Ototoxic Drugs


April 7, 2011: 7:13 am: Ototoxic Drugs

by Neil Bauman, Ph.D.

A man asked,

If Ibuprofen (Advil), Aspirin, Naproxen (Aleve), and Acetaminophen (Tylenol) are ototoxic, what’s safe for over the counter pain relief?

I don’t keep track of all the over-the-counter (OTC) pain relievers or any other drugs for that matter. I just keep track of drugs with ototoxic side effects. As a result, I can’t tell you the drugs that are “safe to take”.

However, the above drugs you mention, although all ototoxic, when taken in low doses and for short periods are probably not going to cause severe or permanent ototoxic side effects. But taken in higher doses, for longer periods or taken regularly in lower doses over a period of months can and do damage ears.

Instead of taking drugs for pain, why don’t you first consider natural alternatives. These differ depending on the pain. For example, for minor pains, I just tough it out. Hot packs and cold packs work in many cases. Depending on the source of pain, I use a chiropractor. Then too, there are a number of herbs for pain—again depending on the source of pain—for example, Feverfew is good for headaches. Sometimes you really need bed rest. Other times you really need exercise. All these things are safer alternatives than drugs—and none of them cause ototoxic side effects.

Another man asked, “Please send me in order the ototoxicity ranking of the below drugs so if I have to take one I can consider my options. But first let me guess. I promise I haven’t goggled any of this. This is my own experience.

In order of ototoxicity:

  1. Ibuprofen
  2. Excedrin
  3. Aspirin
  4. Aleve
  5. Tylenol”

That’s was a good attempt. It goes to show how everyone’s experience is different. However, on the average, here’s my order—from least ototoxic (Class 1) to most ototoxic (Class 5)

  1. Acetaminophen (Tylenol) (normally Class 2—but can be class 5)
  2. Acetylsalicylic acid (Aspirin, Excedrin) (Class 2)
  3. Ibuprofen (Advil, Motrin) (Class 3)
  4. Naproxen (Aleve) (Class 4)

Now let’s look at these drugs in more detail so you have a better understanding of their ototoxic ranking.

Acetylsalicylic acid (Aspirin) almost always causes temporary side effects (tinnitus and hearing loss). So if you take it and notice increased tinnitus and reduced hearing, when you get off it, your tinnitus should go away in 3 or 4 days and your hearing return in a week or so. Also, typically you need to take 6 or more Aspirin a day to get tinnitus (unless you are particularly sensitive to Aspirin). So if you don’t take too much per day, this is probably the way to go.

Acetaminophen (Tylenol) in normal doses for short periods (i.e. a couple of weeks or less) shouldn’t give you any problems. But recent research has shown that taking Acetaminophen regularly (say a couple of times a week for a year) increases your risk of hearing loss 99%. Thus if you only take it occasionally or for short periods at normal doses, it shouldn’t bother your ears much if at all. Note, taking Acetaminophen in very high doses for 2 or more months can cause massive hearing loss—hearing loss so bad you will need a cochlear implant, if it doesn’t kill your liver first.

If I were going to take one of the above drugs, it would be one of those two. Naproxen and Ibuprofen are more ototoxic and since their side effects can be permanent, I put them at the bottom of the list.

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February 10, 2011: 9:54 am: Ototoxic Drugs, Tinnitus

by Neil Bauman, Ph.D.

A lady wrote,

I am 64 years old, and I have had tinnitus since around 1990. I have been taking Propranolol since 1979, which was originally prescribed for my migraines. At this point in my life, I have developed hypertension which is not controlled by this dose of Propranolol. My doctor is trying to find the proper blood pressure drug for me, but unfortunately, she knows little about ototoxic drugs, so I have to make my own suggestions to her. I realize that most ace-inhibitors, calcium channel blockers, and beta-blockers can be ototoxic.

My question is, ‘Are there any blood pressure drugs that do not seem to cause tinnitus or harm our ears?’ I understand that no drug is perfect and may cause other side effects, but I am feeling desperate to find a medication that would help control my blood pressure without worsening my tinnitus.

