Ototoxic drugs that can cause hearing loss or tinnitus

Posted by Julie, Volunteer Mentor @julieo4, Apr 30, 2021

It's wise to know that some prescription drugs are known to cause hearing loss and/or tinnitus. There may (or may not) be an alternative when it's prescribed for a serious condition. Some over the counter medications can also be ototoxic. Below is an article that explains more about this. What are your experiences?
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Here's a resource with information about ototoxic medications, along with a list of ototoxic drugs/medications. They are not all prescription drugs; many over the counter medications are on the list.

List of Ototoxic Drugs that Cause Tinnitus

Certain prescription drugs can, over time, have an ototoxic effect on your hearing, causing hearing loss and ear ringing from tinnitus. Ototoxicity may be reversible or may be permanent, depending on the type of medication used, dosage and duration of treatment. There are many medications that have been listed as potentially ototoxic drugs, including antidepressants, antibiotics, and many painkillers.

What are ototoxic drugs?
Ototoxic medications have a toxic effect on the nerve cells of your inner ears. Over time, long-term usage of certain prescription medications can result in tinnitus or hearing loss.

Please speak with your doctor before discontinuing or reducing your intake of any medication.

Here is a list of medications that can potentially cause tinnitus.

Salicylates – Aspirin and aspirin containing products
Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) – Advil, Aleve, Anaprox, Clinoril, Feldene, Indocin, Lodine, Motrin, Nalfon, Naprosyn, Nuprin, Poradol, Voltarin.
Antibiotics – Aminoglycosides, Erythromycin, Vancomycin
Aminoglycosides – Streptomycin, Kanamycin, Neomycin, Gantamycin, Tobramysin, Amikacin, and Netilmicin
Erythromycin – EES, Eryc, E-mycin, Ilosone, Pediazole and new derivatives of Erythromycin, Biaxin, and Zithromax
Vancomycin – Vincocin
Loop Diuretics – Lasix, Endecrin, and Bumex
Chemotherapy Agents – Cisplatin, Nitrogen Mustard, and Vincristine
Quinine – Aralen, Atabrine (for treatment of malaria), Legatrin, and Q-Vel Muscle Relaxant (for treatment of night cramps)

Ototoxic drugs that worsen tinnitus
Many prescription and nonprescription medicines can worsen ringing in the ears (tinnitus).

Starting a new medication or increasing your dose of ototoxic prescription drugs can make symptoms of tinnitus more pronounced.

Medicines that commonly cause tinnitus or make tinnitus worse include some of the following:

Antibiotics
Antidepressants.
Anti-inflammatory medicines
Blood pressure medicine
Heart medicines
Local anesthetic agents
Medicines used to treat cancer
Medicine used to treat Parkinson’s disease
Radiation therapy to the head or neck.
Some vitamins or mineral supplements, such as niacin or vitamin A.
Water pills (diuretics)
The signs of ototoxicity, in order of frequency
Symptoms of ototoxic drug reaction include:

a) Development of tinnitus in one or both ears.

b) Intensification of existing tinnitus or the appearance of a new sound.

c) Fullness or pressure in the ears other than being caused by infection.

d) Awareness of hearing loss in an unaffected ear or the progression of an existing loss.

e) Development of vertigo or a spinning sensation usually aggravated by motion which may or may not be accompanied by nausea.”

It is strongly suggested that if any of these symptoms develop while taking any medication, call your doctor immediately.

Antioxidants help with tinnitus
If you must take ototoxic medications, it is a good idea to also take antioxidants, in order to lower your chances for developing tinnitus.

Interested in more discussions like this? Go to the Hearing Loss Support Group.

@suzanne2951

Hi curious what brand you got - I have been looking into getting a pair but am so confused to what kind to get. I was thinking about the Costco brand. Any recommendations???

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Good evening @suzanne2951
Hi there and welcome to Connect. Thanks for responding to my post about how hearing aids have quieted my tinnitus. Do you have tinnitus? Are you also in need of hearing aids?

Because of the tinnitus, I went to an eye clinic to make sure I got tested correctly by a PhD audiologist and because of the desire to quiet the tinnitus. I also wanted to make sure I had coverage for injury and loss as well as a generous trial period. In addition, I can drop by if I need adjustments or more directional information.

My hearing aids are Signia. And they have all of the add-ons that are desirable including the vacuum cleaner and the telecoils, etc. They also replace my iPods for Zoom, and connect directly for Facetime and phone calls.

Good luck to you. I love how my life has changed now that I have the hearing aids. I no longer have to point to my ear to indicate that I didn't hear someone. I have also tried wearing them all night to keep the tinnitus from interferring with sleep.
Have you already had the hearing tests?

May you have happiness and the causes of happiness.
Chris

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@tykehome

She thought I had a compressed nerve after a blood draw and that the ibuprofen would take down any compression internally on that nerve. I had numbness and weakness in my hand from the band used around the arm and blown vein. She was a NP that I had never seen before. Stopped in just to have it checked out. I had no idea tinnitus could be made worse. I asked my ENT about it last week after the major spike and she was no help. She said that once you have Tinnitus, it can't get worse by a medication. If you don't have Tinnitus, it could cause it but not worsen existing Tinnitus. I beg horribly to differ. She said it was my anxiety. I'm very scared. I had a hard time with the last noise but this is to the point where I feel so out of control and not even sure where to go or what to do.

