Drugs That Can Cause Hearing Loss and Tinnitus

Ototoxic Medications:
Drugs That Can Cause Hearing Loss and Tinnitus

Orin S. Kaufman, D.O.
Physician, a volunteer at the League for the Hard of Hearing, and a late-deafened adult.

The importance of compiling and publishing a list of fairly commonly used medications and compounds that can cause either tinnitus and/or hearing loss is self-evident. Usually, these problems are reversible; that is, the hearing change is corrected when the medication is discontinued. But there are still infrequent times when this change can be permanent. If someone is experiencing a hearing problem or if there is a hearing disorder in the family, it is imperative the treating physician be aware of this fact. If a person is prescribed one of the medications found on this list, (s)he should speak to the physician to see if another, potentially less toxic drug could be used in its place.

This information is very important to a physician. Armed with it, (s)he may then be able to prescribe a drug that would have a potentially less toxic effect on hearing. The likelihood of having a problem with hearing from the use of one of these medications is usually extremely small. The drugs with the greatest potential to cause a hearing loss are usually used only in life-threatening situations.

Remember, the physician is the person best qualified to determine which medication is best for you. It is important that (s)he be aware of not only any real or potential problems concerning hearing, but also of any other conditions which may be present that would influence the selection of medication.

In the lists that follow, the generic name of the drug is given first, with the trade name, if available, following in parentheses and capitalized. Also, many times a particular generic drug is produced by different manufacturers with different trade names. The trade names mentioned in this article were selected by the author over other trade names purely by coincidence. The inclusion of a particular trade name and the exclusion of another should not be interpreted as prejudicial either for one nor against the other.

Drugs That Can Cause Hearing Loss


A. Salicylates

1. aspirin and aspirin-containing products
2. salicylates & methyl-salicylates (linaments)

(Toxic effects appear to be dose related and are almost always reversible once medications are discontinued).

B. Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)

1. diclofenac (Voltaren)
2. etocolac (Lodine)
3. fenprofen (Nalfon)
4. ibuprofen (Motrin, Advil, Nuprin, etc.)
5. indomethacin (Indocin)
6. naproxen (Naprosyn, Anaprox, Alleve)
7. piroxicam (Feldene)
8. sulindac (Clinoril)

(Toxic effects are dose related and are almost always reversible once medications are discontinued).

C. Antibiotics

1. aminoglycosides
a. amikacin (Amakin)
b. gentamycin (Garamycin)
c. kanamycin (Kantrex)
d. neomycin (Found in many over-the-counter antibiotic ointments)
e. netilmicin (Netromycin)
f. streptomycin
g. tobramycin (Nebcin)

(Of particular interest is that topical ear drop medications containing gentamycin or neomycin do not appear to be ototoxic in humans unless the tympanic membrane (ear drum) is perforated. When a solution of an aminoglycoside antibiotic is used on the skin together with an aminoglycoside antibiotic used intravenously, there is a risk of an increase of the ototoxic effect, especially if the solution is used on a wound that is open or raw, or if the patient has underlying kidney damage.

Neomycin is the drug that is most toxic to the structure involved in hearing, the cochlea, so it is recommended for topical use only. But even topical therapy has resulted in hearing loss when large areas were treated which allowed for large amounts of the drug to be absorbed into the body. Hearing loss caused by this class of antibiotics is usually permanent).

2. erythromycin

a. EES
b. E-mycin
c. Ilosone
d. Eryc
e. Pediazole
f. Biaxin
g. Zithromax

(Usually ototoxic when given in intravenous doses of 2-4 grams per 24 hours, especially if there is underlying kidney failure).

3. vancomycin (Vancocin) (Similar to aminoglycosides in that it may be ototoxic when used intravenously in life- threatening infections. To further exaggerate the problem is the fact that aminoglycosides and vancomycin are often used together intravenously when treating life-threatening infections).
4. minocycline (Minocin) (Similar to erythromycin).
5. polymixin B & amphotericin B (Antifungal preparations).
6. capreomycin (Capestat) (Anti-tuberculosis medication).

