The Impact of Medications on Hearing

Various medications have side effects that include hearing problems, tinnitus (the experience of ringing in the ears), and equilibrium disturbances like dizziness. The American Speech-Language-Hearing Association (ASHA) has identified over 200 drugs that can potentially impact hearing and balance.

This medical phenomenon is termed ototoxicity, where “Oto” stands for ear and “toxic” indicates harm. It can also be called drug-related hearing loss.

Medications Associated with Hearing Loss

The extent of hearing impairment and tinnitus can differ significantly based on the specific medication, its dosage, and the duration of consumption. Typically, the potential for ototoxic effects grows as the medication builds up in your system. The resulting hearing damage might be either temporary or permanent.

Below are several classes of drugs known to be associated with ototoxicity:

Anti-Malarial Medication

Quinine has a longstanding history of being employed as an anti-malarial medication and is also prescribed off-label for night-time leg cramps. Chloroquine, a drug closely related to Quinine, is used for malaria prevention and treatment. Its counterpart, hydroxychloroquine (under the brand name Plaquenil), addresses autoimmune conditions like lupus, which in some instances can induce hearing loss on its own.

These medications have been recognized for leading to temporary hearing issues and tinnitus, often after extended consumption. In certain cases, individuals on these drugs have experienced hearing loss and tinnitus within a mere few days of starting them. Thankfully, these symptoms typically subside once the medication is discontinued.

Antibiotics

Antibiotics help treat bacterial infections. Some, like gentamicin from the aminoglycosides group, can cause hearing loss. These are primarily administered in medical settings to counteract severe infections like meningitis when other antibiotics prove ineffective. Newborns are especially vulnerable to auditory damage from these drugs, and it’s recommended they undergo hearing checks if exposed to significant doses.

Chemotherapy Medications

Certain drugs used for cancer, like cisplatin, can result in hearing issues. This medication, primarily used for advanced bladder, ovarian, and testicular cancers, can cause side effects such as tinnitus, vertigo, and both temporary and permanent hearing loss. Nearly half of the patients on this medication might face ototoxicity. 

Common Pain Relievers

Regular painkillers, like aspirin, naproxen, and acetaminophen, may cause hearing problems and tinnitus, especially with prolonged, high-dose usage. Research has linked these drugs with an increased risk of hearing issues, more so in men under 60 using them frequently. Women using OTC pain relievers also showed similar patterns. If your doctor recommends daily intake of these medicines, discuss potential hearing risks, but remember that risks are minimal if you adhere to the recommended doses. Using these during pregnancy might also increase the risk of hearing issues in newborns.

Opioids

Medications from the opioid category, whether prescribed like Vicodin, Oxycontin, and Fentanyl, or illicit like heroin and methadone, might cause hearing loss and balance disturbances.

Blood Pressure Medications 

Not all, but some medications for high blood pressure are related to tinnitus. It’s speculated that tinnitus might be an outcome of decreased cochlear blood flow when the medication lowers blood pressure.

Diuretics

Diuretics, used to control body fluid, can affect hearing. Common ones are furosemide (Lasix), ethacrynic acid, and bumetanide. These “loop diuretics” are prescribed for various health issues, including edema and hypertension. The reasons behind their ototoxicity remain unclear, but it’s believed they might temporarily affect the cochlear wall in the inner ear. The impact tends to be more intense with IV administration or when combined with other ototoxic medications.

Unpredictability of Drug-Induced Hearing Loss

Responses to medications are individual, with side effects ranging from temporary hearing issues to permanent damage or no effects at all. If a medication is prescribed, it’s primarily due to its necessity for a specific health condition, and hearing concerns are secondary. Always discuss potential hearing risks with your physician.

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