Ototoxic drugs that can cause hearing loss or tinnitus

Posted by Julie, Volunteer Mentor @julieo4, 6 days ago

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.

Great information, Julie. Thank you!

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Merci beaucoup pour l'information
Svp moi je suis devenu sourd lorsque les docteurs ont utilisés de la gantamicine et du cipox pour me traiter une méningite bactérienne qui m'avait conduite dans coma de trois jours, dès lors je suis sourd et j'ai acouphènes très aiguë
Quel traitement thérapeutique peut m'aider à résoudre ce problème.merci

English Translation: thank you very much for the information
Please I went deaf when the doctors used gantamicin and cipox to treat me for bacterial meningitis which had left me in a three day coma, therefore I am deaf and have very acute tinnitus
What therapeutic treatment can help me to solve this problem.Thank you

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Thank you for the information on Tinnitus. I developed severe Tinnitus after being prescribed Neomycin at a very high dose. It's now been about 10 months and I was managing as best I could. I recently had nerve issues and my doctor told me to take 1800mg of Ibuprofen for 4 days. I followed her orders and now my tinnitus has worsened to a level I never thought it could. I stopped the Ibuprofen 2 weeks ago tomorrow. Is there still a chance that it could reverse? I am very frightened at how loud it is and very upset not knowing such a common medication could cause or worsen Tinnitus. Any advice would be greatly appreciated. Thank you.

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What are the antioxidants you can take to help with timnitus? kathleenerushing

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@tykehome

Thank you for the information on Tinnitus. I developed severe Tinnitus after being prescribed Neomycin at a very high dose. It's now been about 10 months and I was managing as best I could. I recently had nerve issues and my doctor told me to take 1800mg of Ibuprofen for 4 days. I followed her orders and now my tinnitus has worsened to a level I never thought it could. I stopped the Ibuprofen 2 weeks ago tomorrow. Is there still a chance that it could reverse? I am very frightened at how loud it is and very upset not knowing such a common medication could cause or worsen Tinnitus. Any advice would be greatly appreciated. Thank you.

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…am curious what the doctor who prescribed this large dose of Ibuprofen has to say …eg why he/she did prescribed so much, has he/she had success with this prescribed dose before, and what is he/she going to do to help you now? Was it a family doctor or an
ENT specialist just curious…. wishing you the best outcome , J.

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@lacy2

…am curious what the doctor who prescribed this large dose of Ibuprofen has to say …eg why he/she did prescribed so much, has he/she had success with this prescribed dose before, and what is he/she going to do to help you now? Was it a family doctor or an
ENT specialist just curious…. wishing you the best outcome , J.

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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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Tinnitus is a topic that HLAA has been included in national convention presentations and webinars over the years. There is some information on the HLAA website; https://www.hearingloss.org/?s=tinnitus For the most part, tinnitus continues to be a mystery when it comes to treatment. This is a huge issue among veterans who return from combat with noise induced hearing loss, and has been discussed a lot in veteran's groups. I wish I had more information to share on this topic.

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@julieo4

Tinnitus is a topic that HLAA has been included in national convention presentations and webinars over the years. There is some information on the HLAA website; https://www.hearingloss.org/?s=tinnitus For the most part, tinnitus continues to be a mystery when it comes to treatment. This is a huge issue among veterans who return from combat with noise induced hearing loss, and has been discussed a lot in veteran's groups. I wish I had more information to share on this topic.

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@julie04 @kittyrushing I found this literature that discusses the role of antioxidants and prevention of hearing loss. It talks about oxidative stress (which happens with aging as our bodies "rust") and the role it plays in causing hearing loss and tinnitus. One of the master antioxidants in the body is glutathione that is used for detoxification. The precursor to that is NAC (N- Acetyl L Cysteine) which will be converted to glutathione. NAC is available as a supplement. The literature discusses other antioxidants as well.

The inner ear has "hair cells" that are actually nerve endings bathed in fluid that receive sound waves and convert them to nerve impulses for hearing. These hair cells are easily damaged or destroyed which causes hearing loss. Loud noises acutally fracture them, and drugs can cause inflammation that damages them. Allergies also increase fluid pressure in the ear and can amplify tinnitus sounds.

