by Neil Bauman, Ph.D.
A lady asked,
Please be so kind and help me answer this question. Does the application of Tobramycin on a piece of gauze inserted in the ear canal (in contact with the ear drum) pose risks for the health of the ears? I’ve been prescribed this antibiotic to help a perforated tympanic membrane to heal better. I suffer from tinnitus and hyperacusis as it is, so I am very wary of doing anything that can make this worse. The treatment prescribed is for 5 days. Please advise, based on your experience and knowledge.
Surely your doctor must know of other antibiotics that will do the job that are not as ototoxic as Tobramycin. Tobramycin is very ototoxic. For example, Tobramycin can affect both your cochlea and your vestibular (balance) system resulting in hearing and balance problems. Between 6.1% and 11.5% of the people taking Tobramycin experience ototoxic side effects. (These figures, scary as they are, are low as not all side effects by any means are reported.) Therefore, with reported results like these, I’d only use it myself in a matter of life and death, or something almost as serious. The same goes for all the other aminoglycoside antibiotics.
Here are some quotes from my book, “Ototoxic Drugs Exposed” regarding Tobramycin so you can see for yourself what real people have experienced from taking this drug for their ears and eyes.
“A man reported that he was treated with Tobramycin (as ear drops) and developed tinnitus in both his ears.”
“Another man was prescribed an ointment containing Tobramycin for a sty on his left eyelid. He wrote, ‘I started using the cream on my left eyelid on Tuesday at 1 PM. At 8:30 AM Wednesday, I lost the hearing in my left ear while listening on the telephone.’ In his case, the Tobramycin apparently caused sudden hearing loss just 19 hours later—and this was just from using an ointment on his eyelid!”
“Yet another man was prescribed Tobramycin ear drops for one ear. The result was that he now has ‘permanent, profound unilateral deafness, dizziness and tinnitus all caused by a doctor who had me use Tobradex drops in my ear, while assuring me they were safe, despite my questions’.”
“A lady told about her experience with Tobramycin (Tobradex) eye drops. She wrote, ‘I was prescribed Augmentin and Tobradex for conjunctivitis—2 drops each eye twice a day. After the 6th dose, I suddenly developed tinnitus—louder in the left ear than the right. I immediately stopped taking both medications.’ She had her hearing checked and found she had lost significant hearing at 6,000 and 8,000 Hz. She continued, ‘I still have the same tinnitus and hearing loss over 2 weeks later. My worst fear is that the loss will get worse.’ ”
“Another woman told about her similar experience with Tobramycin (Tobradex) eye drops. She wrote, ‘It took only one dose of two drops in each eye. After a few hours my tinnitus was greatly worse. When I got up in the morning I leaned over and fell. My eye doctor said it couldn’t do that, but it did.’ ”
“A man took a few doses of Tobramycin eye drops and developed a tinnitus ‘tone’ in his right ear. His tinnitus seems to be permanent as it happened ‘a few months ago’.”
These are just some of the stories I’ve collected on this drug. You’ll notice that all of these were either eye drops or ear drops—we’re not talking of high doses by mouth or IV. This is how ototoxic this drug can be at these low doses—and yet the doctors swear that it doesn’t happen as the above quotes testify.
Ultimately, it’s up to you, of course, to decide what you want to do, but consider the risks carefully first and see if there isn’t a much less ototoxic alternative. I’m sure all the above people wish they had known about Tobramycin’s ototoxicity before they took this drug.
If you want to look up the ototoxic side effects of Tobramycin or any other ototoxic drugs, see my book Ototoxic Drugs Exposed 3rd edition. This book contains information on the ototoxicity of 877 drugs, 35 herbs and 148 chemicals.
I was prescribed Tobramycin eye drops for pink eye two weeks ago. I have a severe congenital hearing loss to begin with (a cochlear underdevelopment which I advised my doctor about). This medication should have been contraindicated for me, but I was given the medication without ANY warnings, either verbal or written. Five days after beginning use, I began having dizzy spells. On the last day of use I had an episode of extreme vertigo – episodes which have been ongoing since then. I also am having more difficulty hearing. I feel like I am hearing “underwater.” The CVS Minute clinic I went to is claiming that this medication is only toxic when given intravenously – but I am clearly having toxic symptoms. Of course I stopped taking the medication. I am going to the doctor today about the vertigo. I’m scared and angry. What do you recommend that I do from here?
Hi Michelle:
Tobramycin is very ototoxic–no matter what doctors and pharmacists say. It can and does affect your ears when used as eye drops. A number of people have had somewhat similar experiences to yours.
You’ve done the most important thing–stopped taking the Tobramycin. Now there is not much you can do except wait and see whether the side effects are temporary or not. (I fear they will likely prove to be permanent.)
It’s a bit late now, but if you had taken powerful antioxidants such as glutathione (which your body makes naturally), (or better yet N-acetyl-Cysteine and D-methionine which are two of the big building blocks of glutathione and let your body synthesize them into glutathione) right away, you might have been able to stop the damage in its tracks.
Cordially,
Neil
Should I try? The nurse gave 2 doses and I’m petrified to make my Ti kit is worse??
Hi Dana:
Personally, I would not take Tobramycin eye drops as I figure the risk is too high for damaging my ears. But it is up to you. You know your own situation, I don’t. I’d ask my doctor for lesser-ototoxic drugs instead or use alternative medicine treatments.
Cordially,
Neil
it was prescribed to me for ear infection, I put 2 drops in my ear and i can’t hear a thing also my ear is inflameted i will not use the tobramycin any more.
Julie.
I took Tobramycin eye drops for 5 days, and felt dizzy. I have been off the drops for a few days now, and feel much better, but still s bit dizzy at times. What are the odds that this is now a permanent impairment?