I sure understand your desire, but I can’t tell you which drugs do not cause tinnitus because I don’t compile information on non-ototoxic drugs, just on ototoxic ones. Thus, I really don’t know if there are other drugs in the above classes that are not ototoxic.

Since I list all known ototoxic drugs in the above classes in my book Ototoxic Drugs Exposed, if you find drugs in these classes that are not in my book, there is a good chance they are not ototoxic (unless they are new drugs just on the market).

If you want to stay on the typical prescription drug blood pressure medications, rather than use natural means to lower your blood pressure, then you need to look for the drugs with the fewest ototoxic side effects—and in your case, specifically for drugs that are not listed as causing tinnitus.

You can quickly and easily find this out if you have the latest edition of Ototoxic Drugs Exposed. All you’d need to do is turn to Table 14-1 and under section 20.8 you’ll find all the ototoxic anti-hypertensive drugs listed by class.

Thus, for example, if you wanted to know whether there are any Beta-blockers (section 20.8.12) that are not known to cause tinnitus, of the 19 Beta Blockers listed there, 4 of them are not listed as causing tinnitus. Therefore, you might want to suggest to your doctor that if you have to take a Beta Blocker, you’d like to try one of these four drugs if he thinks they will do the job—namely Labetalol, Levobunolol, Nebivolol or Sotalol—since none of these are known to cause tinnitus.

You can take this one step further and of these 4 drugs find the one that is the least ototoxic by looking each of these up in the main drug listings and compare all their ototoxic side effects. If you did this, you would find that Levobunolol is the least ototoxic, followed closely by Nebivolol. These two drugs are much less ototoxic in my opinion than the most ototoxic Beta Blockers such as Betaxolol and Propranolol.

However, if you want to bring your blood pressure down by natural means and not use prescription drugs you have other choices.

First you need to determine whether your blood pressure is too high or not. Far too many doctors want everyone to have ridiculously low blood pressure according to complementary medicine standards. You see, some people naturally have higher blood pressure and that is normal for them and is not wrong.

The rule of thumb seems to be that you should keep your blood pressure below 140/90, so if it is lower than that, you probably don’t have to worry about it. The book “Prescription Alternatives” explains that if you are over 60 (which you are), your blood pressure can be up to 180/100 and still be “normal” (although that is a very high “normal”). Thus, trying to get your blood pressure down to 120/80 may be completely wrong for you (but its a good way to sell more drugs).

You want to keep your blood pressure at a reasonable level to be sure. I suggest you first try to do this naturally, and only use drugs as a last resort.

The four main factors that can help reduce your blood pressure naturally are weight loss, exercise, diet and stress reduction. Here are a few examples to get you started.

Weight Loss: If you are overweight, for every 2 pounds of weight you drop, your blood pressure will drop at least 1 point.

Exercise: Just a brisk walk for 30 minutes 3 or more times a week can lower your blood pressure between 3 and 15 points in just 3 months.

Diet: Eat lots of fiber-filled vegetables and whole grains and drink plenty of water. For example, just eating 4 stalks of celery a day can significantly reduce blood pressure. So can taking garlic every day. Another secret to reducing blood pressure is drinking 6 to 8 glasses of clean water a day. It’s so simple that few people believe it works.

Stress Reduction: Getting your stress under control is almost guaranteed to bring down your blood pressure.

There are many natural and healthy ways to reduce your blood pressure if you are so inclined to try. I took much of the above information from the book “Prescription Alternatives” (1st edition) by Earl Mindell and Virginia Hopkins.

If you are serious about reducing your blood pressure the natural way without taking drugs, I recommend you carefully read the chapter “Drugs for Heart Disease and Their Natural Alternatives” in this book.

To find a good price on this book, go to Amazon and in the search box type the words “prescription alternatives”. You will have a number of choices from the 1st to the latest editions.

