Megestrol acetate is used for treatment of cachexia and anorexia associated with cancer and human immunodeficiency virus infection. Megestrol acetate is relatively well tolerated even when administered in high doses. Although in several double-blind prospective trials differences in the incidence of adverse reactions associated with use of megestrol acetate and placebo were often not statistically significant,1- 4 adverse effects have been documented. These include irregular vaginal bleeding, fluid retention or edema, nausea, and impotence.2,5 Also, although self-limited hiccups can occur without sequelae; severe or intractable hiccups may lead to difficulties with eating and sleeping resulting in malnutrition, weight loss, dehydration, fatigue, exhaustion, and depression.6 Reported herein are 4 cases of hiccups probably induced by megestrol acetate use occurring in persons with the acquired immunodeficiency syndrome.
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