D. Diuretics

1. bendroflumethazide (Corzide)
2. bumetadine (Bumex)
3. chlor-thalidone (Tenoretic)
4. ethacrynic acid (Edecrin)
5. furosemide (Lasix)

(These are usually ototoxic when given intravenously for acute kidney failure, acute hypertensive crisis, or acute pulmonary edema/congestive heart failure. Rare cases of ototoxicity have been found when these medications are taken orally in high doses by people with chronic kidney disease).

E. Chemotherapeutic Agents

1. bleomycine (Blenoxane)
2. bromocriptine (Parlodel)
3. carboplatinum (Carboplatin)
4. cisplatin (Platinol)
5. methotrexate (Rheumatrex)
6. nitrogen mustard (Mustargen)
7. vinblastin (Velban)
8. vincristine (Oncovin)

(The ototoxic effects can be minimized by carefully monitoring blood levels).

F. Quinine

1. chloroquine phosphate (Aralen)
2. quinacrine hydrochloride (Atabrine)
3. quinine sulfate (Quinam)

(The ototoxic effects are very similar to those of aspirin).

G. Mucosal Protectant

1. misoprostol (Cytotec)

Drugs That Can Cause Tinnitus

This list of drugs is very similar to the list of ototoxic drugs that can cause hearing loss. There are some notable additions to the previous list.

A. Vapors, Solvents

1. cychohexane
2. dichloromethane
3. hexane (gasoline)
4. lindane (Kwell)
5. methyl-chloride
6. methyl-n-butyl-ketone
7. perchlor-ethylene
8. styrene
9. tetrachlor-ethane
10. toluol
11. trichloroethylene

B. Antibiotics

1. aminoglycosides (see previous section)
2. amphotericin B
3. chloramphenicol (Chloromycetin)
4. minocycline (Minocin)
5. polymyxine B
6. sulfonamides (Septra, Bactrim)
7. vancomycin (Vancocin)

C. Anti-Neoplastics

1. bleomycin (Blenoxane)
2. cis-platinum (platinol)
3. carboplatinum (Paraplatin)
4. methotrexate (Rheumatrex)
5. nitrogen mustard (Mustagen)
6. vinblastin (Velban)

D. Diuretics

1. acetazolamide (diamox)
2. bumetanide (Bumex)
3. bendrofluazide
4. clorothalidone (Hygroton, Tenoretic)
5. diapamide
6. ethacrynic acid (Edecrin)
7. furosemide (Lasix)
8. hydrochlorthiazide (Hydrodiuvil)
9. methylchlorthizide (Enduron)

E. Cardiac Medications

1. celiprolol
2. flecainide (Tambocar)
3. lidocaine
4. metoprolol (Lopressor)
5. procainamide (Pronestyl)
6. propranolol (Inderal)
7. quinidine (Quinaglute, Quinidex)

F. Psychopharmacologic Agents

1. amitryptiline (Elavil)
2. benzodiazepine class
a. alprazolam (Xanax)
b. clorazepate (Tranxene)
c. chlordiazepoxide (Librium)
d. diazepam (Valium)
e. flurazepam (Dalmane)
f. lorazepam (Ativan)
g. midazolam (Versed)
h. oxazepam (Serax)
i. prozepam (Centrax)
j. quazepam (Doral)
k. temazepam (Restoril)
l. triazolam (Halcion)
3. bupropion (Welbutrin)
4. carbamzepine (Tegretol)
5. diclofensine
6. doexpin (Sinequin)
7. desiprimine (Norpramin)
8. fluoxetin (Prozac)
9. imipramine (Tofranil)
10. lithium
11. melitracen
12. molindon (Moban)
13. paroxetin
14. phenelzin (Nardil)
15. protriptilin (Vivactil)
16. trazodon (Desyrel)
17. zimeldin

G. Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)

1. asprin
2. acematacine
3. benorilate
4. benoxaprofen
5. carprofen
6. diclofenac (Voltaren)
7. diflunisal (Dolobid)
8. fenoprofen (Nalfon)
9. feprazon
10. ibuprofen (Motrin, Advil, Nuprin)
11. indomethacin (Indocin)
12. isoxicam
13. ketoprofen (Orudis)
14. methyl salicylates (BenGay)
15. naproxen (Naprosyn, Anaprox, Alleve)
16. D-Penicilliamin
17. phenylbutazone (Butazolidine)
18. piroxicam (Feldene)
19. proglumetacin
20. proquazon
21. salicylates
22. sulindac (Clinoril)
23. tolmetin (Tolectin)
24. zomepirac