You can actually get this hardcover book on Amazon for as little as 1 cent to 10 cents (plus shipping which is typically about $4.00) so it is well worth it. There are newer editions too—you can get the latest edition in paperback form for as little as $11.48 (used).

Don’t let ototoxic drugs inadvertently damage your ears and cause hearing loss, tinnitus or balance problems. To learn which drugs are ototoxic, get the 3rd edition of  Ototoxic Drugs Exposed. This book contains information on the ototoxicity of 877 drugs, 35 herbals and 148 chemicals.

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January 30, 2011: 8:12 am: Ototoxic Drugs, Tinnitus

by Neil Bauman, Ph.D.

A man wrote,

Three weeks ago I started taking Esomeprazole (40mg) 1 tablet daily in the morning before breakfast because of a case of stomach and gastric reflux sufferings. Everything was going well, but about four days ago I started to suffer from strange noises in my ears like bells—very sharp ringing sound. This makes it impossible to lead a normal life, and I can hardly sleep. Yesterday I decided to stop the drug and consult with my doctor. Please, I need your advice because I am concerned that my persistent tinnitus will not go away.

It is interesting that you are the second person in the past few days to tell me much the same thing about this side effect of taking Esomeprazole. A man on the other side of the world from you also took Esomeprazole for three weeks and then began experiencing tinnitus too.

And you two are not the first to report this either. I’d previously heard from another man with much the same story. Furthermore, officially, Esomeprazole causes tinnitus in somewhere around 1% of the people taking it.

Stopping taking the drug as soon as you realized that it was causing your tinnitus was a good first step. The sooner you do this, the greater the chances that your tinnitus will go away.

However, tinnitus doesn’t typically go away immediately after stopping a drug. It can take some days for the drug to get out of your system and your tinnitus to die down. As a rule of thumb, I tell people to give it at least two weeks before they start worrying whether their tinnitus will go away or not.

There are no guarantees that your tinnitus will ever go away—it may or may not. Hopefully it will go away. However, one of the best ways to help it go away is to completely and totally ignore your tinnitus by focusing your mind on other things.

If you worry over, and focus on, your tinnitus, it will just become even louder and more intrusive, and it won’t go away. So treat it as a “non-person”, as though it were a constant inconsequential sound such as a fridge motor running, or a fan, or traffic noise—and just ignore it. Hopefully, it will begin to fade into the background and finally you’ll realize its gone, or it will become very faint and you will only hear it when you really listen for it.

If you want to learn more about tinnitus and the things you can do to help bring it under your control, check out the book, When Your Ears Ring! Cope with Your Tinnitus—Here’s How.

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January 19, 2011: 8:01 am: Ototoxic Drugs, Tinnitus

by Neil Bauman, Ph.D.

A lady wrote,

I think the tinnitus and intense ear pain I’ve had for 17 months might be a combination of things—Eustachian tube dysfunction from a lot of airplane flights, and some arthritis in my jaw joint aggravated from dental work? I have been taking 5 mg. Ambien to sleep all this time. As an experiment I stopped the Ambien one week ago and slowly have less pain and tinnitus every day that goes by.

It is true that Eustachian tube dysfunction could result in ear pain and tinnitus. Although, personally, I don’t see why flying should cause Eustachian tube dysfunction. I can see it happening the other way around—Eustachian Tube dysfunction causing problems with your ears during and after flying.

Dental work, especially on the upper molars also can cause tinnitus and ear pain. I’ve had a number of people complain about that.

Thus, it seems perfectly logical to blame the various ear conditions you suffer on your Eustachian tubes or your dental work. At the same time, it never crosses your mind that the drug your doctor prescribed is actually causing your problems.

Did you know that Zolpidem (Ambien) can cause tinnitus, ear pain, and middle ear infection problems—in other words the very problems you list above?

When your ear problems exactly correlate to the time you are taking a given drug, you need to be highly suspicious of that drug. You did a little experiment that proved to me that the Zolpidem you are taking is the real culprit.