Here are some links to literature.
https://clinmedjournals.org/articles/ijnn/international-journal-of-neurology-and-neurotherapy-ijnn-6-083.pdf
Here is another link that discusses Aminoglycoside antibiotics that are known to cause cause hearing loss and discusses protective effects of antioxidants and NAC. Read the section 4.2. Neutralization of Reactive Oxygen Species. It also discusses hearing loss related to formation of compounds with iron and chelation to remove the iron. That caught my attention since my doctor told me my iron levels are too high in my blood.

"Mechanisms of Aminoglycoside Ototoxicity and Targets of Hair Cell Protection"
https://www.hindawi.com/journals/ijoto/2011/937861/

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@jenniferhunter

@julie04 @kittyrushing I found this literature that discusses the role of antioxidants and prevention of hearing loss. It talks about oxidative stress (which happens with aging as our bodies "rust") and the role it plays in causing hearing loss and tinnitus. One of the master antioxidants in the body is glutathione that is used for detoxification. The precursor to that is NAC (N- Acetyl L Cysteine) which will be converted to glutathione. NAC is available as a supplement. The literature discusses other antioxidants as well.

The inner ear has "hair cells" that are actually nerve endings bathed in fluid that receive sound waves and convert them to nerve impulses for hearing. These hair cells are easily damaged or destroyed which causes hearing loss. Loud noises acutally fracture them, and drugs can cause inflammation that damages them. Allergies also increase fluid pressure in the ear and can amplify tinnitus sounds.

Here are some links to literature.
https://clinmedjournals.org/articles/ijnn/international-journal-of-neurology-and-neurotherapy-ijnn-6-083.pdf
Here is another link that discusses Aminoglycoside antibiotics that are known to cause cause hearing loss and discusses protective effects of antioxidants and NAC. Read the section 4.2. Neutralization of Reactive Oxygen Species. It also discusses hearing loss related to formation of compounds with iron and chelation to remove the iron. That caught my attention since my doctor told me my iron levels are too high in my blood.

"Mechanisms of Aminoglycoside Ototoxicity and Targets of Hair Cell Protection"
https://www.hindawi.com/journals/ijoto/2011/937861/

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Thank you so much for your response to my question about antioxidants and their role in helping with tinnitus. I will endeavor to absorb all of the information you sent. So grateful. @kitty rushing

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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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Hello, almost 2 years ago my wife was experiencing similar, siren level tinnitus. It too, was medication induced. In speaking with her, I understand how horrible and scary it is. All I can say is, hang in there, and once the medication can get eliminated from your system, the siren level tinnitus did come down for her. She still experiences lower level tinnitus, mostly at night but it is nowhere near how bad it was 18mons-2 years ago. Now that she knows she is sensitive to medications, she is super cautious of what she takes now.
I hope this gives some hope that it may come down with time.

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@tjadam

Hello, almost 2 years ago my wife was experiencing similar, siren level tinnitus. It too, was medication induced. In speaking with her, I understand how horrible and scary it is. All I can say is, hang in there, and once the medication can get eliminated from your system, the siren level tinnitus did come down for her. She still experiences lower level tinnitus, mostly at night but it is nowhere near how bad it was 18mons-2 years ago. Now that she knows she is sensitive to medications, she is super cautious of what she takes now.
I hope this gives some hope that it may come down with time.

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So happy to hear your wife's tinnitus has lessened; unfortunately for many of us we were never warned that what a dr. was giving us could cause tinnitus… and honestly did we all read those page of information that come with prescription drugs every time? We tend to rely on our doctors or our pharmacists but it is obvious these days with so many medications being given and taken that we have to do our own research.. and even then , as is said, sometimes we have no choice than to take the causing meds to get better, and suffer with perceived noise the rest of our lives…I now have 24/7 and louder all the time… and it doesn't help with depression and all the other things life can bring. It's a long list of things to avoid isnt it? Thanks for providing… J.

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Very good information! Thank you!

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