Hi Gaddy:
The fact that you are feeling much better now and the dizziness has been getting less as time goes by bodes well for the future. I tend to believe that your dizziness will continue to fade away–but since the Tobramycin has damaged your vestibular (balance) system, you may be left with somewhat reduced (maybe barely noticeable) balance function.
In the future, you know you have to stay away from Tobramycin and the other Aminoglycoside antibiotics as you are obviously sensitive to them.
Cordially
Neil
Tinnitus got worse after I was prescribed tobradex for ear infection.
I wear hearin aids my ears itch. My Dr says i hav. Bacteria in my earswants me to use drops Tobradex , i don’t want to use knowing all the sideeffects what can I use
Hi Tina:
I’m with you. Using Tobradex is just asking for trouble, especially when there are other much safer ways to treat this. I suggest you read my article “Seven Safe Treatments for Ear Infections” and make up your mind what you want to do. You can read it at http://hearinglosshelp.com/blog/seven-safe-treatments-for-ear-infections/.
Cordially,
Neil
thank you Neil for such a useful insight. are Betnisol n containing neomycin…safer???u have a ruptured tympanic membrane and then a boil in ext. ear canal…dr advised me tobra but luckily i sidnt purchased at it was available as an eye solution…but im using betnisol from almost a wk
Hi Mehak:
Betnesol N is a combination of Betamethasone and Neomycin. I would NEVER use anything with Neomycin in it if I had a hole in my eardrum. That’s just asking for trouble. The same is true for Tobramycin products such as Tobradex.
Cordially,
Neil
I spent 3 days in the hospital because of tobradex. My infection went to my mastoid bone
I have pink eye and the doctor prescribed to rancid. I put a drop in my right eye and it stung so I rinsed it out after a couple of minutes. I decided to check google to see if there are alternatives to the eye drops that I am using and as a result found your site. Do you have any natural remedies for pink eye?
Hi Hanan:
I’m away from the office for a couple of weeks so I can’t check my usual sources, but the information in “Natural Pink Eye Remedies” should help you.
Cordially,
Neil
black warm coffee on a warm wash cloth. just dap allow to rest on ur eye please rinse but not rinse dry.
I am pregnant when I went for eye check up.i found that I saw two words with my one eye.dr recommend me tobrex tobramycin ophthalmic solution.should I use it or not..
Hi Neetu;
I would never take Tobramycin unless it was a matter of life and death. Surely there are other eye drops that are not so ototoxic.
Why does he want you to take the Tobramycin for double vision? It is a strong antibiotic.
Cordially,
Neil
Hi there!
I was going to go through a PRK eye laser procedure but actually ended up regretting 1 hour prior the surgery, and ended up not doing it.
The surgeon had me take Tobramycin 4 times a day, the previous day to the “scheduled” surgery date.
When putting the 4th dose that day by accident i ended up putting 2 drops on my right eye.
So to recap. I took Tobramycin eye drops for just ONE DAY, 4 times on my left eye and 5 times on my right eye.
Should i expect any consequences? i did noticed a very minor pain on my right eye and a little blurry.
Thank you very much!!
Hi Joe:
If the Tobramycin was going to affect your ears, I’d expect it would start to show up within 24 to 48 hours. So if nothing has shown up by now, you probably lucked out and are ok.
Cordially,
Neil
ciprodex safe?
Hi Zachary:
Not in my book. It is actually quite ototoxic. Not I drug I’d ever take unless it was a matter of life and death. The same goes for all the drugs in this fluoroquinolone class.
A safer alternative if they will do the job is the drugs in the Cephalosporin class. Note I said safer–not safe. They are all still ototoxic, but much less so.
Cordially,
Neil
my 6yr old son was prescribed ciprodex for ear-pain but insurance doesnt cover it and its very expensive.
If I get the ciprofloxacin eye drops 0.3% and dexamethasone eye drops 0.1% and put them both in ear (same ingredients as ciprodex)- is that pretty much the same- pls. respond soon.
Hi Sean:
I don’t know whether this is the right dose, etc. You need to talk to your pharmacist about this.
Cordially,
Neil
I hope this thread is still open. I have an inner ear infection caused by pseudomonas aeruginosa . I had a reaction to ciprofloxacin ear drops and now don’t know what to do and I am terrified as my doctor said it can cause meningitis . Please advise.
Hi Karin:
I’m not a medical doctor so can’t say which drugs will kill your infection, but if you get your doctor to suggest 3 drugs that would do the job, I can put them in order of least to most ototoxic if you’d like.
Since the Aminoglycosides and Fluoroquinolones are quite ototoxic, maybe he could suggest another class of drugs. Ask you doctor whether any of the Cephalosporin class of drugs would do the job–they are not very ototoxic, so I’d go with them. I’ve taken them myself with no problems.
Cordially,
Neil
I have been RX to use
Tobramycin & Dexamethasone 3%
4 drops in my left ear
2 times a day
I had a radical mastoid
operation about 60 Years ago. Get scar tissue and
other stuff in my ears.
Tinuis problems and
loose ear drum rippled.
Should I use this ?
I was told NEVER get any water in my ear.
Hi Bob:
Personally, I wouldn’t use anything with Tobramycin in it–ESPECIALLY if you are not supposed to get water in your ear. I’d ask for a less ototoxic antibiotic if one is available.
You may not have any problems, but if it were me, I’d consider the risk too high to take chances.
Cordially,
Neil
Hi! I was prescribed Tobradex to treat some inflammation in my eyes and after 2 days of use I noticed some intense ringing in my ears. Decided to read up on this “side effect” and I am astonished to read all these comments.
Tobramycin eye drops really bad for ears.
but nothing has advised for how to reverse Ototoxicity of Tobramycin.
any solution.!
Hi Amir:
I’m not aware that you can reverse Tobramycin ototoxicity. I think it tends to be permanent, unfortunately.