When you stopped taking the Zolpidem your tinnitus and ear pain immediately began to diminish. It had stayed constant for 17 months—during which time you were taking Zolpidem. Then within a day or two of stopping it the pain and tinnitus began to go away. That’s not a coincidence. It’s the Zolpidem. To me, this says that your ear pain and tinnitus are more Zolpidem-related than anything else.

Incidentally, you don’t want to be on Zolpidem for very long as it can be dependence-forming, much like the Benzodiazepine class of drugs. If this happens you will have a lot of difficulty getting off it—and may experience horrible tinnitus and other problems in the process.

Don’t let ototoxic drugs inadvertently damage your ears. Learn which drugs are (or can be) ototoxic. The book Ototoxic Drugs Exposed contains information on the ototoxicity of 877 drugs, 35 herbals and 148 chemicals.

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January 7, 2011: 7:52 am: Ototoxic Drugs

by Neil Bauman, Ph.D.

A medical doctor contacted me because he had a weird set of symptoms. A few times a year he would suddenly get loud tinnitus in one ear that seemed to come out of nowhere and for no reason. Then his hearing would begin to fade away. This would last an hour or two, then his tinnitus would start to go away and his hearing would come back. This scared him. He had been to his doctors, and ear specialists, and had an MRI done, but no one could help him.

He began searching for answers himself. One day he was on the Center’s website reading an article I had written about tinnitus and decided to phone me. He explained his symptoms and asked me if I had any insight as to what might be the cause. As is my custom, I immediately thought “drugs”, but he said he wasn’t taking any. After some time discussing his symptoms and ruling out various other things, I asked him again whether he was taking any drugs.

He said, “Oops—I just remembered that I am taking Atenolol, and have been on it for some years.” Right away something clicked in my mind about this drug and his symptoms. I related some similar accounts of what other people on this same drug had experienced.

For example, I told him of a man who explained,

I have been taking Atenolol for about 3 years with no ill effects—until recently. Over the last month the hearing in my left ear has come and gone—and now there is a constant ringing. I went off the Atenolol for about a week, and my hearing returned about 75%. I took another 25 mg. of Atenolol this morning, and the ringing returned along with the associated loss of hearing in my left ear.

I told him about Peggy, who was prescribed Atenolol and suffered serious ototoxic side effects. She wrote,

I was given Atenolol for some little irregular heart-beats. Within a few days, my perfectly normal ears started to give me all kinds of noise, roaring and muffledness. Within a week, I woke up one morning stone cold deaf in one ear. I had pressure in my head so extreme that it felt like my head was stuffed with bricks. The hearing in my other ear was distorted.

I also told him about a man who lamented,

I started taking Atenolol in November, 2005. In June, 2007, out of nowhere, tinnitus kicked in and never left.

I told him of another man who reported that he got tinnitus “some years after my doctor prescribed Atenolol for high blood pressure”.

Finally, I told him of yet another man who explained: “In November I was given Atenolol. By December I had vertigo, right ear hearing loss, short term memory problems and anxiety issues.”

Immediately, he realized that the weird symptoms he had experienced were similar to what these other people had experienced, and that it had to be the Atenolol that was causing his problems. As a result, he declared that he was going to his doctor and get his prescription changed at once.

If you have been taking Atenolol for some time—months or years—and begin experiencing weird tinnitus and/or episodes of hearing loss/distorted hearing, maybe you should consider whether the Atenolol you are taking might be the culprit and do as this doctor did and get of that drug. Your ears will love you for it!

If anyone reading this has experienced weird episodes of tinnitus and/or hearing loss from taking Atenolol, I’d love to hear from you.

Don’t let ototoxic drugs inadvertently damage your ears. Learn which drugs are (or can be) ototoxic. The book Ototoxic Drugs Exposed contains information on the ototoxicity of 877 drugs, 35 herbals and 148 chemicals.

