Tinnitus Guide

Drugs that Cause Tinnitus: REVEALED

Although tinnitus is often caused due to incessant exposure to loud noise, earwax blockage and senility, certain drugs are also responsible for the exasperating racket that goes on in a person’s ears day in and day out. However, the truth was unearthed only in 1944 when Streptomycin was discovered and extensively applied for treating tuberculosis. Apart from the usual side effects that an antibiotic is often associated with, the patients treated with streptomycin demonstrated irreversible cochlear as well as vestibular tribulations. In other words, they suffered from various hearing and vertigo related problems.

Can Prescription Drugs Cause Tinnitus?

Termed Ototoxicity , the dilemma later became evident with the use of other antibiotics belonging to the aminoglycoside group also. What is more, it covered platinum-based chemotherapy medications, quinine, loop diuretics and even the good old salicylates that are commonly used as household medication for treating minor fevers. And almost all of these carry a relatively high degree of toxicity that affects the cochleo-vestibulat system. These ototoxic medications, to be precise, are toxic (harmful) to the cochlea or vestibular (balance) structure in the ear, having the potential to cause loss of hearing, tinnitus as well as dysequilibrium, causing vertigo and related problems.

However, the modus operandi adapted by these medications that are ototoxic in nature vary from drug to drug. The Aminoglycosides appear to activate the cochlea glutamate receptors, promoting degeneration of the hair cells as well as the cochlear neurons. This gives rise to a spill of damage caused to the free radicals that leads to further destruction of the hair cells while the cochlear neurons suffer too.

It may be interesting to note at this juncture that the destruction initially affects the outer hair cells belonging to the inner row and then advances to reach the inner hair cells belonging to the outer rows. Symptoms usually manifest with termination of therapy or immediately thereafter. Hearing problems that are mostly Ototoxicity-induced, it has been observed, tend to manifest first in higher frequencies that cause tinnitus. As it progressively covers frequencies that are lower, voice recognition becomes difficult.

Since chances of ototoxicity becoming reversible is rather low, doctors prescribe antioxidants prior to exposing their patients to ototoxic medications in order to avoid damage to the free radicals that are mostly involved in lost or affected vestibular disturbances or hearing problems in the ear. And it is sensible to protect them beforehand.

However, to end all confusions about the nature and type of ototoxic medication, an eminent Doctor of Medicine have listed six categories of prescription drugs that bear the stamp of ototoxicity and had published the same in the September 1996 issue of Tinnitus Today. For the benefit of readers, this is reproduced here in its original form in order to avoid any medical misrepresentation or factual distortion.

1 – Salicylates – Drugs that cause tinnitus - Aspirin and/or aspirin related drugs.

Consumption of 6 to 8 pills per day triggers toxicity in most patients. However, it is always reversible after medications are stopped.

2 – List Of Drugs That Cause Tinnitus – Anti-Inflammatory Drugs belonging to the Non-Steroidal Group (NSAIDS)

Anaprox, Advil, Aleve, Clinoril, Motrin, Poradol, Indocin, Lodine, Nalfon, Naprosyn, Nuprine, Feldene and a few more. Toxicity is starts with consumption of 6 to 8 pills par day but the effect is reversible after medication is stopped.

3 – Antibiotics – Erythromycin, Aminoglycosides,  Vancomycin. 

a. Aminoglycosides – Neomycin, Streptomycin, Kanamycin, Gantamycin, Tobramysin, Amikacin, Netilmycin. Used intravenously to overcome life-threatening conditions, these medications prove ototoxic. However, regular monitoring of blood level in relation to these may prevent ototoxicity. Also, Gentamycin and Neomycin based topical preparations or eardrops do not have ototoxicity. 

b. Erythromycin – Newer derivatives of this drug variety comprise E-mycin, Eryc, EES, Pediazol, Ilosone, Biaxine, Zithromax. Administered intravenously in dosage measuring 2 to 4 grams every 24 hours, these drugs prove ototoxic. With underlying renal insufficiency, the problem is manifold. However, oral dose not exceeding one gram every 24 hours is not considered ototoxic. No significant ototoxicity record of these newer Erythromycin drug formulations (given in low oral dose) have been reported till now. 

c. Vancomycin – Vincocin. This antibiotic provides similar benefits like the aminoglycosides. Proves potentially ototoxic when administered intravenously to combat dangerous life-threatening infection. Administered usually with aminoglycosides that is likely to increases the level of ototoxicity.

4 – Loop Diuretics – Drugs that cause tinnitus – Endecrin, Bumex, Lasix 

In treating acute kidney failure or severe hypertension, these medications administered intravenously prove ototoxic. However, when orally administered, even in high dosage, ototoxicity rarely comes to the surface. So, people with chronic kidney failure are usually given oral doses instead of through intravenous injections.  

5 – Chemotherapy Agents – Vincristine, Cisplatin, Nitrogen Mustard.

These medications prove ototoxic when used for cancer treatment. However, the effects can be minimized through constant checking of blood level and serial audiograms performed at regular interval. But patients who are already under sundry ototoxic medications like aminoglycosides or loop diuretics, the ototoxicity level may go beyond tolerance.

6 – Quinine – Anti-malarial drugs and drugs that are used to control night cramps (Muscle relaxants. Comprises Atabrine, Aralen, etc. and Legatrin, Q-Vel Muscle relaxant.

With quinine, the ototoxic effects are similar to that of aspirin. However, it is reversible when medication is withdrawn.

The list also includes the symptoms of ototoxicity, as regard to terms of frequency and is described below.

  • Tinnitus occurrence in one or both ears.
  • Appearance of a new sound intensifies existing tinnitus.
  • Barring infection, fullness or pressure felt in the ears.
  • Hearing loss awareness in an unaffected ear or increment of an existing loss.

Thus, we see that there are many drugs that can cause tinnitus . Also, it is necessary to remember that most conventional drugs fail to provide a permanent remedy. That is because, they just aim to suppress the symptoms, without really trying to fix the internal root causes of the problem. Even home remedies and herbal supplements may not give the results always. The right approach is to first find out the real cause of the problem and then fix it, and only then can you hope to get a remedy.

Drugs that Cause Tinnitus

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