Cordially,
Neil
Hi , I got prescribed Tobradex for my ears because they are infected ( Diffuse Otitis Externa) was my diagnosis , since I don’t know what that was.
I searched it up in google and found out this site and read it ,now I don’t know if I should use it. Any solutions ?
Hi Alex:
If it were me, I’d only take the Tobradex as a lost resort. If your eardrum does not have a hole in it (and you definitely don’t want to mess with Tobradex if you do), then as far as I’m concerned, there are much safer (less ototoxic) alternatives. For example, vinegar or hydrogen peroxide. Here is an article I wrote about such things. You can read it at http://hearinglosshelp.com/blog/seven-safe-treatments-for-ear-infections/
Cordially,
Neil
Hello Neil:
I am currently battling a right ear infection. Unfortunately, it came back after having another one in the same ear four months ago. For the previous infection, I was on Augmentin 875 MG and it cleared it up no problem. Regular Amoxicillin is also too weak for me when it comes to ear infections.
As it stands now, however, I have a perforated ear drum in this ear (which was present even before the infection(s) occured) and was prescribed Augmentin 875 MG (again)…to be taken twice a day. I was also prescribed Tobradex for the infection as well after a visit with my ENT. The prescription requires me to instill four drops in the affected ear twice a day. A couple of years back, I was also prescribed the very similar Ciprodex before for yet another prior ear infection (it was in the left ear), but had to stop that awful medicine after just a couple of rounds due to what I suspect was hearing loss related to the ototoxicity of the drug itself.
With that being said, however, a few days back, I stumbled upon your wonderful article after being prescribed this medication and was browsing through the comments….and I’m glad that I did! I took your recommendation with using the Glutathione antioxidant and purchased it in supplement form through my local vitamin store. It is listed as 500 MG to be taken once a day.
Others online have said that the supplement form might not be that effective, but so far, after just a few applications of the Tobradex, it appears to be helping with reducing the toxic effects of the medication itself.
My main question is even though the Glutathione bottle lists the supplement to be taken only once a day, would it actually be better or worse on my part to take it twice a day due to the fact that I am taking the Tobradex twice a day? The Glutathione is also made by NOW foods.
Thank you,
Josh
Hi Josh:
You raise a good question. I wonder how much glutathione your body is actually receiving since glutathione is typically broken down in your stomach before it has a chance to get into your bloodstream.
That is why I typically recommend taking N-acetyl-cysteine (NAC) one of the three main building blocks of glutathione and let your body make it instead.
It is up to you what you decide to do. Your idea seems reasonable to me. You just do not want to take too much. However, I think you are no where near that limit yet.
See the 5th paragraph from the end of my article at http://hearinglosshelp.com/blog/loud-music-and-hearing-loss/ . Note that this is only talking about NAC and not glutathione itself.
Cordially,
Neil
Hello again Neil:
Thanks so much for the quick reply. For now, I will stick to taking one capsule of the Glutathione supplement a day along with my antibiotics considering the fact that the supplement itself is 500 MG. I suppose taking 1000 MG a day might be too much and it might do more harm than good if I overdosed on it. That’s what packaged directions are for too I suppose.
I do have to note, however, that my hearing has actually improved since starting the Tobradex on Wednesday evening (Oct. 4). I actually noticed an improvement after taking it for just two days. Moreover, I should also mention that I started taking the Augmentin last Sunday (Oct 1) as well. If it weren’t for the Glutathione supplement, I fear that I would likely have permanent hearing damage by now considering the fact that it only took two rounds of Topradex’s sister medication, Ciprodex, to have a slight negative impact on the hearing in my left ear when I had the previously mentioned infection then. Every now and then, I also get light tinnitus in my left ear along with a little bit of pulsatile tinnitus as well, but one dose of Allegra 24 hour (I also unfortunately have allergies) usually helps a lot with that.
In any case, I read a few reviews of the Glutathione supplement that I previously mentioned online before purchasing it. It wasn’t cheap (it was around $30 or more with a 15% or 20% discount) but it is worth it, in my opinion, if it means retaining my hearing.
Some have said that one way to tell if the supplement is working is when you start developing some acne marks on your skin. This is the supplement’s way of ridding toxins from your body if I’m not mistaken. After just a couple of days with the Glutathione supplement, I have indeed had that side effect. I do often wonder myself, however, how much of it is actually being absorbed, but I wasn’t going to settle for 200 MG as I thought that dose was too weak, especially while knowing that I was going to be taking something like Tobradex. So far, however, I have been sleeping better and the infection itself does appear to be subsiding.
I am on course to take the Tobradex up until next Wednesday, Oct. 11. This is when I will also run out of the Augmentin as well. Thanks also for the recommendation about taking NAC. I will definitely consider it in the event that I come across another infection (hopefully not anytime soon, though).
Thanks again, Neil! I really appreciate the advice and will definitely read your article about the NAC too. You’re a real life saver!
Kind regards,
Josh
I hope i can get a reply…I have a hole in my left ear drum, and it’s also very swollen and I was given ciprodex and omg that hurt so bad I instantly sat up crying and had to get it out. This time, he gave me tobramycin and dexamethasone and I’m terrified to use it, but he thinks i have cholestoma so idk what I should do.
Hi April:
Personally, I wouldn’t use the Ciprodex and I very definitely wouldn’t take the Tobradex. There are much safer antibiotics your doctor could prescribe.
If you think you have a cholesteatoma, find yourself a skilled/experienced ENT or otologist and get it removed before it does further damage. The longer you wait, the worse things get.
Cordially,
Neil
My 6yr old son was prescribed the opthalmic drops to try to lessen his congenital leucoma (opacity on his cornea .left eye only). I used it on him last night, then tonight he complained of his ears being wet. I checked and his left ear has yellow discharge. No pain though. I will stop the drops tonight (supposedly only his 2nd day) until i get further information. Please advise. Thank you so much.
