OTOTOXIC MEDICATIONS LIST

The following lists of medications have been linked to or known to cause deafness or tinnitus in some people or aggravate an existing hearing problem. Generally hearing problems due to such medications will be caused when the recommended dosage is exceeded. Most of the hearing problems are reversible when ototoxic drugs are discontinued, but sometimes they can cause permanent damage. It is advised to consult your doctor if you are unsure about your drug’s ototoxicity or if you happen to experience any changes in your hearing.

_Hearing Loss Medicines (Drugs)_

Salicylates

  • Aspiring and aspiring containing products
  • Salicylagtes and methylsalicylates (linaments)

Toxic effects on the hearing are mostly related to dosage and hearing resumes to normal once the medications are discontinued.

Chemotherapeutic Agents

  • Bleomycine (Blenoxane)
  • Carboplatinum (Carboplatin)
  • Bromocriptine (Parlodel)
  • Nitrogen mustard (Mustargen)
  • Vinblastine (Velban)
  • Cisplatin (Platinol)
  • Methotrexate (Rheumatrex)
  • Incristine (Oncovin)

The effects of medication can be minimized or controlled by carefully monitoring blood levels

Antibiotics

Aminoglycosides

  • Amikacin (Amakin)
  • Gentamycin (Garamycin)
  • Kanamycin (Kantrex)
  • Neomycin (Found in many over the counter antibiotic ointments)
  • Netilmicin (Netromycin)
  • Streptomycin
  • Tobramycin (Nebcin)

Use of aminoglycoside antibiotic on the skin along with intravenous use of aminoglycoside antibiotic increases the risk of ototoxic effect, especially if the patient has underlying kidney issues, or if the solution is applied on the wound that is open or raw. Neomycin drug is most toxic to cochlea (inner structure of ear), so it is recommended for topical use only. Sometime even the topical therapy results in hearing loss, especially when broad areas were treated which allowed for large amounts of drug to be absorbed into body. Hearing loss caused by such antibiotics is usually permanent.

Erythromycin

  • (EES)
  • (E-mycin)
  • (Ilosone)
  • (Eryc)
  • (Pediazole)
  • (Biaxin)
  • (Zithromax)

These medications are generally ototoxic when they are delivered intravenously, 2-4 grams per 24 hours, and especially when the patient has an underlying kidney failure

Vancomycin (Vancocin)

  • (EES)
  • (E-mycin)
  • (Ilosone)
  • (Eryc)
  • (Pediazole)
  • (Biaxin)
  • (Zithromax)

These medications are generally ototoxic when they are delivered intravenously, 2-4 grams per 24 hours, and especially when the patient has an underlying kidney failure

  • Minocycline (Minocin) (Similar to erythromycin)
  • Polymixin B & amphotericin B (Antifungal preparations)
  • Capreomycin (Capestat) (Anti-tuberculosis medication)

Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)

Most NSAID drugs have potential to cause hearing problems and/or tinnitus. It is strongly advised to consult your doctor or pharmacist to determine if the drug you were prescribed can cause hearing problems.

  • Dicofenac (Voltaren)
  • Etocolac (Lodine)
  • Fenprofen (Nalfon)
  • Ibuprofen (Motrin, Advil, Nuprin, etc.)
  • Indomethacin (Indocin)
  • Naproxen (Naprosyn, Anaprox, Aleve)
  • Piroxican(Feldene)
  • Sulindac (Clinoril)

Toxic effects on the hearing are mostly related to dosage and hearing resumes to normal once the medications are discontinued.

Mucosal Protectant

  • Misoprostol (Cytotec)

Diuretics

  • Bendroflumethazide (Corzide)
  • Bumetadine (Bumex)
  • Chlor-thalidone (Tenoretic)
  • Ethacrynic acid (Edecrin)
  • Furosemide (Lasix)

Diuretics are usually ototoxic when they are given intravenously to the patients for acute kidney failure, acute hypertensive crisis or pulmonary edema/congestive heart failure. Though rare, but when high dosage of these medications are taken orally by people with chronic kidney disease it can cause ototoxicity.

Quinine

  • Chloroquine phosphate (Aralen)
  • Quinacrine hydrochloride (Atabrine)
  • Quinine sulphate (Quinam)

Toxic effects on the hearing are mostly related to dosage and hearing resumes to normal once the medications are discontinued.

