Frequent use of OTC pain relievers linked to tinnitus

New data analysis from the large Nurses’ Health Study II found that women who reported frequent use of certain over-the-counter painkillers were more likely to report a history of tinnitus, as well.

The longitudinal study looked at the overlap between women who take common OTC pain relievers and a history of tinnitus, or ringing in the ears. The pain relievers included aspirin and acetaminophen and other NSAIDs like naproxen. "Frequent use" was defined as taking the medication every day or almost every day. Specifically, the study found:

• Frequent use (6 to 7 days per week) of moderate-dose aspirin was associated with a 16 percent higher risk of tinnitus among women aged younger than 60 but not among older women. However, frequent low-dose aspirin (≤100 mg) was not associated with elevated risk of developing tinnitus.
• Frequent use of NSAIDs or acetaminophen was associated with an almost 20 percent higher risk of developing tinnitus, and the magnitudes of the elevated risks tended to be greater with more frequent use.
• Regular use (two or more days per week) of prescription-only COX-2 inhibitors (such as Celebrex) was associated with a 20 percent higher risk of developing tinnitus as well.

Ototoxic drugs can be harmful to hearing

In a news release about the study findings, the research authors said more study is needed, as the study was not designed to prove whether painkillers caused tinnitus. However, people should still be mindful that all drugs carry side effects.

“OTC analgesics clearly have benefits with short-term use. However, frequent use of these medications and use over long periods of time may increase the risk of tinnitus and may cause other adverse health effects," said lead author Sharon Curhan, MD, ScM, of the Brigham’s Channing Division of Network Medicine. "Therefore, it is important to take these medications mindfully and to limit their use as much as possible, and to discuss any change in medication use, whether prescription or non-prescription, with your health-care provider.”

The study isn't the first to surface a link between common pain relievers and tinnitus. Several other studies have shown that OTC pain relievers may cause hearing loss and tinnitus, but generally only after prolonged use of very high doses. When that happens, the damage is usually reversible after the drugs are stopped. This new study is the first to look at possible medical causes of chronic tinnitus.

Besides pain relievers, there are many other "ototoxic drugs," which means they carry side effects that can trigger or worsen hearing loss, tinnitus and dizziness.

Tinnitus is very common

About 1 in 10 people report frequent tinnitus. The symptoms (or sound) can vary a lot and may come and go. Tinnitus has many potential causes. Some people report their diet worsens their tinnitus, for example. However, most of the time the cause is not known.

One thing that is clear—tinnitus and hearing loss often go hand-in-hand. As the ear's fragile hair cells deteriorate, tinnitus can be more common.

Related:

• What the research says about caffeine, hearing loss and tinnitus
• Treatments for tinnitus: What works?