Why does codeine give me hiccups?

I take codeine for migraine pain. I only take it occasionally when the headaches are bad. I get two side effects from it:

  1. It makes my insomnia worse (I have a sleep disorder) and
  2. It gives me frequent bouts of hiccups.

I can cure the hiccups so it’s not really a problem. But it’s not unusual for me to get 3-4 bouts in an hour sometimes. And it’s only sometimes. I’m just curious, why would codeine bring on hiccups, of all things?

And why the insomnia? Isn’t codeine supposed to make people sleepy? I mean, going to sleep for me is always a battle I’m just surprised that codeine would make it worse?

Oh - my current subscription is hydrocodone/apap 5MG/500MG tablets. I usually take 2. I’ve been taking it as needed for years and these are the only two side effects, afaik.

All opiates can cause hiccups but it is usually dose related - if you took them more often you would become tolerant to this side effect. The same cannot be said for the insomnia. Opiates do make most people sleepy but it is a very light sleep and easily disturbed. Addicts refer to this as “nodding”. If you really want some good sleep, it is best to avoid opiates for several hours before bedtime. I am not sure of the mechanisms for these effects but maybe someone else will come along to enlighten us.

There are a couple of other common side effects you didn't mention.  One is an increase in general "itchiness" caused by a release of histamine stimulated by opiates.  Another is constipation caused by a decrease in peristalsis (which, in turn, increases absorption of water from the intestines).  Many people also develop nausea from opiates but this is relieved if the stomach is empty or by sitting or lying still.  

Sorry to hear about the headaches but glad you are able to get relief.  I guess you have to choose between pain and sleep sometimes unless you can get relief from a non-opioid or want to travel down the slippery slope of adding a sleeping pill.

FYI, hydrocodone is not codeine. It’s much stronger than codeine. It’s a semi-synthetic opioid created from codeine and thebaine, both of which are found in opium.

I get the hiccups from hydrocodone too – I’ve heard speculation about how it may stimulate activity in the vagal nerve, but I don’t know if that’s got any research to back it up.

As Little Cloud says, opiates do cause a release of histamines, which can make it harder to fall asleep. Personally, when I have a migraine I can’t sleep without painkillers, but then they make me much easier to wake up too, so there’s definitely a tradeoff.

Thanks for the info. See, all this time I’ve been thinking hydrocodone was just a generic name for codeine. That’s interesting about the histamines too. I haven’t noticed any extra itchiness when I take it, but I do sometimes feel a little flushed now that I think about it.

I’m sorry this is anecdotal. I just finished a big bottle of liquid hydrocodone (Lortab). I had the hiccups something FIERCE. Just want to add that, yes, it opiates cause hiccups.

This was my 3rd time taking codeine and i have killer hiccups… glad I’m not alone!

I’m in heaven…

i take it periodically for degenerative disc disease and tolerate it well. no hiccups for me, but my side effect is even more interesting. the stuff (same dosage as the OP) makes me ITCH…

I think some codeine preparations have promethazine added to reduce the upset to the stomach.

Hydrocodone is the generic name for Vicodin. I took it for a year up to and after a knee replacement. I take it very occasionally now,(the withdrawls are a mother).
I never had hiccups with it, but did experience itching and insomnia.