Hi Carmela:
You don’t say which ophthalmic drops you used–I’m assuming ones containing Tobramycin–is this correct?
I can’t see that using such drops would CAUSE an ear infection such as your son experienced. You should take him to your doctor to see exactly what is wrong.
Cordially,
Neil
Would use of tobrex eye drop during the pregnancy could possibly cause the hearing loss to the baby as well?
Hi Nat:
I’ve not heard of it, but I wouldn’t be at all surprised that it could. Your unborn baby is particularly vulnerable to ototoxic drug damage during the first trimester, especially between weeks 6 and 8.
Cordially,
Neil
i was prescribed an Optidex for my right eye stye .i was using it for a week and it got better and in that same week i got my right ear swollen and as i was on a resort away from the city i assumed i had a bacterial infection from the water from swimming so i started to use the optidex directly on my ears (for 4 days)and it seems to feel better and swelling reduced .
But now i am back to the city and i have pain when swallowing and chewing and also itching on my right ear and started to google the medicine and find out that Torbamycin is an ototoxcin and very harmful. i have scheduled a doctors appointment for this afternoon but i am really worried that i might have done a damage to my ears. please let me know with in how many days will the medicine do the damage and how can i know?
Hi Tseday:
If your ears begin to ring or produce other phantom sounds, or you lose some hearing, you’ll know you have damaged your ears. This will probably show up in the next two weeks or so, but it could be longer.
Cordially,
Neil
Hi Neil,
I suffer from tinnitus and see the doctor. The doctor said that at my left ear is dry. The treatment prescribed is Tobradex for 5 days Please advise, based on your experience and knowledge.
Hi Ketty:
Personally, I’d never take Tobradex until I had exhausted every other course of action.
I don’t know what you doctor means my your ear canal is “dry”. It’s supposed to be dry, not wet. So what is really the problem with your ear canal that you went to the doctor for? Was it itchy? or scaley? or what?
If you have any kind of infection in your ear canal, then you might want to try some of the natural remedies such as hydrogen peroxide, or vinegar–buth usually diluted half and half with water. If you ear canal is not infected, then something soothing such as olive oil could help.
I suspect you have an infection of some sort which is why your doctor prescribed an antibiotic.
Cordially,
Neil
My 2 year old daughter was prescribed Tobramycin drops for bilateral MRSA in while also having tubes in her ears. Her primary care doctor (who I actually worked for and trusted) prescribed I use them TID for 3 weeks. I did that, no help. Noticed my daughter’s balance and hearing along with her speech started to get bad. I took her to her ENT for an emergency office visit, and only then I was told immediately to STOP giving her the drops as they cause hearing loss n major issues when used in the ear. Here I was, on the advise from her PCP giving her the drops TID!!!! When I brought this matter up to the Chief Medical Office of the clinic for some help or advise, I was told he would have NEVER prescribed the medication and to stop using them. Now, after a second ear surgery, my daughter is speaking somewhat alright however, we cannot perform a complete OAE hearing test as her ENT feels she will fail it! Now, I am frustrated and wondering what to do from here. any advise would be helpful.
Hi Emily:
I agree with the chief medical officer that your doctor should NEVER have prescribed Tobramycin ear drops, and especially knowing she had tubes in her ears. That was just asking for trouble.
I don’t understand your ENT’s “cannot perform a complete OAE as she will fail it”. First, it is not a test that you pass or fail. It is an evaluation of her hearing–and if the OAE shows massive loss, that’s something you want to know. You want to know what her hearing is like now.
What can you do now. It’s like asking whether you should close the gate after the horse has escaped.
You didn’t say how long ago this happened. If it was in the last 2 months or so, I’d suggest giving her N-acetyl-cysteine–a main building block of glutathione–the body’s most powerful antioxidant. This is because aminoglycoside antibiotics can persist in the inner ear and continue doing their dastardly deeds for up to a year. The glutathione will help zap all the free radicals that do the damage. Run this by her pediatrician to be sure this would be ok for a young child. Follow his advice. He might suggest glutathione injections instead, and this is fine too. Note, taking glutathione via the mouth is basically a waste of time as the stomach’s digestive juices break it down. Injections or taking NAC don’t have this problem.
Second, if she has a significant hearing loss in one or both ears, then you need to get her amplification–hearing aids or cochlear implants as appropriate–so she can continue to develop language normally. I don’t think anything will bring back her hearing.
Cordially,
Neil
Hi, I had strep throat, went to a walk In clinic. 5 days later developed pink eye in my right eye, went back to the clinic and they prescribed Sandoz 0.3 and Tobramycin 0.3 one drop 3 Times a day. I took it for 5 days, then saw my regular GP and she said stop taking it, it damages your hearing. I have had tinnitus for years, but my right right ear has felt plugged for 3 weeks now. I did a hearing test and was told my hearing is fine, a little less in one ear but my ears are clear. Can this eye drop damage my ear and make it feel full and plugged permanently or is it just my inner ear tube inflamed and will settle down? I’m scared this eye drop has damaged my right ear into feeling plugged. I had crainialsacral massage, help maybe a little, but will try again. Please let me know.thx
Hi TB:
Your GP is right that taking Tobramycin eye drops can cause ear problems such as hearing loss. The blocked feeling could be a psychological feeling, not a physical feeling that your ear is blocked because you have hearing loss. When they checked your hearing, they only tested your hearing to 8,000 HZ, but natural hearing goes up to 20,000 Hz. If you had significant hearing loss in those higher frequencies, it wouldn’t show on your audiogram, but your brain notices it and you could have this blocked feeling. It should go away in time as your brain gets used to the new normal level of hearing–if indeed this is what your real problem is.