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November 10, 2010: 11:12 am: Hearing Loss, Ototoxic Drugs

by Neil Bauman, Ph.D.

For centuries, Chinese herbalists have proclaimed that your ears and your kidneys are “connected”. In other words, what affects your kidneys, also affects your ears (or maybe it is vice versa).

This is nothing new. What is new is that modern medical science is finally realizing just how true this is.

A recent study of 2,564 adults over 50 revealed that of those with moderate chronic kidney disease, 54% of them also had some degree of hearing loss in the four frequencies tested (500, 1,000, 2,000 and 4,000 HZ). (1) The scary thing is that 30% of those with moderate chronic kidney disease had severe hearing loss. (The comparable figures for those with no kidney problems were 28.3% and 10%.) (2)

Thus, you want to be careful to protect your kidneys from the effects of such problems as diabetes and hypertension—the two main causes of chronic kidney disease, and from drugs that are both nephrotoxic (kidney-damaging) and ototoxic (ear-damaging) drugs, if you truly value your hearing.

Remember, as your kidneys go, so (almost certainly) goes your hearing.
_________

(1) American Journal of Kidney Diseases (2010;56:661-660) as reported in The Hearing Journal, October 13, 2010.

(2) Hearing Loss Associated with Moderate Chronic Kidney Disease in Older Adults. Medical News Today. October 2, 2010.

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November 4, 2010: 11:04 am: Ototoxic Drugs

by Neil Bauman, Ph.D.

People have asked me,

When are you going to update the 2nd edition of your book Ototoxic Drugs Exposed, which is now about 8 years old? There are many new drugs that have come out since you put out the 2nd edition. We want to know which of these new drugs are ototoxic.

Here’s the good news. The brand new 3rd edition of Ototoxic Drugs Exposed is now printed and available for you to purchase! This newly-revised and expanded edition contains information on 877 ototoxic drugs and medications, 35 ototoxic herbals and 148 ototoxic chemicals—that’s a total of 1,060 ototoxic substances!

The 3rd edition also includes a good number of personal experience stories (what I call “anecdotal reports”) of real people that have damaged their ears from taking various drugs. This gives you a better idea of how bad the risk may be, and what you might experience if you have an ototoxic reaction.

In addition, I have added two new chapters. One is a general chapter on the Benzodiazepine class of drugs, and why taking these drugs in the long term can cause certain ototoxic side effects to blind-side you.

The second chapter I added is called, “Keep Yourself Healthy While Taking Few or No Drugs”. This chapter begins:

People often ask me how they can protect their ears from the ravages of ototoxic drugs. They want to know about safer alternatives. In fact, one man took me to task. He wrote, “You keep saying what drugs are ototoxic and should not be used if we want to protect our ears and hearing. However, you don’t tell us what we should be taking. It would enlighten us all if you explained some of the safer treatments we can use.”

With this in mind, I have added this chapter. The information in it is not intended to be comprehensive, as that would be a major book in itself. In this brief overview, I give examples of some things you can do in order to help protect yourself from the side effects of ototoxic drugs. For those of you who want to get off the drug treadmill, I think you will find this chapter most helpful.

The new 3rd edition of Ototoxic Drugs Exposed (798 pages) is packed with information to help you protect your ears from the ravages of ototoxic agents. The list price of the new edition is $52.45, but as an introductory special, you can get it at a 20% discount by just putting the code word “INTRO” in the Coupon Code box in the shopping cart and clicking the “Apply” button before you check out.

If you already own the 2nd edition, you can get the 3rd edition at a special 35% discount. All you have to do is enter the last word on page 301 of your 2nd edition (to prove you already own it) in the Coupon Code box in the shopping cart and click the “Apply” button before you check out, and you’ll automatically receive this discount. Both of these offers are good until December 31, 2010.

Here is the link to order the 3rd edition of Ototoxic Drugs Exposed.

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October 17, 2010: 10:24 am: Ototoxic Drugs

by Neil Bauman, Ph.D.