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I have had severe tinnitus for 3 months now that is blaring loud. The only thing that has brought the noise slightly down is acupuncture for me specifically as I know everyone is different. My heart goes out to you as my doctor also did not tell me that the erythromycin that they had me on was ototoxic. It was given to me as an off label use to help my gastroparesis (slow stomach emptying condition). After 11 days of use I woke up with the sound of a siren in both ears. I find it difficult that tinnitus isn't the center of more research and trials as it is debilitating and takes months to years to habituate to if you do at all. Give acupuncture a try, it takes a few visits but even if it helps reduce it slightly that's better than full volume. I wish medical providers were more educated about the side effects of medications as many of us could have avoided this terrible fate if we were told everything. I hope you find relief in different therapies like acupuncture or tinnitus retraining therapy.

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@lovemydane1

I have had severe tinnitus for 3 months now that is blaring loud. The only thing that has brought the noise slightly down is acupuncture for me specifically as I know everyone is different. My heart goes out to you as my doctor also did not tell me that the erythromycin that they had me on was ototoxic. It was given to me as an off label use to help my gastroparesis (slow stomach emptying condition). After 11 days of use I woke up with the sound of a siren in both ears. I find it difficult that tinnitus isn't the center of more research and trials as it is debilitating and takes months to years to habituate to if you do at all. Give acupuncture a try, it takes a few visits but even if it helps reduce it slightly that's better than full volume. I wish medical providers were more educated about the side effects of medications as many of us could have avoided this terrible fate if we were told everything. I hope you find relief in different therapies like acupuncture or tinnitus retraining therapy.

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So often ototoxic medications are prescribed without any information about potential problems. It's probably in the fine print that comes with the prescription. Oh so difficult for most eyes to read! We want our providers to tell us about side effects, and most of us trust them explicitly and don't ask questions. When we do ask questions, it's easy to offend them.

Of course sometimes we have to accept the consequences of side effects if the prescribed medication is the only possibly remedy for the health issue.

Tinnitus is awful. Hearing aids often help diminish it. How is your hearing? Do you use hearing aids?

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A Dr should never be offended by your asking questions. If so change Drs. It is your decision to make as to whether you can or want to cope w side effects & what other options if any are available. Re:medications Speak w & Ask your pharmacist questions about prescribed or even over the counter medications. I find mine to be well informed. Drugs /meds are their specialty . It’s also impt to Read the disclosure w prescriptions. —this seems overwhelming but it’s in your best interest. -I learned the hard way.

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@willows

I read a lot of comments about metropolol being associated with tinnitus. I was wondering why this is not mentioned in the Mayo Clinic site under possible side effects.

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I would like to know this too! I've been on metropolol for almost 2 years and 6 months ago suddenly lost the hearing in my left ear along with developing severe tinnitus. Never had a doctor tell me, nor have I read or heard about that side affect until just now. Have been thinking my situation was maybe covid related. It does sound like there are many possibilities and or combinations of tinnitus cause, would love to find some real, accurate information! And a doctor that would take a real interest!!

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@snl1

I would like to know this too! I've been on metropolol for almost 2 years and 6 months ago suddenly lost the hearing in my left ear along with developing severe tinnitus. Never had a doctor tell me, nor have I read or heard about that side affect until just now. Have been thinking my situation was maybe covid related. It does sound like there are many possibilities and or combinations of tinnitus cause, would love to find some real, accurate information! And a doctor that would take a real interest!!

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I have the same concerns about the side effects of many medications. Whenever I am prescribed something new, I diligently sit down and read the WHOLE long description of the med that is handed to me with the package. If it is not there, I ask the pharmacist to print it out for me. Some roll their eyes, but they do it - because by law they must.

Then, if I am still concerned about interaction with another medication, or one of the listed side effects, I will use drugs.com - it has a section that reports serious side effects and the statistical likeliness of them and all potential interactions.

So, I did that for metoprolol and found tinnitus listed as a very rare side effect - less than 1 in 10,000 patients. And no listing for hearing loss. There is however, a long list of other medications that can interact with it, including things like ibuprofen and calcium supplements as well as many prescription drugs.

So, what to do now? Review what else is going on in your life, what other meds you take, and maybe consult your doctor?
Sue

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@sueinmn

I have the same concerns about the side effects of many medications. Whenever I am prescribed something new, I diligently sit down and read the WHOLE long description of the med that is handed to me with the package. If it is not there, I ask the pharmacist to print it out for me. Some roll their eyes, but they do it - because by law they must.

Then, if I am still concerned about interaction with another medication, or one of the listed side effects, I will use drugs.com - it has a section that reports serious side effects and the statistical likeliness of them and all potential interactions.

So, I did that for metoprolol and found tinnitus listed as a very rare side effect - less than 1 in 10,000 patients. And no listing for hearing loss. There is however, a long list of other medications that can interact with it, including things like ibuprofen and calcium supplements as well as many prescription drugs.

So, what to do now? Review what else is going on in your life, what other meds you take, and maybe consult your doctor?
Sue

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Thank you. I do use ibuprofen or Tylenol often for arthritis pain, as well as various supplements. I'll go to that site and check on interactions with metropolol.
This has been a frustrating and discouraging journey so far but will definitely keep at it!

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@snl1

Thank you. I do use ibuprofen or Tylenol often for arthritis pain, as well as various supplements. I'll go to that site and check on interactions with metropolol.
This has been a frustrating and discouraging journey so far but will definitely keep at it!

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Maybe also check any other prescriptions you take, like cholesterol medications, for their side effect and interactions?
Sue

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