Cordially,
Neil
Thanks for the response. I’ve been taking Mometasone Furoate nasal spy to help the blocked ear. Will this help?
What other problem do you think it could be? If that is not the real problem? thx
Hi TB:
Mometasone is a steroid and as such is used to reduce inflammation which may allow hearing to come back. I can’t say whether it will work in your case or not as the feeling may go away on its own. It really depends on whether you have blocked Eustachian tubes/middle ears or it is a psychological feeling due to no longer hearing well in certain frequencies.
I think it is one of these two possibilities. If it is real congestion in the ear/Eustachian tube, it should show up when you had a complete audiological evaluation.
Cordially,
Neil
The ENT said my ears are clear from congestion.
Does it sound like hearing loss due to using the Trobramycin eye drops?
I used it for 5 days before I saw my doctor who told me to stop.
I’ve tried everything else to unblock it and nothing has helped. So my only conclusion is hearing loss from the drops.
I’m seeing an ENT again next week, is there anything specific I should be asking or test for? Should I check the hirer frequency?
This was the first time I’ve been tested where one ear should hearing loss.
It sounds like Trobramycin, damages your hearing within days? Why is it still allowed on the market when there are other safer methods.
Hi TB:
Since your ears are free from congestion and this blocked feeling came right after taking the Tobramycin eye drops, I’d say they were related. So you may have high-frequency hearing loss, or hearing damage that doesn’t show up on standard audiometric testing (called hidden hearing loss).
You can ask for high-frequency hearing testing, but few places have the equipment to do this (beacuse they think it is unnecessary).
Although doctors often say that drugs will damage both ears at the same time, I’ve heard from numbers of people like yourself that only have damage on one side–and often it is on the same side on which some treatment was made.
In answer to your last question–who really knows. My top choices are ignorance, laziness and greed.
Cordially,
Neil
Hi Dr Bauman
I used Tobradex for 2 days in one eye 2x day. An hour after administering the forth drop, I got a high pitched hissing in both ears. This is after only 4 drops total over 2 days. Do you think it will be permanent ? Im terrified it wont go away. I stopped the drug immediately. Do you know of any people who had this clear up? The hissing started last night. Its fluxuating slightly. Thanks
Hi Sally Anne:
You were wise to stop the eye drops as soon as you realized what was happening. You don’t ever want to take anything with Tobramycin in it again as you know it will affect your ears. At least it didn’t affect your hearing as far as you know so that is a blessing.
Unfortunately, people tell me their initial results, but seldom tell me later how things turned out, so I don’t have a lot to go on in regards to whether their tinnitus ever went away or not. Even so, this is highly personal–each person is different. Thus for some their tinnitus goes away, for others it slowly fades into the background and for others–especially if they worry about it–becomes permanent.
Thus the best thing you can do is learn to ignore your tinnitus and focus on the loves of your life. In time, it should fade into the background and not be a problem even if you can still hear it.
The fluctuating tinnitus is a good sign. I’m hopeful that it will have more periods of lower levels as time goes by.
Cordially,
Neil
Thank you very much for your answer. I am prone to anxiety so I will take extra measures to distract myself and as you say (paraphrasing) pretend that it is the fridge noise. That is helpful. The physician who prescribed it said this is “not possible.” and the Pharmacist also said the same. But clearly it is and I am not the only one here!
I am going to keep you updated because I did notice that there are only people posting that it has happened but not how things went later. When people get better they have very short memories for their past suffering, I think.
Aside from that, today when I awoke, it was lower, now higher and louder. Also it was in both ears yesterday and today I had a brief break in my left ear, now both again. I do hope this is a good sign. Either way, I am going to fight to stay out of despair. Thank you for all the hard work, You are a lifeline to those of us who find ourselves in this position.
Best,
Sally
Hi Sally:
Both your physician and pharmacist are grossly ignorant about the drugs they handle/prescribe. They need to get educated on the subject. By being so adamant that the drug did not cause your tinnitus, they perpetuate the myth that drugs are not ototoxic when in fact, tobramycin is very ototoxic in my opinion.
I think you will do well, because you are already working on “ignoring” your tinnitus. The key is not to view your tinnitus as a threat to your well-being in any way. Then, and only then, can you habituate to it and let it fade away.
Cordially,
Neil
Hi Dr Bowman – I hope you can stand one more question. My eye drop induced tinnitus seems to be much less at certain times (more quiet) then back to louder. Also
( since taking the eye drops) my ears have been feeling very full and pop when i swallow. I am using some saline spray in my nose which seems to help a little with pressure in my sinuses. My right ear also has some “clicking” when i massage in front of it under the cheek bone and above the jaw. Does this give you any ideas about how i might go about treating this? Does the occasional disappearance of the tinnitis mean that it may go away with some time? On day 1 it was 24/7. Now little breaks. Im trying to habituate but it is a struggle as this is so new. If I did not know that advil was also ototoxic I would take some and see it there is inflammation. So for now saline very gently. Im trying to stay calm, its difficult. Thank you again for being the only knowledgeable source for so many of us who are bewildered and anxious. Your help is very much appreciated! Best, Sally
Hi Sally:
If your right ear clicks when you rub your face in front of your ear, I wonder if you have temporomandibular jaw (TMJ) problems. That could also affect your Eustachian tubes and your ears popping. As far as I’m concerned, this has nothing to do with your eye drops but could be a result of the top vertebrae in your neck not being in proper alignment.
I’m hopeful that your tinnitus will eventually fade away given that it comes and goes. You just want it to go more and come less. Just learn to focus on the loves of your life and in the process ignore your tinnitus as much as possible. It’s not easy to do, but I think you are doing a good job of it.
Cordially,
Neil
Thank you, you are truly a blessing for us out here with no help! Im deeply grateful. I assume taking a small amount of advil would be a bad idea? And as you’ve advised others I will also seek treatment by a specialised chiropractor. Thank you very much.
