Medications and Your Hearing

By Stacey Samuels-Cole, AuD

Do you experience a “ringing, buzzing, or cricket-like” sound in either ear? Are you experiencing new symptoms of dizziness or balance issues? Then you may have been exposed to certain medications, which can result in ear poisoning or ototoxicity. Ototoxic medications are by definition those drugs/chemicals that are toxic or poisonous to the hearing and/or balance structures in the ear. The chemicals or drugs can affect the vestibulocochlear nerve, which is responsible for sending information from the balance and hearing systems in the inner ear to the brain.

Auditory side effects from ototoxicity may include tinnitus (ringing, roaring, clicking, banging, buzzing sound in the ear), hyperacusis (a perception of abnormality of loudness), aural fullness, distorted hearing, auditory hallucinations or phantom sounds, and hearing loss. Vestibular side effects may include dizziness, vertigo (spinning), nystagmus, loss of balance/disequilibrium disorder, and oscillopsia (bouncing vision).

Ototoxicity may be reversible or permanent, and symptoms vary from person to person and drug to drug. Symptoms may also be dependent on the duration of treatment or medication use. The six major categories of medications that can be ototoxic and the signs of ototoxicity are

Salicylates Aspirin and aspirin containing products

Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)

Antibiotics Aminoglycosides, Erythromycin, Vancomycin

Loop Diuretics Lasix, Endecrin, Bumex

Chemotherapy Agents Cisplatin, Nitrogen Mustard, Vincristine

Quinine Aralen, Atabrine (for treatment of malaria), Legatrin, Q-Vel Muscle Relaxant (for treatment of night cramps)

The signs of ototoxicity, in order of frequency, are

Development of tinnitus in one or both ears.

Intensification of existing tinnitus or the appearance of a new sound.

Fullness or pressure in the ears other than being caused by infection.

Awareness of hearing loss in an unaffected ear or the progression of an existing loss.

Development of vertigo or a spinning sensation.

If the ototoxicity is not reversed, treatments focus on reducing the effects of the damage and rehabilitation function. People with hearing loss and/or tinnitus may benefit from audiologic treatment, which would include the use of hearing instruments. In the case of balance issues, vestibular rehabilitation therapy has been a great help for many. Therefore, if you've recently noticed the onset of tinnitus or balance/dizziness issues, consult an audiologist. Review your medical history for changes in medications with your primary physician and be sure to read the information from your pharmacist regarding any potential side effects of your medications.