How Medications Can Cause Tinnitus

how medications can cause tinnitus

The connection between certain drugs and development of tinnitus is truly alarming, as almost four hundred pharmaceutical products can potentially lead to this condition. But before we jump to specific names it is essential to understand why this number is so gargantuan and how medications can cause tinnitus at all.

The good news is that if your ringing in the ears is caused by a drug, it’s very likely to subside once you stop taking the culprit. Excited? Let’s move on!

How can medications cause tinnitus?

As a rule, tinnitus is caused by drugs that exhibit significant ototoxic effects, meaning that they can seriously damage the nerves that take part in the process of auditory perception.

This can happen in the following cases:

  • High-dose treatment (e.g., antibiotics for life-threatening infections)

  • Prolonged treatment (quinine for the treatment of malaria)

  • Impaired excretory or detoxifying function of the body (for example, during kidney or liver failure)

The same thing happens in every one of the described scenarios: the amount of the medication circulating in the patient’s body reaches a point after which it starts damaging the nerves responsible for the perception of sound. Naturally, there’s just one solution to this problem.

The use of the drug in question should be stopped immediately, excluding those cases in which taking the medication is a matter of life and death (like antibiotics during severe sepsis).

After all, it’s better to live with crickets chirping in your ears than to not live at all.

What are the most common drugs that can cause tinnitus?

More than two decades ago Stephen Epstein, MD, published an article named What You Should Know About Ototoxic Medications in the September issue of Tinnitus Today. He divided all ototoxic drugs into 6 major groups, and this classification has become a classic.

The vast majority of modern drugs that may lead to hearing loss and tinnitus fall into one of the following categories:

  1. Salicylates (drugs derived from salicylic acid)

how medications can cause tinnitusAspirin is the most common culprit in this group, but it has an ototoxic effect only when taken in exceptionally high doses (more than 6 pills per day), for example, for the treatment of severe autoimmune diseases. Whenever possible, opt for an alternative medication.

  1. Non-steroidal anti-inflammatory drugs (NSAIDs)

Ibuprofen (Advil, Motrin, Nuprin), naproxen (Aleve, Anaprox), sulindac (Clinoril), piroxicam (Feldene), indomethacin (Indocin), etodolac (Lodine), fenoprofen (Nalfon), naproxen (Naprosyn), paracetamol (Paradol), diclofenac (Voltaren) – these are the most commonly used NSAIDs, also known as non-prescription painkillers. They are used for a wide variety of conditions, including inflammatory processes and pain in general. Toxic effects take place when these medications are taken in unusually high doses (again, more than 6 pills per day).

  1. Antibiotics

The most dangerous antibiotics in terms of ototoxicity are medications from the aminoglycosides (gentamicin, streptomycin, kanamycin, tobramycin, amikacin) and macrolides (erythromycin) groups, plus vancomycin (a glycopeptide antibiotic). Aminoglycosides are administered mainly through injections for the treatment of life-threatening infections, and doctors are usually well-aware of the possible ototoxic effect. In which cases it is a necessary risk, and the amount of the drug in the patient’s bloodstream is closely monitored at all times to prevent overdose and subsequent ototoxicity. But sometimes aminoglycosides are present in ear drops for the treatment of ear infections, and this could be a potential risk. Whenever possible, try to avoid such medications, especially as there are quite a few natural and safe ways to treat ear infections at home (confirmed by science, of course).

  1. Water pills (loop diuretics)

Furosemide (Lasix), etacrynic acid (edecrin), and bumetanide (bumex) are all bright examples from this group of medications. As a rule, they impose an ototoxic effect when administered intravenously during kidney failure. Ototoxicity after oral ingestion of diuretics is rare, but still possible, especially as some excessively arduous dieters tend to abuse water pills to lose weight. Luckily, the damage is usually reversible.

  1. Chemotherapeutic drugs (cytotoxic medications)

Drugs from this pharmaceutical group are crucial for the survival of thousands of cancer patients all around the world, but it is important to be aware of the risks related to them. Cisplatin, carboplatin, mechlorethamine (nitrogen mustard), vincristine and many other chemotherapeutic agents can lead to hearing loss and tinnitus if taken in high doses, especially when the same patient receives another ototoxic drug from another group (like an aminoglycoside antibiotic or a loop diuretic). Almost 47% patients on chemotherapy develop tinnitus, and the damage is often irreversible.

  1. Antimalarial drugs

Namely quinine, one of the oldest medications in this group. Tinnitus associated with this drug has been deemed a common side effect for more than 30 years. Although modern antimalarial medications usually do not have ototoxic effects, quinine is still widely used in those countries where alternative drugs are extremely expensive. Tinnitus usually subsides after cessation of quinine intake.