Hi Sally:
Ibuprofen (Advil) is one of the drugs I get the most reports of resulting tinnitus, so I wouldn’t suggest taking it. If you needed something, Acetaminophen (Tylenol) would have less risk on your ears when taken occasionally in lower doses, but it is ototoxic too.
Cordially,
Neil
Hi Dr Bowman – I purchased your book to help me cope with tinnitus. Its very helpful. Im on my 11th day of “T” so I know its still very new. Im especially focusing on chapter 16 of your book at the moment but im having a really hard time adjusting. I think in the first few days I thought it might just away or that I would easily habituate, but that has not happened . Also, a question: the volume of the tinnitus fluctuates some days lower and some louder (most on the louder side) sometimes its in one ear sometimes both. On 2 days (out of 11) there were several hours where it seemed to go away entirely, then came back again. Is this a sign that maybe it may resolve? Or is this just “how it goes” with tinnitus. Im having a lot of very high anxiety. I know from your book that its better to stay calm and view it as a “non-threat” but my mind and body are not listening at this time! Any extra info would be greatly appreciated! Thank you again for writing the book. – Sally
Hi Sally:
Since your tinnitus is fluctuating and going away, I think this is a good sign. Continue to ignore your tinnitus as much as you can by focusing on other things and hopefully you’ll get more good days and fewer bad days. Habituation doesn’t happen overnight. It can take months to happen. But I think you are on your way. Keep putting into practice the principles I lay out in Chapter 16, and you should continue to see improvements as the weeks go by.
Cordially,
Neil
What about ciprofloxacin? I was prescribed a strong dose of this for 2 weeks to be followed by 3 months of a lower dose for a bladder inflammation. NB not infection.
After 2 weeks I took a flight. Result – severe deafness in both ears and tinnitus for 4 months. Similar flight before and since did not have same effect. Hearing still slightly reduced
I did not continue with this drug. Was it correct to prescribe this for bladder inflammation/no infection?
Hi Mary:
In my opinion (remember, I’m not a medical doctor), you should NOT take an antibiotic if there is no infection present, except maybe when you have an operation to prevent one from taking hold since you have been “opened up” to some degree.
Thousands of people have have had ototoxic side effects from taking Ciprofloxacin–including many getting hearing loss and tinnitus as you did. This is a good drug to avoid unless absolutely necessary. There are safer drugs for bladder infections (which you didn’t have).
Cordially,
Neil
Hi Neil,
I have a question for you.
I was prescribed Tobramycin eyedrops by a doctor for an eye infection about 1.5 months ago. I was on my way to visit family friends who live out of the city, so I picked up the prescription and just started using it. And of course, being so far away from home for most of the week, I was unable to really research what I was taking on my computer. (Lesson learned).
When I got back home, I somehow managed to find this website, and was shocked to learn of the side-effects of what I had just taken for 7 days. I immediately started taking antioxidants from a health store (NAC and L-Methionine) when I finished the 7 day eyedrop “treatment”. And have been taking them now for 1 month.
I’m not sure if it’s the power of suggestion, or the “placebo effect”, but I have noticed the high-pitched ring in both ears shortly after. And have noticed it off and on, especially before I go to sleep.
I stupidly put the eyedrops in both eyes, even though the infection was only in one eye. Again, I didn’t know about it’s ototoxicity. I didn’t even know what ototoxic meant. Neither the doctor, nor the pharmacist warned me about it.
And it’s just now gotten worse.
Is it unusual for the high-pitched ringing/tinitus to get worse over the course of a month?
Or is this something maybe unrelated to the Tobramycin eyedrops now, as it’s been more than a month?
I take other medications for my heart, but they never gave me problems and I’ve been taking them for more than 2 years.
The real joke here, is the antibiotic eyedrops didn’t even work — the tearing and gunk I experience seems to be chronic. So I possibly damaged my ears all for nothing.
In fact, I saw the same doctor again after the treatment, and I mentioned the ototoxicity of the antibiotic, and he insisted it was not damaging to hearing.
I believe I have some type of chronic eye infection (that’s contagious to others) that i’ve had for years and years. I’m hopefully seeing an “infectious disease specialist” soon, who will no doubt prescribe a systemic antibiotic.
Hi Barry:
It’s possible that the Tobramycin caused your tinnitus, but focusing on it and worrying about it is a sure way to make it worse. The best way to deal with tinnitus is to focus on other things and treat it as you do any other totally useless, meaningless background sounds you encounter daily that you no longer bay attention to such as the sounds your fridge makes. When you ignore your tinnitus just like you do your fridge noises, they will fade into the background and disappear for hours on end. However, if you feel your tinnitus is a threat to your well-being in any way, your tinnitus will never go away and will likely get worse.
Cordially,
Neil
Hi Dr Bowman, do you have any knowledge of potential duel vestibular otoxicity from taking amoxicillin and nsaid painkillers?
Hi Colin:
No, I have no information on whether they have a synergistic effect with each other. Thus, your best bet is to consider the side effects of each drug separately.
Cordially,
Neil
Hello doctor, I was prescribed oral antibiotics For 7 days twice a day in addition to Tobradex ointment 3tines a day for a month to get rid of an infected chalazion in my left eye. It’s been a week almost and after reading all these comments I’m scared to death to continue using Tobradex ointment for 3 more weeks. What do I do?
Hi Fernanda:
If it was me, I’d refuse to take anything with Tobramycin in it, and Neomycin too. There are other drugs I’m sure that will do the job that don’t contain these two aminoglycosides. You are right that taking it 3 times a day for month is pretty risky regarding your ears. You have to decide how much risk you are prepared to take.
Cordially,
Neil
Hi
I was prescribed low dose lasix 20mg every other day. I never had any issues with it.