H. Glucocorticosteroids

1. prednisolone (Prednisone)
2. ACTH (adrenocorticotrophic hormone) (Acthar)

I. Anesthetics

1. bupivacain
2. tetracain
3. lidocaine (Novacaine)

J. Antimalarials

1. chloroquine (Aralen)
2. hydroxychloroquine (Plaquinil)

K. Miscellaneous Toxic Substances

1. alcohol
2. arsenum
3. caffeine
4. lead
5. marijuana
6. nicotine
7. mercury
8. auronofin (gold), (Ridaura)

Ironically, several of these drugs found to cause tinnitus are also used to treat tinntus (e.g. amitryptiline, benzodiazepine class, carbamzazpine, furosemide, lidocaine, prednisone).

Interesting compilation--am sure some members here in AD can appreciate seeing this list. However, not to alarm anyone, I'm sure it can be added that all that is listed, it doesn't say how much, what percentage used, etc., that would make it more significant and likely to attribute to such loss.

Bottom line: Your own physician is more knowledgeable with these and more--and evidently knows what to prescribe for his/her patients.

Otherwise, it is still an interesting article.





~RR

I find one of drug I am taking on the list. Interest here. Thanks for post.

WOW Everything but the kitchen sink on that list.I also recall Vicodin being blamed for Rush Limbaugh's deafness .The eardrops I was using for the ear infection I had had the pamphlet left in it and said may cause cochlear damage if used for more than 10 days.Need that like a hole in the head(excuse the pun)Im sure the pharmicist wouldnt have mentioned that.Well, I just found out my Mom had taken some sort of Quinine drug when she was pregnant with me and I looked up the side effects. Surprise everything I have. It was the 60's back then I think they thought it was all right to drink and smoke.i have stopped taking aspirin myself and have noticed a difference in the loudness of the ringing and not quite as much hearing fluctuations.

Roadrunner said:

Interesting compilation--am sure some members here in AD can appreciate seeing this list. However, not to alarm anyone, I'm sure it can be added that all that is listed, it doesn't say how much, what percentage used, etc., that would make it more significant and likely to attribute to such loss.

Bottom line: Your own physician is more knowledgeable with these and more--and evidently knows what to prescribe for his/her patients.

Otherwise, it is still an interesting article.

RR,

I debated whether or not I should post this, but thought the information might be helpful to other ADers. I'm glad you added a notation about the fact that the article does not indicate how much of a given drug causes hearing loss and/or tinnitus and the fact that your doctor knows how much to prescribe for you.

I hope I haven't alarmed anyone and hope the article was helpful just the same.

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e

Hear Again Im really glad you posted it and Im going to keep it for a reference.With my hearing fluctuation it really makes a difference on what I take so I thank-you. Tami

jazzy and Tami,

I'm glad you found the article useful!

Tami, in regards to your comments...I was born prematurely and was given ototoxic drugs and antibiotics while in the neonatal ICU. Until my initial CI evaluation I never knew ototoxic drugs, antibiotics and prematurity caused my progressive hearing loss. I also didn't know that many years of untreated allergies was also a factor.

Fortunately, they know more about the causes of hearing loss today than they did back in the 60s and 70s. Infants are also given hearing screenings -- something that wasn't done back then.

Interesting thread. I didn't know that drugs also cause hearing loss and tinnitus. Thank you for share thread here which is good education for us.

Many people including 2 policemen, I met at Spa resort last year, they suffers hearing loss and tinnitus. They shared their stories with us and said that loud music and noise in companies, stress cause hearing loss and tinnitus.

Hear Again, yes very helpful!

TAMI SAM said:

Hear Again Im really glad you posted it and Im going to keep it for a reference.With my hearing fluctuation it really makes a difference on what I take so I thank-you. Tami

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The specialists say they strongly believe that my son has a fluctuating hearing loss. The reason they think that is cuz he responds to loud noises at times and other times he doesnt even flinch. Does the same happen with u regarding to loud and sudden noises?

Thanks for the post Hear Again...nice to be aware of this issue.

shel90 said:

The specialists say they strongly believe that my son has a fluctuating hearing loss. The reason they think that is cuz he responds to loud noises at times and other times he doesnt even flinch. Does the same happen with u regarding to loud and sudden noises?

