Many drugs cause side effects, including hearing loss, tinnitus (a sound heard in the ears or head), and balance problems such as dizziness. In fact, there are almost 200 medications linked to hearing loss and balance disorders, according to a review published in the medical journal Pharmacotherapy.
Medically, this is known as ototoxicity (“oto” means ear and “toxic” means harmful). It’s also sometimes referred to as drug-induced 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 types of medications that are linked to ototoxicity.
OTC and prescription pain relievers
Over-The Counter (OTC) pain relievers, such as aspirin, naproxen, and acetaminophen may cause hearing loss and tinnitus, but generally only after prolonged use of high doses.
Opioids
Any of the drugs that belong to the “opioid” class of medications are capable of causing sudden hearing loss and balance problems. This includes medications prescribed by a doctor and illicit drugs, such as Vicodin, Oxycontin, fentanyl, heroin, morphine, and methadone.
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 as aminoglycosides are linked to hearing loss. One of the more commonly used is Cortisporin, and Casporyn HC. Other antibiotic ear drops also contain aminoglycoside ingredients, such as neomycin.
These drugs tend to clear slowly from the fluids in the inner, and have been detected in inner ear fluid months after the final dose was given. 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.
Erythromycin and others
A number of other antibiotics can cause hearing loss, particularly in people with impaired kidney function and/or newborns and children. This includes:
- capreomycin (for drug-resistant tuberculosis)
- erythromycin
- azithromycin
- vancomycin
- tetracycline and related drugs like doxycycline
Chemotherapy drugs
Some cancer drugs can 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.
Hearing loss side effects from these medications include tinnitus, vertigo, temporary or permanent hearing loss. As many as half of all patients who take these drugs experience ototoxicity.
Quinine, chloroquine and hydroxychloroquinenine
Quinine has long been used as an anti-malarial drug and is also used off-label for nocturnal leg cramps. A closely related drug, chloroquine, is also used to prevent and treat malaria. Its cousin, hydroxychloroquine (brand name:Plaquenil) is used to treat autoimmune diseases like lupus. These drugs are known to cause temporary hearing loss and tinnitus, usually after long-term treatment.
High blood pressure drugs
Most blood pressure medications are linked to tinnitus. It isn’t entirely clear why certain blood pressure medications (aka BP meds or antihypertensives) are more likely to provoke tinnitus than others. Some researchers think that tinnitus is caused by a reduction in blood flow to the inner ear, which occurs when blood pressure is lowered by the medications.
Diuretics
Diuretics are used to reduce the amount of fluid in the body and are known to cause hearing loss. Some examples include furosemide (lasix), ethacrynic acid and bumetanide, all of which are known as “loop diuretics”.
Physicians prescribe diuretics to treat a variety of health conditions, including edema and high blood pressure. Sometimes these drugs cause hearing loss and/or tinnitus. It’s thought that loop diuretics can temporarily increase the permeability of the wall of the cochlea, the nerve for hearing, which is a barrier that isn’t usually penetrated by medicine.
The effects tend to be more severe when the drug is given intravenously and/or in combination with other ototoxic drugs.
Some Diabetes drugs
Diabetes is a condition characterized by high blood sugar levels. While diabetes medications do not typically cause ototoxicity, chronic high blood sugar can lead to hearing problems by impairing nerve signaling to the ear.
Viagra and similar drugs
Another drug class associated with a possible risk of hearing loss and/or tinnitus is phosphodiesterase-5 (PDE5) inhibitors, such as sildenafil, more commonly known as Viagra. These drugs are used to treat erectile dysfunction and pulmonary arterial hypertension.
Alcohol and nicotine
While not medications per se, both alcohol and nicotine affect blood flow to the inner ear, and therefore cause hearing problems. Cutting back or stopping altogether will help your hearing.
Drug-Induced Hearing Loss Is Unpredictable
Just because you need to take one of these medications, it does not mean you will lose your sense of hearing. Everyone reacts to medications differently and side effects can range from temporary to permanent hearing loss and/or tinnitus.
Don’t Ignore Sudden Hearing Loss
If you are taking any of these drugs and experience sudden hearing, tinnitus or balance problems, promptly contact your doctor. Do not stop taking your medication without consulting your doctor, but also do not dismiss the seriousness of sudden hearing loss or tinnitus which should be evaluated as soon as possible.
Schedule an appointment with Dr. Elena Maresca today. Visit liaudiology.com or call 631-180-4327 to schedule an appointment and get more information.