Do medications cause hearing loss (ototoxic drugs)?

Do Medications Cause Hearing Loss (Ototoxic Drugs)?

Yes, certain medications can cause hearing loss, tinnitus (ringing in the ears), or balance problems. These drugs are called ototoxic medications, meaning they are harmful to the ear, particularly the inner ear and auditory nerve. The hearing loss from ototoxic drugs can be temporary or permanent, depending on the medicine, dosage, and duration of use.

How Ototoxic Drugs Affect Hearing

The inner ear contains delicate hair cells in the cochlea that detect sound and help maintain balance. Ototoxic medications may:

• Damage these hair cells, leading to sensorineural hearing loss.

• Affect the auditory nerve, reducing sound transmission to the brain.

• Disturb the inner ear’s balance system, causing dizziness or vertigo.

Common Ototoxic Medications

1. Aminoglycoside Antibiotics (e.g., gentamicin, streptomycin, tobramycin)

   • Often used to treat serious bacterial infections.

   • Can cause permanent hearing loss or balance issues, especially with prolonged use.

2. Chemotherapy Drugs (e.g., cisplatin, carboplatin)

   • Powerful cancer-fighting medicines.

   • Known to cause high-frequency hearing loss and tinnitus.

3. Loop Diuretics (e.g., furosemide, bumetanide)

   • Used to treat high blood pressure and heart/kidney conditions.

   • May cause temporary hearing loss, which usually improves after stopping the drug.

4. Salicylates (High-Dose Aspirin)

   • Large doses can cause tinnitus and reversible hearing loss.

5. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) (e.g., ibuprofen, naproxen)

   • May cause temporary hearing issues at high doses.

6. Antimalarial Drugs (e.g., quinine, chloroquine)

   • In some cases, associated with reversible hearing loss.

Symptoms of Ototoxicity

• Difficulty hearing high-pitched sounds

• Tinnitus (ringing, buzzing, or roaring in the ears)

• Feeling of fullness in the ears

• Dizziness, imbalance, or vertigo

• Sudden or gradual hearing loss

Who Is at Higher Risk?

• Older adults

• Patients receiving high doses or long-term treatment

• People with kidney disease (since the drugs may not clear from the body quickly)

• Those with a family history of hearing problems

Can Ototoxic Hearing Loss Be Prevented?

• Regular hearing tests during treatment help detect early changes.

• Doctors may adjust medication dose or switch to a safer alternative if possible.

• Staying hydrated and monitoring kidney function can reduce risk.

• Informing the doctor immediately if tinnitus or hearing changes occur.

Treatment Options if Hearing Loss Occurs

• If reversible, stopping the medication may restore hearing.

• For permanent damage, hearing aids or cochlear implants can help.

• Balance therapy may be recommended for inner ear–related dizziness.

Conclusion

While life-saving in many cases, certain medications can cause hearing loss or balance problems. This side effect—known as ototoxicity—may be temporary or permanent. With regular monitoring, early detection, and the support of audiologists and doctors, the risks can be minimized, and hearing health can be better protected.