Below is the first part of a revealing article that shows how the drug companies “hook you” into taking their drugs for conditions that never were diseases in the first place—like shyness. When you take drugs, you also expose your body to drug side effects. Some of these side effects (ototoxic side effects) can affect and damage your ears.

On October 11, 2010, CNN published an article by Dr. Carl Elliott entitled, “How to brand a disease—and sell a cure” It begins:

If you want to understand the way prescription drugs are marketed today, have a look at the 1928 book, “Propaganda”, by Edward Bernays, the father of public relations in America.

For Bernays, the public relations business was less about selling things than about creating the conditions for things to sell themselves. When Bernays was working as a salesman for Mozart pianos, for example, he did not simply place advertisements for pianos in newspapers. That would have been too obvious.

Instead, Bernays persuaded reporters to write about a new trend: Sophisticated people were putting aside a special room in the home for playing music. Once a person had a music room, Bernays believed, he would naturally think of buying a piano. As Bernays wrote, “It will come to him as his own idea.”

Just as Bernays sold pianos by selling the music room, pharmaceutical marketers now sell drugs by selling the diseases that they treat. The buzzword is “disease branding”.

To brand a disease is to shape its public perception in order to make it more palatable to potential patients. Panic disorder, reflux disease, erectile dysfunction, restless legs syndrome, bipolar disorder, overactive bladder, ADHD, premenstrual dysphoric disorder, even clinical depression: All these conditions were once regarded as rare until a marketing campaign transformed the brand.

Once a branded disease has achieved a degree of cultural legitimacy, there is no need to convince anyone that a drug to treat it is necessary. It will come to him as his own idea.

Disease branding works especially well for two kinds of conditions. The first is the shameful condition that can be destigmatized. For instance, when Pharmacia launched Detrol in the late 1990s, the condition the drug treated was known to doctors as “urge incontinence”. Patients called it “accidentally peeing in my pants” and were embarrassed to bring it up with their physicians.

Pharmacia fixed the problem by rebranding the condition as “overactive bladder”. Whereas “incontinence” suggested weakness and was associated mainly with elderly women, the phrase “overactive bladder” evoked a supercharged organ frantically working overtime.

To qualify for a diagnosis of “overactive bladder”, patients did not actually have to lose bladder control. They simply needed to go to the bathroom a lot.

The vice president of Pharmacia, Neil Wolf, explained the branding strategy in a 2002 presentation called “Positioning Detrol: Creating a Disease”. By creating the disease of “overactive bladder”, Wolf claimed, Pharmacia created a market of 21 million potential patients.

Another good candidate for branding is a condition that can be plausibly portrayed as under-diagnosed. Branding such a condition assures potential patients that they are part of a large and credible community of sufferers. For example, in 1999, the FDA approved the antidepressant Paxil for the treatment of “social anxiety disorder”, a condition previously known as “shyness”.

Imagine that? Shyness is now a disease that needs to be treated with drugs! No wonder people are grossly overmedicated—and consequently experience all sorts of negative side effects to the drugs they are taking. To read the rest of this enlightening article, click here.

If you value your ears (and the rest of your body), you want to take fewer drugs, not more drugs—with their numerous harmful ototoxic, and other, side effects! You need to learn to resist the powerful advertising of the drug companies. Learn how to be healthy, rather than buying into their siren disease-branding song of “a pill for every ill”!

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October 7, 2010: 10:21 am: Ototoxic Drugs, Tinnitus

by Neil Bauman, Ph.D.

A lady wrote,

I am currently feeling like I am losing my mind due to the ringing in my ears. I have Lyme Disease, and have been on Minocin for one year. I was off it for about two weeks, and just got back on it. I thought it was the Savella that I started on. I have very little patience right now. Can you tell me specifically about this? Is it from Lyme disease or the medications? What, if any, are the remedies?

Relentless, unceasing tinnitus can be a bit much if you let it, can’t it? You want to know what caused your tinnitus—the Lyme disease, the Minocin or the Savella.”