Narcotic Analgesics

  • Hydrocodone (Lorcet, Vicodin)

_Tinnitus causing Medications (Drugs)_

Antibiotics

  • Aminoglycosides (see earlier section)
  • Polymyxine B
  • Amphotericin B
  • Chloramphenicol (Chloromycetin)
  • Sulfonamides (Septra, Bactrim)
  • Vancomycin (Vancocin)
  • Minocycline (Monocin)

Cardiac Medications

  • Celiprolol
  • Lidocaine
  • Flecainide (Tambocar)
  • Procainamide (Pronestyl)
  • Metoprolol (Lopressor)
  • Quinidine (Quinaglute, Quiniedex)
  • Propranolol (Inderal)

Glucocorticosteroids

  • prednisone (Deltasone)
  • prednisolone (Prelone)
  • ACTH (adrenocorticotrophic hormone) (Acthar)

Antimalarials

  • Chloroquine (Aralen)
  • Hydroxychloroquine (Plaquinil)

Anesthetics

  • Upivacain
  • Tetracain
  • Lidocaine (Novacaine)

Vapors, Solvents

  • Cyclohexane
  • Dichloromethane
  • Lindane (Kwell)
  • Methyl-n-butyl-ketone
  • Methyl-chloride
  • Styrene
  • Trichloroethylene
  • Hexane (gasoline)
  • Perchlor-ethylene
  • Tetrachlor-ethane
  • Toluol

Non-Steroidal Anti-inflammatory Drugs (NSAIDS)

As mentioned earlier, NSAID drugs have potential to cause hearing problems and/or tinnitus. It is strongly advised to consult your doctor or pharmacist to determine if the drug you were prescribed can cause hearing problems.

  • Aspirin
  • Acematacine
  • Benorilate
  • Benoxaprofen
  • Carprofen
  • Diclofenac (Voltaren)
  • Diflunisal(Dolobid)
  • Fenoprofen (Nalfon)
  • Feprazon
  • Ibuprofen (Motrin, Advil, Nuprin)
  • Indomethacin (Indocin)
  • Isoxicam
  • Ketoprofen (Orudis)
  • Methyl salicylates (BenGay)
  • Naproxen (Naprosyn, Anaprox, Aleve)
  • D-Penicilliamin
  • Phenylbutazone (Butazolidine)
  • Piroxicam (Feldene)
  • Proglumetacin
  • Proquazon
  • Rofecoxib (Vioxx)
  • Salicylates
  • Sulindac (Clinoril)
  • Tolmetin (Tolectin)
  • Zomepirac

Psychopharmacologic Agents

  • Amitryptiline (Elavil)
  • Diclofensine
  • Benzodiazepine class
    • Alprazolam (Xanax)
    • Clorazepate (Tranxene)
    • Midazolam (Versed)
    • Lorazepam (Ativan)
    • Chlordiazepoxide (Librium)
    • Diazepam (Valium)
    • Temazepam (Restoril)
    • Flurazepam (Dalmane)
    • Oxazepam (Serax)
    • Prozepam (Centrax)
    • Quazepam (Doral)
    • Triazolam (Halcion)
  • Buptopion (Welbutrin)
  • Carbamazepine (Tegretol)
  • Melitracen
  • Protriptilin (Vivactil)
  • Doxepin (Sinequin)
  • Desiprimine (Norpramin)
  • Lithium
  • Fluoxetin (Prozac)
  • Imipramine (Tofranil)
  • Molindon (Moban)
  • Paroxetin
  • Phenelzin (Nardil)
  • Trazodon (Desyrel)
  • Zimeldin

Anti-neoplastics

  • Aminoglycosides (see earlier section)
  • Bleomycin (Blenoxane)
  • Cis-platinum (Platinol)
  • Carboplatinum (Paraplatin)
  • Methotrexate (Rheumatrex)
  • Nitrogen mustard (Mustagen)
  • Vinblastin (Velban)

Miscellaneous Toxic Substances

  • Alcohol
  • Arsenum
  • Caffeine
  • Lead
  • Marijuana
  • Nicotine
  • Mercury
  • Auronofin (gold, Ridaura)

Others

  • Thalidomide (Thalomid)

Strangely, most of these drugs found to cause tinnitus, are also used to cure tinnitus. For example amitryptiline, furosemide, prednisone, benzodiazepine class, carbamazepine, lidocaine.