I was given tobradex for blepharitis and used it on my right eyelids, much less than the 1/2” of ointment as prescribed, twice a day, instead of 3 times a day.
In other words, an extremely small amount.
On the the second day I was getting annoyed with my wife for ‘mumbling’ I couldn’t hear her very well. The next morning I woke up with what sounded like hair dryers near my ears.
I stopped both medications and was put on a steroid course. It lessened the tinnitus, but 6 months later I still suffer from it, hyperacussis and a constant “full ear” sensation. I
Of course all of the ENT’s said the dose is too small to cause the symptoms I have.
There is a genetic mutation in approx 1 in 500 People that make them extremely susceptible to aminoglycose toxicity.
I suppose I’m one of them.
I’m an ER RN and had no idea an ointment could subsequently ruin my life.
I’m 45 and had perfect hearing. Now I doubt I will ever be comfortable with again.
I’m not sure if I can live like this forever.
Hi G:
You’re fortunate that taking Lasix hasn’t affected your ears, especially if you take any aminoglycoside antibiotic at the same time.
I don’t know why doctors are so “pig-headed” that they can’t accept that since people are all different, some people’s ears are much more sensitive to drugs than others are, and thus a “small amount” can damage some people’s ears. As you now know, numbers of people have similar experiences to yours after taking Tobramycin for their eyes.
And you are right, if you have the 1555A>G mutation, you can have a serious ototoxic side effect from taking aminoglycosides. Here is a quote from my book.
“Researchers now know that you can inherit a genetic susceptibility to hearing loss. via mitochondrial DNA. This is an example of the way medications and genes interact.
Mitochondria have their own genome. The genome is passed down from mother to child (maternal inheritance) and contains 37 genes, one of which is the MT-RNR1 gene (mitochondrially encoded 12S RNA). The most common MT-RNR1 variant is a single nucleotide substitution of a guanine at position 1555 for an adenine (m.1555A>G).
You are much more likely to have a resulting hearing loss from taking an AMINOGLYCOSIDE if you have this particular variant present. The prevalence of this m.1555A>G variant varies among different populations. For example, the prevalence of this m.1555A>G variant is thought to be 1 in 385 Caucasians. That translates into about 846,000 Americans carrying this particular genetic variant and thus should never take AMINOGLYCOSIDE antibiotics if they want to preserve their hearing.
If you have this variant, it appears that only your cochlea—but not your vestibular system—is extremely susceptible to AMINOGLYCOSIDES. In contrast, if you do not have this variant, then dose-dependent ototoxicity can occur after you take AMINOGLYCOSIDE therapy. However, in this case, ototoxicity involves both the cochlear and vestibular systems.
Furthermore, if you have this variant, you are exquisitely sensitive to AMINOGLYCOSIDE-induced hearing loss. This hearing loss typically will be moderate to profound, bilateral, irreversible, and have a rapid onset.
The relationship between the 12S rRNA gene and hearing loss caused by AMINOGLYCOSIDE antibiotics is very interesting. Here is how it works. AMINOGLYCOSIDE antibiotics kill bacteria by interfering with the normal operation of certain proteins in the bacteria. Fortunately for us, these proteins are either unimportant or not present in humans. This is why AMINOGLYCOSIDES do not kill us.
However, the 1555A>G variant of the 12S rRNA gene changes this balance. The 1555A>G variant “looks” similar to a protein in the bacteria the AMINOGLYCOSIDE is targeting. When this variant is present in humans, an AMINOGLYCOSIDE can interfere with the function of this variant protein. For reasons still unknown, this leads to loss of hearing.
For example, even a single injection of Gentamicin may cause hearing loss in people who have this m.1555A>G variant. Furthermore, this occurs in genetically-susceptible people—even in cases where drug levels remain within the therapeutic range.
Note that this effect is distinct from “dose-dependent ototoxicity” (damage to the inner ear), which can affect any person, typically occurring after 5-7 days of AMINOGLYCOSIDE therapy.
Incidentally, people carrying the 1555A>G variant are also more likely to develop hearing loss over time even if they never take AMINOGLYCOSIDE antibiotics.
In the past, genetic testing for the MT-RNR1 gene was slow—taking up to 3 days for hospital laboratories to provide the results. This is much too long to wait if you have a septic condition requiring immediate treatment such as is the case with newborns.
Dr John McDermott, from the Manchester Centre for Genomic Medicine, Manchester, UK explains, “This is inadequate, considering that life-saving antibiotics need to be given in the first hour of admission.”
In June, 2018, together with another Manchester-based company, he developed a simple bedside test that uses a cheek swab that can produce results in around 40 minutes. This permits tailored prescribing. The result? “We are thus able to avoid the antibiotic-related deafness that can occur in infants with this genetic mutation.”
So your doctor could have given you this test and in 40 minutes, known whether you are particularly sensitive to aminoglycosides or not. But if you take this test now, you’ll know whether you are sensitive to aminoglycosides and never want to take them again (unless a matter of life and death and no other antibiotic will work for you).
Have you taken any therapy to specifically reduce your tinnitus, hyperacusis and full ear sensation? There IS help for these. My recent book, “Hypersensitive to Sound?” can help you with these as well as my book “Take Control of Your Tinnitus”. You can get them at
https://hearinglosshelp.com/shop/hypersensitive-to-sound/
https://hearinglosshelp.com/shop/take-control-of-your-tinnitus-heres-how/
Cordially,
Neil
My doctor has prescribed me Tobrex (tobramycin 0.3%) Eye drop for my ear infection. I read all the conversation, plz let me know should I Use it or No
Hi Aysha:
If it were me, I’d refuse anything with Tobramycin in it for treating anything in/around eyes or ears. The risk is just too big in my opinion.
