@loh , like you, I experienced tinnitus while I was on Tymlos. I had been on alendronate for many years (with drug holidays) and never had any ringing in my ears during that time. Last year, while on a drug holiday from alendronate, my doctor prescribed Tymlos. During Tymlos treatment I developed gum infections, among many other side effects, and a periodontist prescribed antibiotics to treat the infections.

The tinnitus began suddenly: after the first day on antibiotics, I woke up around 3:00 a.m. to a very loud ringing in my ears. That intense ringing eventually stopped, but I’ve had persistent, lower‑level tinnitus ever since.

I honestly don’t know which of the three — alendronate, Tymlos, or the antibiotic — or what combination of them contributed to the tinnitus. I only know that the symptom began during that period when all three were part of my medical history.