Although most cases are transient and resolve on their own, certain medical conditions and pharmacological agents can induce them. Diazepam, marketed under brand names like Valium, has been recognized in medical literature as a potential cause of hiccups, though it is not a frequently reported side effect. The official labeling for Diazepam injection even lists hiccups as a less frequently reported adverse reaction.

The link is not unique to diazepam. The class of drugs to which it belongs, benzodiazepines, is mentioned frequently in medical case studies and reviews regarding drug-induced hiccups. Other benzodiazepines, such as midazolam and lorazepam, have also been implicated, often in the context of procedural sedation or in specific patient populations. This suggests that the hiccup-inducing potential may be a class effect rather than a characteristic of diazepam alone.

The Pharmacological Mechanism: How Benzodiazepines May Trigger Hiccups

The exact mechanism by which benzodiazepines like diazepam can cause hiccups is not fully understood, but it is thought to involve the complex hiccup reflex arc. This arc consists of three main components: an afferent limb, a central processing unit, and an efferent limb.

The Afferent Limb: Sensory signals travel along the phrenic, vagus, and sympathetic nerves to the brainstem. These signals can be triggered by various irritations, such as gastric distention or irritation of the respiratory pathways.
The Central Processing Unit: The integration of these signals occurs in a non-specific area of the brainstem, which involves various neurotransmitters, including dopamine and gamma-aminobutyric acid (GABA).
The Efferent Limb: Motor signals then travel via the phrenic nerve to the diaphragm and the vagus nerve to the glottis, causing the characteristic 'hic' sound.

Benzodiazepines are known to enhance the effect of GABA, a major inhibitory neurotransmitter in the central nervous system. By influencing GABAergic pathways, these drugs can interfere with the normal function of the hiccup reflex arc, potentially triggering erratic contractions of the diaphragm and intercostal muscles. In addition, some studies suggest a link between dopamine pathways and the hiccup reflex, which could be another point of influence.

The Paradoxical Effect of Benzodiazepines

In a peculiar twist, benzodiazepines exhibit a paradoxical relationship with hiccups: while they can induce them at lower doses, higher doses are sometimes used as a treatment for intractable hiccups. This has been observed with other benzodiazepines like midazolam and lorazepam. The discrepancies likely reflect the different physiological responses to varying doses and the complicated nature of the hiccup's origin. For instance, a small dose might irritate the central pathways, while a higher dose provides enough sedation to suppress the reflex entirely.

What Puts a Person at Risk?

Several factors may increase the likelihood of developing hiccups while taking benzodiazepines. These include:

Dose: As discussed, there is some evidence for a dose-dependent relationship, particularly with midazolam, where higher doses correlate with a higher incidence of hiccups.
Co-administration with Other Drugs: Taking other medications known to cause hiccups, such as certain steroids (like dexamethasone) or chemotherapy drugs, could increase the risk. A study found a significantly increased hiccup risk in patients taking aripiprazole and benzodiazepines concurrently.
Pre-existing Conditions: Patients with conditions that irritate the nerves controlling the diaphragm, like Gastroesophageal Reflux Disease (GERD), may be more susceptible.
Specific Patient Populations: A case series highlighted an increased risk of benzodiazepine-induced hiccups in adult male patients with Down Syndrome and catatonia.
Male Gender: Some studies suggest that drug-induced hiccups, in general, are more common in men.

Management and When to Seek Medical Help

If hiccups occur after taking diazepam, they are often transient and can be addressed with standard home remedies aimed at interrupting the hiccup reflex. These can include:

Drinking a glass of cold water quickly.
Holding your breath for a short period.
Gargling with ice water.
Breathing into a paper bag (not covering your head).
Pulling your knees up to your chest and leaning forward.

However, if the hiccups are persistent (lasting more than 48 hours), intractable (lasting more than a month), or accompanied by other concerning symptoms, it is crucial to consult a healthcare professional. In cases where the hiccups are clearly drug-related, an adjustment of medication or dose may be necessary. Do not stop or change your medication without consulting your doctor first. For more information, you can refer to the official MedlinePlus drug information for Diazepam.

Comparison of Hiccup-Inducing Medications


Medication Class	Example Drug	Proposed Mechanism	Onset of Hiccups	Management Considerations
Benzodiazepines	Diazepam, Midazolam	Modulation of GABA and dopamine pathways in the hiccup reflex arc.	Variable; can occur during or after administration.	Dose adjustment or alternative medication; paradoxical effect may exist.
Corticosteroids	Dexamethasone	Thought to affect the central nervous system, with higher doses increasing risk.	Varies, can occur shortly after administration.	Can often be managed by switching to an alternative steroid (e.g., methylprednisolone).
Opioids	Morphine	Central nervous system effects, particularly with long-term use.	Can occur during extended therapy.	Often requires addressing the underlying pain and potentially switching pain management strategies.
Antipsychotics	Aripiprazole	Often tied to interactions with other medications like benzodiazepines.	Typically develops early in treatment.	Discontinuation or dose reduction of the offending agent, particularly when used with benzodiazepines.

Conclusion

The answer to can diazepam cause hiccups? is yes, though it is a rare and uncommonly reported adverse effect. The mechanism likely involves the drug's influence on neurotransmitter systems within the brainstem's hiccup reflex arc. The phenomenon is also shared by other benzodiazepines and, paradoxically, these drugs can also be used to treat intractable hiccups at higher doses. Risk factors such as dose, co-administered drugs, and underlying conditions may play a role. For most individuals, hiccups induced by diazepam are transient and can be managed with simple home remedies. However, any persistent, distressing, or long-lasting hiccup episodes warrant a consultation with a healthcare provider to investigate the cause and determine the best course of action.

Frequently Asked Questions

No, hiccups are an uncommonly reported side effect of diazepam. While documented in medical literature and drug labeling, it is considered a rare adverse reaction.

The mechanism is not entirely clear but involves influencing the central nervous system. Benzodiazepines may disrupt the normal function of the brainstem's hiccup reflex arc, particularly by interacting with GABA and dopamine pathways, triggering involuntary diaphragm contractions.

Yes, other drugs in the benzodiazepine class, such as midazolam and lorazepam, have also been linked to causing hiccups. This suggests it may be a class-wide effect.

Yes, in some cases. There is a documented paradoxical effect where low doses of some benzodiazepines might induce hiccups, while higher, therapeutic doses can effectively treat intractable hiccups.

You should consult a doctor if hiccups are persistent (lasting more than 48 hours), intractable (lasting over a month), or accompanied by other severe symptoms. It is important to rule out other underlying causes.

Risk factors can include the specific dose of the medication, taking other drugs that also cause hiccups (like certain steroids), having a pre-existing condition such as GERD, or belonging to a specific population like males or those with Down Syndrome.

For temporary hiccups, common home remedies can be effective. These include drinking cold water, holding your breath, or breathing into a paper bag. If they persist, your doctor may need to adjust your medication or consider other treatments.