Cordially,
Neil
I have bilateral vestibular loss after taking tobramycin sinus rinse. Have you ever encountered damage after a sinus rinse? 300mg BID 4 weeks.
Hi Joshua:
No, I haven’t heard of a Tobramycin sinus rinse causing vestibular problems, but then again, I haven’t heard of using Tobramycin in a sinus rinse.
However, Tobramycin is quite ototoxic and even small amounts can cause all sorts of hearing and balance problems. It is absorbed through your skin–so the more often you use it, the more that gets into your body and can cause ear problems. It sure wouldn’t be a drug I’d use unless it were a matter of life and death–not a “minor” sinus problem.
Cordially,
Neil
Thank you for your quick
response!
Hello,
I used Tobradex drops once in my ear (was also using the Polysporin drops). Within hours, I had intense nerve pain in my ocular nerve, down my neck into my arm, as well as down my spine to foot. For days after I felt unbalanced on same side, and am still dealing with inflammation in my neck on that side. No doctor is telling me that the drops caused this, so maybe they didn’t. Curious about your thoughts?
Hi Lindsay:
I wouldn’t be surprised that the Tobradex caused the problems you name, but I have no proof about your nerve pain as I only study ear (ototoxic) side effects. However, having said that, you mention feeling unbalanced, and that is a vestibular (balance) side effect that taking Tobramycin can cause. Furthermore, since your symptoms occurred only hours later is another indication it was caused by the Tobramycin. Other people have reported their ototoxic side effects occurred just hours later too–so what you experienced is consistent with other reports of Tobramycin side effects.
Cordially,
Neil
Hi Dr.Bauman,
I use makeup a lot, so I’m much more susceptible to pink eye. I got pink eye a few weeks ago, and an optometrist prescribed me 0.3%Tobramycin/0.1 % dexamethasone drops for my pink eye. The doctor instructed me to use it 4 times a day in my left eye. I used it for seven days and then stopped it. I had no hearing or other problems after that. She told me my infection was cleared up and to use it if I ever needed to. I got pink eye a few days ago, and I used it three times, less than my previous dosage. However, this time, I woke up the following day and began experiencing some dizziness and a faint high-pitched ear ringing. I put it down to the pretty drastic weather changes in my area, but I am now thinking it could be the eye drops. I was given. This tinnitus I’m experiencing seems to be relatively mild, though, and I can’t hear it unless I’m in a quiet room. The dizziness has pretty much gone away.
I’m feeling quite frustrated as I developed tinnitus a year and a half ago due to a shot of NSAID medication. The tinnitus almost killed me before subsiding 9-10 months later almost completely; I should’ve known better. However, doctors told me since the amount of Tobrmyamycin is so low in eye drops to not worry about it, and I thought that if it came in the form of eye drops, I would be completely fine. Knowing now that pink eye usually heals on its own, I’m upset the optometrist insisted on prescribing antibiotics.
I’m working on trying to focus on other things, but I’m really worried and frustrated. Given that I’m 21 this year and always have had perfect hearing, have you seen cases like this go away in time? Any advice would be greatly appreciated.
Thank you,
Lana
Hi Lana:
Although the amount of Tobramycin may be low in eye drops, that’s no guarantee that the Tobramycin won’t affect your ears. Many times it doesn’t, but sometimes it does. You are a good example. The first time no, and the second time yes.
Since your tinnitus is so soft you only hear it in quiet places, learn to ignore it and focus on the loves of your life. And in time it could fade away, but if not, it will be in the background and not cause any problems UNLESS you focus on it.
I’ve had tinnitus for more than 70 years, but I do not let it bother me. It is just there–a useless, unimportant background sound that is safe for me to ignore–and that is what I do so hours go by without my even being aware I have tinnitus. But whenever I think or write about tinnitus (like right now) immediately my tinnitus becomes fairly loud. However, I am so habituated to my tinnitus that within 5 minutes of finishing talking/writing about tinnitus, I no longer am aware I have tinnitus. You can do the same. Thus, whether you hear your tinnitus or not doesn’t make any difference to your life.
Cordially,
Neil
Made my tinnitus worse after just one drop of tobradex. An hour later, my head hurt, and I immediately realized that it was because of the drops. The ophthalmologist who prescribed these drops and the hearing doctor completely denies the possibility of ototoxicity of these eye drops. Started taking acetylcysteine and methionine.
God forbid that everything works out, I already have third-degree hearing loss and any hearing loss is very sensitive.
I was prescribed tobramycin eye drops for a corneal ulcer last Thursday(I am post floxed 2018 from Cipro, so my list of meds is short) and I was unaware of the ototoxic nature of this drug. Today is day 9 and I have fullness in both ears, and dizziness (something I thought I was recovered from post flox), and burning in my arms and hands. When I called the doc and pharmacist they couldn’t believe that the eye drops are causing these symptoms but agreed I should stop taking them immediately. I’m really worried about having any permanent issues because of this drug, especially if it keeps progressing after stopping it. It took me alot of time, and supplements and a complete life style change to regain my health the first time a drug damaged me and I don’t know if I can go through this again.
Hi Izabella:
I’m glad you noticed the problem and stopped taking the Tobramycin before it caused even more damage.
It seems you are sensitive to various drugs. I’d NEVER recommend anyone take any of the “floxacin” drugs. They are on my do not take list–second from the top, behind the aminoglycosides which as you know, include Tobramycin.
All you can do now is wait and see what happens. Do whatever you did to get better from being floxed. I think the same principles will apply.
Cordially,
Neil
Hello Doctor,
I have a question about absorption of this drug.
Is it ototoxic when used in the eye because it absorbed in to the bloodstream, or is it possible that it goes through the tear canal into the nose and from there through the eustachian tube and gets into the cochlea?
Also, do you know if any cases of ototoxicity with use of proxymetacaine/oxybuprocaine or fluorescein in the eye?