So where are the 300+ other drugs that may cause tinnitus?

And why are there so many of them anyway?

According to the British Tinnitus Association, if a single patient comes to his or her Doctor tinnitus and tells him that he or she had started suffering from ringing in the ears after the beginning of treatment with a certain drug, the doctor is obliged to report this to a special organization that keeps tracks of all side effects of all drugs in existence.

And then tinnitus is listed in the side effects section of the medication’s official instruction, even if it’s just a single case in 100,000. In other words, there are almost four hundred drugs that have caused ringing in the ears in certain people at a certain point, but this is far from being a scientifically confirmed association.

Contrary to the little big dangers listed above. Those are real, so stay alert!

By no means do I imply that NSAIDs and antibiotics are a universal evil, no. These (and many other) drugs have saved millions of lives throughout human history, and this is fantastic.

And yet I want to highlight the importance of responsible approach in matters of prescribing AND taking these medications. You never know what they may cause in your specific case, so don’t take the risk.

Whenever possible, opt for something safer and more natural.

Stay healthy and take care!

If you found this article helpful in any way or if you have any questions, please leave a comment in the section below and I will respond at the soonest opportunity.

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  1. Having forever suffered from blocked ears, this has been a good read. What is interesting in my case is that it is always both ears at the same time, never just one. Any idea what you think this could be?

    • Hi kevin, thanks for you question. I have suffered lots from blocked ears as well but it is difficult for me too suggest what could be the cause of your blocked ear problem without knowing the symptoms. If you have had tinnitus, caused by block ears, it could be from a ear infection. In this case I would recommend using garlic oil but I will provide you with a link to another one of my post’s that can hopefully answer you question.

  2. That was very interesting, thanks a lot. I happen to have tinnitus, but I believe it’s caused by allergies in my case. In fact, when I eat sugary things, the ringing gets stronger, and it can get really loud at night when I’m lying on my bed.

    I stopped antihistamines because of brain fog, but do you think antihistamines could trigger tinnitus? I have been taking these drugs for a very long time (maybe 20 years now).

    Thanks for this information anyway!

    • Hi Dan, I do believe that antihistamines could be triggering your tinnitus. There are always potential side effects to medications that we take and I would always encourge people to try and find a natural remedy. Stinging nettles can be used as a natural antihistamine, don’t worry you dont need to pick them as they can be found online or in health stores.

      Also you mentioned how you think sugar can make the ringing in your ears worse and you are right in thinking that, as our diet can have an effect on tinnitus. I will put a link to another one of my articles in which I provide a couple of dietary suggestions that can really help in reducing the ringing your ears. Hope this helps.


  3. I have certainly learned something from reading your article about Tinnitus and my interest was peaked as I suffer from it, but not sure why.
    Personally, I stay away from medications and prefer alternative herbal remedies which work much better.
    Thank you for your most informative expose on the topic.
    Much appreciated!

    • Thank you for your comment Edu, it’s a shame you don’t know what’s causing your tinnitus. Tinnitus is normally a symptom caused by another condition and by finding the source of the original problem you can help to stop the tinnitus. It’s good to hear that you try a more natural approach, I believe that this is more beneficial to your health in the long term.

  4. I had no idea that tinnitus was such an issue with different drugs. I am glad I learn so much on the web. I am also all about taking something natural instead of drugstore any condition. Always the best course of action.

    • Thanks for commenting Brent, most people don’t really think about the side effects of the medication they are taking. Although it may be helping one problem, it can also be causing another that can be much worse. Yes, trying a natural remedy should always be the first line of defence as it doesn’t come with the terrible side-effects that most drugs do.

  5. When you hear about all of the side effects of many drugs, including the ills of tinnitus, you have to wonder if we, as a society, have become overly dependent on OTC medicine. What about natural living? Have we forgotten that our Planet has everything we need to take care of us? Often times, I’d be watching the television at night and all of these ads come on about this or that drug. And most of the ad is spent warning about the side effects. It makes you wonder if medicine is for creating well being or are more harmful to us. Just saying.

    • I believe you are absolutely right Kevon, we are as a society becoming over dependent on these drugs available to us so easily. I think that there are some pharmaceutical companys that do think medicine is for creating but for money rather than well being. Most people will know of someone that is on a cocktail of drugs, each one trying to counter another ones side effects. Anyway thanks for commenting Kevon and I hope you enjoyed this article.

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