Numerous studies have shown that certain medications can cause side effects, including hearing loss, tinnitus, and balance issues. Nearly 200 medications are associated with these issues, indicating a significant concern in pharmaceutical treatment options. This condition, known as ototoxicity, is also commonly identified as drug-induced hearing loss. Hearing loss can manifest as either temporary or permanent, and the severity of both hearing loss and tinnitus may vary considerably based on the selected medication, the prescribed dosage, and the length of treatment. In general, it is important to note that the risk of ototoxicity tends to increase as the drug accumulates in the body.
Drug-Induced Hearing Loss: Common Medications and Ototoxicity
Over-the-Counter Pain Relievers
Over-the-counter (OTC) pain relievers, including aspirin, naproxen, and acetaminophen, have been associated with auditory side effects, such as tinnitus (ringing in the ears) and other hearing issues. This risk is particularly relevant following prolonged use or at high doses. Studies have shown a correlation between the regular use of these medications and an increased likelihood of hearing loss, especially among men under 60. The overall risk is minimal when adhering to the recommended dosage guidelines.
Antibiotics and Aminoglycosides
Antibiotics treat bacterial infections; among these, aminoglycosides are a category noted for the potential risk of hearing loss. These medications are primarily administered intravenously in hospital settings for severe infections when alternative treatments have proven ineffective. Antibiotic ear drops, like Cortisporin and Casporyn HC, contain aminoglycosides and should not be prescribed for a duration exceeding ten days or for patients with perforated eardrums, which may elevate the risk of permanent hearing loss. These medications tend to vacate slowly from the fluids in the ear and have been found in ear fluids months after the medication was ended. It can cause hearing issues long after using the medication, known as delayed-onset hearing loss. It could also make you more susceptible to noise-induced hearing loss.
Erythromycin Antibiotics
Certain antibiotics come with the risk of ototoxicity, particularly among individuals with impaired kidney function, as well as in newborns and children. It is critical to monitor these vulnerable populations closely when prescribing such medications:
• tetracycline and related drugs like doxycycline
• capreomycin (for drug-resistant tuberculosis)
• clarithromycin
• erythromycin
• azithromycin
• vancomycin
Chemotherapy Medications
Certain cancer medications are associated with the risk of hearing loss. One notable example is cisplatin, a platinum-based chemotherapy agent utilized in the treatment of advanced bladder, ovarian, and testicular cancers, among other malignancies. The ototoxic side effects of cisplatin may include tinnitus, vertigo, and both temporary and permanent hearing loss. Research indicates that up to fifty percent of patients receiving this treatment may experience varying degrees of ototoxicity.
Blood Pressure Medication
Certain blood pressure medications have been linked to the occurrence of tinnitus, though this is not true for all such medications. The specific reasons why some antihypertensives are more likely to induce tinnitus remain uncertain. Some researchers propose that tinnitus may be related to diminished blood flow to the inner ear, which can result from lowered blood pressure from these medications.
Diuretics
Diuretics are a class of medications utilized to decrease fluid levels in the body; however, they may also have the potential side effect of hearing loss. Noteworthy examples of loop diuretics include furosemide (Lasix), ethacrynic acid, and bumetanide. Physicians commonly prescribe diuretics for the management of various health conditions, including edema and hypertension. It is important to note that the underlying mechanisms for these effects are not yet fully understood. Studies indicate that loop diuretics may temporarily increase the permeability of the cochlear wall, a structure in the inner ear that generally limits chemical penetration. This effect tends to be more significant when the drug is administered intravenously or combined with other ototoxic agents.
Opiates
Certain medications classified as opioids have the potential to cause sudden hearing loss and balance issues. This includes prescription medications such as OxyContin, morphine, methadone, Vicodin, and fentanyl, as well as illicit substances like heroin. It is crucial to be aware of these risks when prescribing or using these drugs.
The Symptoms and Severity of Ototoxicity Can Vary
It is essential to understand that taking certain medications does not automatically result in hearing loss. Individual responses to medications can vary significantly, and the range of side effects may include temporary tinnitus, hearing loss, or in some instances, permanent hearing damage. Conversely, some individuals may not experience any adverse effects on their hearing.
If you experience sudden changes in hearing or balance while on any medication, it is crucial to contact your healthcare provider promptly. While it is important not to discontinue any medication without consulting your doctor, sudden hearing loss is a severe issue that mandates immediate attention.