Thanks for the post Hear Again...nice to be aware of this issue.

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Hi everyone,

I'm glad you found the article helpful!

shel90,

Given what you've described, I wonder if your son could have auditory neuropathy? I know some children with AN can respond to sounds one minute and act as if they don't hear them the next. Their hearing loss can also fluctuate from mild to profound. If you'd rather not answer, I respect your privacy. Otherwise you can send me a PM if you wish.

Hear Again: Thanks very much for posting this.

I know all too well about drugs and averse reactions to them. My friend Nikki died due to the drug she took for her Arthritis. It was the year after she had a CI. It was really sad as her CI was very successful. She could even hear tapes. Also like you she was totally deafblind before she had the CI.

dreama said:

Hear Again: Thanks very much for posting this.

I know all too well about drugs and averse reactions to them. My friend Nikki died due to the drug she took for her Arthritis. It was the year after she had a CI. It was really sad as her CI was very successful. She could even hear tapes. Also like you she was totally deafblind before she had the CI.

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dreama,

Oh, I'm so sorry to hear that! If only drug manufacturers could do something to minimize the potential risks associated with taking some of these drugs. I'm on several medications myself and whenever a dosage or med is changed, I'm always thinking about what the consequences will be. I try to educate myself about the meds that are prescribed to me, but one can only do so much...

Hear Again said:

dreama,

Oh, I'm so sorry to hear that! If only drug manufacturers could do something to minimize the potential risks associated with taking some of these drugs. I'm on several medications myself and whenever a dosage or med is changed, I'm always thinking about what the consequences will be. I try to educate myself about the meds that are prescribed to me, but one can only do so much...

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Thanks Hear again.

It's best, if you can help it, to avoid newer drugs and try taking the ones that have been on the market for at least 10 years.

Sometimes doctors can be a little too quick to provide drugs. I used to be on a pain killer called Co Proximol but I think it's been taken off the market now. I took it when I started having problems with my hearing aids causing migranes and I was also in an abusive relationship at the time so that sure didn't help. Fortunately the drug didn't cause me any damage so I was lucky there.

I try to avoid taking medicine when I can help it. I now only liquid thyroxine which I've been taking since I was 8 months old. I used to take tegretol (for epilepsy) but stopped last year. I was worried about stopping before that but my dad who has a heart condition doesnt take any of his prescribed drugs. I worried a lot about his decision but he is still alive and well and this is over a year ago, so I thought I'd try come of tegretol and see what happened. It was easier then I thought.

dreama,

Unfortunately, I need to be on all of the medications I take. One of them is for migraines (Imitrex) and the others are for conditions that can only be controlled by medication.

Having said that, I won't take any medication unless it's absolutely necessary.

I definitely agree with you about doctors pushing meds too often. It also doesn't help that every other commercial on TV is an advertisement for the latest and greatest pharmaceutical.

Hear Again said:

dreama,

Unfortunately, I need to be on all of the medications I take. One of them is for migraines (Imitrex) and the others are for conditions that can only be controlled by medication.

Having said that, I won't take any medication unless it's absolutely necessary.

I definitely agree with you about doctors pushing meds too often. It also doesn't help that every other commercial on TV is an advertisement for the latest and greatest pharmaceutical.

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I understand. I found I couldn't come off Thyroxine. It made me ill when I tried. I also had to take pain relief when I had tooth ache and also when I had an ear infection. Unfortunately I had an alergic reaction to one of the drugs I was given for the ear infection. I think because it contained lactose and I am lactose intolerant. I was hoping the doctor would give me pain relief by injection until my stomach settled down but he wouldn't even though my ear infection was causing a lot of pain.

Hear Again,
Thanks for sharing this. I'm taking one drug from this list. I had no idea but .. my tinnetus has been ongoing many years prior before taking this medication.

How can anyone take an asprin a day for heart attack prevention? Also, doesn't asprin give stomach aches? I can not tolerate asprin.

Thanks for the info. We all need to be well informed regarding these things.

Aspirin is taken one a day for heart problems, because it has the side effect of thinning the blood. One a day would not be enough to cause hearing problems.

And yes, it can cause ulcers over a period of time. Most physicians reccommend that you take a coated aspirin if you are taking frequent doses to help prevent stomach problems.