The bad news is that all three are possible culprits. Lyme disease by itself can cause tinnitus. Minocycline (Minocin), a tetracycline class of antibiotics, can cause tinnitus in about 2% of the people taking it. Milnacipran (Savella) is also listed as causing tinnitus in some people, but I don’t think this is very common.

As you can see above, it can be from the Lyme disease, the Minocin, the Savella or any combination of the above. I don’t know which is contributing most to your tinnitus at this point.

Did you notice any difference in your tinnitus when you went off the Minocin or the Savella? That could give you a clue as to which drug is making it worse if one of them are.

It may not be easy to get rid of your tinnitus until you get your Lyme disease under control—and you need the drugs to do that—and that could make your tinnitus worse in the meantime.

At the same time, your emotional reaction to your tinnitus is also making it worse. The more you focus on your blankety-blank tinnitus, the more your emotional (limbic) system flags these tinnitus sounds, and as a result, they become even louder and more intrusive.

Thus, you need to learn to focus on other things—the loves of your life—and by doing so, totally ignore your tinnitus. You must not have any emotional attachment or feelings towards your tinnitus. When you feel totally neutral towards your tinnitus (treat it as though it didn’t exist), your limbic system slowly but surely turns down the internal volume on your tinnitus, and it begins to fade into the background. (This is easier said than done—I know—but it is something that you also need to do if you want to get your tinnitus under control.)

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September 18, 2010: 10:16 am: Ototoxic Drugs

by Neil Bauman, Ph.D.

A concerned mother wrote,

My 17 year old son has never had any hearing issues in the past. He does not have a history of listening to loud music, etc., nor does he have ear infections. Last Thursday, he failed his annual hearing test. In fact, he failed it in both ears at first, then after a repeat test he failed it in just one ear. They tested him for fluid in his ear with tympanography and found very little, if any fluid.

The pediatrician questioned the antibiotics which my son has been taking for his acne. He took Erythromycin—500 mg. twice a day, 4 prescriptions filled for 60 tabs each in a period of 7 months, and for the last month, Septra. My son only weighs about 125 pounds.

I did some research, and became so concerned about the ototoxicity of the drugs he was taking, I told him to stop taking them.

Today my daughter took my son to a friend who is a pediatrician. She tested his hearing, and again he failed the test in both ears. I’d appreciate your feedback as to whether his hearing loss could be related to the antibiotics, and whether it is reversible. What should be my next step? I am hoping it is the medication, and not anything more serious. I do hope any hearing loss is minimal and reversible.

There are probably three main reasons for hearing loss in teens. First, exposing their ears to loud music for too long. Second, the results from repeated middle ear infections when they were younger, or even now, and third, from taking ototoxic drugs.

From what you have said, you can rule out noise and middle ear infections as the likely cause. That leaves ototoxic drugs.

Erythromycin can and does cause hearing loss. The good news is that when you stop taking it, in many cases hearing comes back, but unfortunately, some people are left with permanent hearing loss. Having an audiogram now, and then another one in two or three months should reveal whether his hearing loss is going to be temporary or permanent.

If the Erythromycin proves to be the culprit, your son should not take it anymore in the future either, as it will very likely cause further damage to his ears then too.

Interestingly enough, Erythromycin is one of the few drugs that can affect hearing in the speech frequencies right from the get go, and thus hearing loss can be caught early. In contrast, almost all other ototoxic drugs begin affecting hearing in the very highest frequencies a person can hear, well above the speech test frequencies. Thus, no one even knows they are losing their hearing until it is too late to do much about it.

Septra is a combination of Trimethoprim and Suflamethoxazole. I have not seen either of these drugs listed as causing hearing loss, although they can cause some other ototoxic side effects.

Antibiotics can be necessary at times, but they should only be taken for a short time—2 weeks or so—not 4 months or more! A number of studies have shown that doctors often prescribe antibiotics unnecessarily—and this can cause a lot of unnecessary damage to people’s ears.

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