Drugs that have hearing loss and tinnitus as side effects
Many drugs cause side effects, including hearing loss, tinnitus (ringing in the ears) and balance problems such as dizziness. In fact, there are currently more more than 200 medications linked to hearing loss and balance disorders, according to the American Speech-Language-Hearing Association (ASHA).
Medically, this is known as ototoxicity. ("Oto" means ear and "toxic" means harmful.) It's also sometimes referred to as drug-induced hearing loss.
Medications linked to hearing loss
The severity of the hearing loss and tinnitus can vary widely, depending on the drug, the dosage, and how long you take it. In general, the risk for ototoxicity increases as the drug accumulates in your body. The hearing loss may be temporary or permanent.
Below are some of the more well-known classes of drugs that are linked to ototoxicity. If you are taking any of these drugs and are experiencing hearing or balance problems, promptly contact your doctor. Do not stop taking your medication without guidance from your physician.
Quinine, cholorquine and hydroxychloroquine
Quinine has long been used as an anti-malarial drug. Two synthetic drugs that mimic its structure—cholorquine and hydroxychloroquine—are used off-label for autoimmune diseases like lupus (which can cause hearing loss in and of itself) and nocturnal leg cramps.
In 2020, hydroxychloroquine was approved by the FDA as a short-term emergency hospital-only treatment for children and adults with the coronavirus. (However, the drug's effectiveness and safety are moving targets.)
All of these drugs—and some others—are known to cause temporary hearing loss and tinnitus, usually after long-term treatment, according to the American Academy of Audiology. While rare, some patients who use these drugs have developed hearing loss and tinnitus within days of starting treatment. The good news? The impact is usually temporary and subsides when a person stops taking the drug.
Antibiotics including aminoglycosides
Antibiotics are drugs that are used specifically to treat bacterial infections. There are many different types of antibiotics, but a specific classification of antibiotics known as aminoglycosides are linked to hearing loss. (One of the more commonly used aminoglycosides is gentamicin.) These are mostly prescribed to treat serious infections such as meningitis when other antibiotics haven’t worked. Newborn babies are particularly at risk of hearing damage and should be screened for hearing loss if they receive a large dose.
These drugs tend to clear slowly from the fluids in the inner, and have been detrected in inner ear fluid months after the final dose was given, according to a handout from the Academy of Doctors of Audiology. This means it can cause hearing loss long after the drug was used, known as delayed-onset hearing loss. It may also make you more susceptible to noise-induced hearing loss.
Some cancer drugs cause hearing loss. For example, Cisplatin, which is a platinum-based chemotherapy used to treat bladder, ovarian, and testicular cancers that have spread, as well as some other forms of cancer.
Over-the-counter pain relievers, such as aspirin, naproxen and acetaminophen may cause hearing loss and tinnitus, but generally only after prolonged use of very high doses. These drugs are medically known as both "analgesics" and "non-steroidal anti-inflammatory drugs" (NSAIDs). A study published in The American Journal of Medicine found a correlation between taking these drugs and and increased risk of hearing loss, particularly for men younger than 60 who regularly used NSAIDs. Similar results were found in another study looking at patterns of hearing loss among women who reported taking NSAIDS. If you’re taking daily aspirin or another NSAID recommended by your physician, ask about the hearing loss side effects of the medication. However, keep in mind that the overall risk is low if you're following recommendations about dosing. Using NSAIDs during pregnancy is also linked to an increased risk of congenital hearing loss in newborns.
Diuretics are used to reduce the amount of fluid in the body. Some examples include furosemine, ethacrynic acid and bemetanide, all of which are known as "loop inhibiting diuretics."
Physicians prescribe diuretics to treat a variety of health conditions, including edema, glaucoma and high blood pressure. Sometimes these drugs cause temporary hearing loss and tinnitus, although the reasons why are not well-understood. The effects tend be more severe when the drug is given intravenously and/or in combination with other ototoxic drugs.
In this round-up of 75 different drugs approved for diabetes management, the authors note that about a quarter of the drugs were linked to auditory effects, such as ear congestion. (The good news? Tinnitus was extremely rare.)
Drug-induced hearing loss is unpredictable
Just because you need to take one of these medications doesn't always mean you will lose your sense of hearing. Everyone reacts to medications differently, and side effects can range from temporary tinnitus and hearing loss to permanent hearing damage. Or, in some cases, it could mean no hearing loss at all.
It's best to be prepared with questions for your physician about hearing concerns. If they are prescribing these medications, it's because you have a health condition that requires it and your hearing health is a secondary concern.
What to do if your medication causes hearing loss
If you are experiencing symptoms of hearing loss, and suspect it may be a side effect of medication, contact your physician ASAP.