Do you ever get a ringing sound in your ears?
Well, a pharmacist has revealed 11 of the common medications that can trigger the uncomfortable sensation known as tinnitus.
The condition, which affects more than 50 million people in the US, is a symptom of several medical conditions like ear injuries, earwax blockage or age-related hearing loss.
Sometimes the noise is present in one or both ears and it is most commonly described as a ringing, but it can also present itself as a range of sounds including buzzing, roaring, and whistling.
While there is no cure, pharmacist Ayesha Gulzar says there are things you can do to reduce its impact, starting with checking what medications you are taking.
She explains: ‘Certain medications cause tinnitus, which can be temporary or rarely permanent and depends on different factors.
‘Common ototoxic drugs (drugs that can have toxic effects on the ears) include antibiotics, analgesics (pain relievers), blood pressure medications, anticonvulsants (anti-seizure drugs), and others.’
First on Ms Gulzar’s list of tinnitus-induced medications is Tylennol (acetaminophen), which is most commonly used to treat minor aches and pains.
She warns that prolonged use of the pain reliever can cause hearing problems.
Research has found the drug can even cause hearing loss in some cases, particularly when used at high doses and in younger individuals.
This is because it can deplete a protective antioxidant within inner ear called glutathione, making the ear more susceptible to damage from noise and other factors.
NSAIDs fall into the same bracket, and Ms Gulzar says aspirin and ibuprofen are the worse offenders for causing temporary tinnitus if used in high doses.
Next up, Ms Gulzar touches on antidepressants. While they are sometimes used to treat tinnitus she says they have ‘also been reported to cause or worsen tinnitus in people with previous symptoms’.
Explaining why this happens, she says: ‘Studies have suggested that serotonin may exacerbate tinnitus.
‘This means that selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant that increases serotonin (a chemical in the brain that regulates various functions such as mood and cognition), could make tinnitus worse.’
Some of the most common tricyclic antidepressants and SSRIs used in treating tinnitus‐related symptoms include Zoloft, Lexapro, and Prozac.
Anti-seizure drugs can have a similar effect on hearing as they can have a direct toxic impact on the inner ear, a phenomenon called ‘ototoxicity,’ which damages the delicate hair cells responsible for hearing.
This can manifest as tinnitus, decreased hearing ability, and balance problems depending on the severity of the damage.
Ototoxicity with antiepileptic drugs (AEDs), Ms Gulzar says, is ’caused by delayed signal transmission between the neurons (cells that transmit signals throughout the body) and neurotransmitters (chemical messengers that carry messages between nerves).
‘These side effects may be temporary, long-lasting, or irreversible.’
Moving on to her next drug to watch out for, Ms Gulzar flags that anti-malarial medications are more likely to cause tinnitus when taken in high doses over a prolonged period.
Short-term use rarely causes tinnitus, but it can occur. The anti-malarial drugs most associated with tinnitus are quinine, hydroxychloroquine (Plaquenil), and chloroquine.
While benzodiazepines such as Xanax and Valium are used to treat several health conditions – including anxiety and panic disorder – they can trigger tinnitus if they are stopped abruptly.
This is because the medications can disrupt the normal neural pathways involved in hearing perception, leading to the perception of ringing sounds in the ears.
This withdrawal symptom is most likely in people who’ve been taking the medications for longer periods of time.
To avoid this side effect, Ms Gulzar says a healthcare provider can help you to taper your dose over weeks or months.
A fair amount of blood pressure medications have also been found to cause temporary or permanent hearing loss and tinnitus.
Ms Gulzar says this is particularly prevalent in older adults and a healthcare provider should be alerted if symptoms develop.
Certain groups of antibiotics also fall into this category, with aminoglycosides – used to treat severe infections in people of all ages – being one of the culprits.
The health expert notes: ‘Aminoglycoside antibiotics are ototoxic drugs that can cause hearing loss.
‘They affect the inner ear, and some people may develop tinnitus. Healthcare providers will closely monitor people taking these drugs to detect any early hearing loss.’
The aminoglycoside drugs carrying a high risk of tinnitus include Amikacin, Neomycin, Kanamycin, Tobramycin.
While they are necessary for cancer treatment, studies have shown that common chemotherapy drugs seem to increase hearing loss in some adults and can lead to permanent damage.
Ms Gulzar explains: ‘Platinum-based drugs, such as cisplatin and, to a lesser extent, carboplatin and oxaliplatin, are the primary chemotherapeutic drugs that can damage the ear.
‘However, taxane drugs (another class of chemotherapy drug) can also affect hearing. Taxane drugs include Taxol (paclitaxel) and Taxotere (docetaxel).’
She highlights one study of 273 individuals, who used both platinum-based and taxane-containing drug regimens and 37 percent to 40 percent of participants went on to develop tinnitus.
The last two medications Ms Gulzar highlights are Isotretinoin (formerly known by the brand name Accutane) is an oral medication used to treat severe acne, and Proton pump inhibitors (PPIs), used to treat and prevent gastric disorders.
She says both groups of medicines can cause tinnitus in rare cases.
‘Ask your healthcare provider about alternative options if you have any symptoms,’ she concludes.
