by Neil Bauman, Ph.D.
A lady asked:
Can HCTZ cause the constant roar I now hear in my ears?
Hydrochlorothiazide (HCTZ) is about the least ototoxic of all the diuretics. It is listed as sometimes causing dizziness or vertigo, but is not listed (as far as I have ever seen) as causing tinnitus.
However, one lady told me that whenever she takes HCTZ, her tinnitus gets louder. Thus, it could be the cause your constant roar (tinnitus) too.
Think back to when you started taking HCTZ. If you didn’t have the loud roar before you began this drug, and your tinnitus started soon after (in the following 14 days or so), then this is strong circumstantial evidence that Hydrochlorothiazide is indeed causing your tinnitus.
To learn which drugs are (or can be) ototoxic, see “Ototoxic Drugs Exposed“. This book contains information on the ototoxicity of 877 drugs, 35 herbs and 148 chemicals.
Around six months ago (2011), I was prescribed Hydrochlorothiazide (HCTZ) for hypertension and after around 2-3 weeks of being on this medication (I take no other meds), I started suffering from a very powerful and strong case of tinnitus. It took me a week or so to figure out what tinnitus was as I’d never experienced it before (nor would I like to again!) and it wasn’t until I tried stopping the medication, that the symptoms went away very quickly.
As a test, I tried taking the tablet once more the day after the symptoms disappeared and the tinnitus came roaring back within hours.
My doctor also said it wasn’t a side effect but I think very rarely it can be.
The tinnitus has never resurfaced since stopping the HCTZ.
I hope this helps someone out there having the same problem.
Paul …..I saw this post from a couple of years ago and I am wondering how long after stopping this drug did the tinnitus go away? I am experiencing the same thing but for me it sounds like crickets. Please help!
I am experiencing ringing in my ears too. Just recently started on this medication. Its driving me crazy. I’m calling my doctor tomorrow.
Seven days ago I began to have this roaring sound in my right ear. I Google it and docs and others say go see a doc if it persists over 5 days. Day six I go to the doc, show him my head phones and tell him this occurred after working out. I didn’t know that the hydrochlorothiazide pills as a part of a weight loss regime prescribed by the weight loss clinic could play a part until I continued to research even more. Can this be possible for me? When will it stop? What should be my next steps? My doc said wait a few more days.
I also was prescribed this medication on 8/31/09 to help with the swelling in my ankles. I didn’t know it then but after stopping it and now started to use a different kind of diuretic pill the whooshing in my left ear came back, this is when I put 2 and 2 together. I read in a web page, (now I can’t find the page) that it can cause ringing in the ears.
It is the worst feeling you can have, I went through a lot of testing and analysis before they said it was tinnitus. The doctor had prescribed a high dose of calcium vitamins that together with my ears popping during a coast to coast flight the tinnitus stopped. The doctor prescribed me some other diuretic pill not too long ago and last week the tinnitus came back. I stopped taking the pills and it the symptoms stopped also. Glad I googled it and found this page along with the other one that I lost. Thank you for posting your story.
I have been experiencing ringing in the ears when started taking Telma H 40 + 12.5mg Hydrochlorothiazide. What is your advice because this is desturbing me a lot?
Hi Charles:
Telmisartan and Hydrochlorothiazide can both cause tinnitus. Tinnitus from HCTZ may be temporary while you are taking it. You might want to talk to you doctor about this and just take a pill containing Telmisartan alone and see whether your tinnitus reduces or goes away. If so, you know it is the HCTZ.
Or get your doctor to try a totally different medication and see whether your tinnitus goes away.
Cordially,
Neil
I have taken HCTZ for years now, and just this year I developed tinnitus. I have stopped taking but so far still have crickets. I would assume if it could cause it immediately then it could also build up over time. I read somewhere that Vit.B-12 deficiency may be a culprit.
I have been taking hctz for three days, and have pain in my ears similar to an ear ache and slight ringing. Is this a common side effect?
Hi Kcarr:
Hydrochlorothiazide can certainly cause both ear pain and tinnitus in some people. These two side effects are among the top 7 ototoxic side effects of this drug. The other 5 in the top 7 are hearing loss, ataxia, balance disorder, dizziness and vertigo.
Cordially,
Neil
Count me in as a believer that HCTZ causes tinnitus. I tied to go off and on many times and at least i can say that it makes it worse.
Hi Lou:
Right. And that’s not all. I was reading a couple of days ago that taking HCTZ increases your risk of skin cancer by 700%. So even though it seems to be a relatively benign drug, it’s not when you consider everything.
Cordially,
Neil
I started taking Hydrochlorothiazide several months ago. I now have very loud cricket sounding tinitus. I had tinitus before but not this loud and annoying. If I stop the hydrochlothiazide will the tinitus get better? I am also taking Toprol XL.
Hi Deborah:
Both Hydrochlorothiazide and Metoprolol (Toprol XL) can cause loud tinnitus. My money is on the Metoprolol rather than on the Hydrochlorothiazide as the cause of your tinnitus as it is much more ototoxic than the HCTZ.
There is a good chance that if you stop these drugs (particularly the Metoprolol) your tinnitus will go away, or at least drop in volume.
Cordially,
Neil
Hello, I started taking hydrochlorothiazide about two months ago. About a month and a half later my right ear started ringing like a loud high pitched hissing noise. I called my Dr and she said it was my blood pressure but I informed her that I was monitoring it and it was fairly normal. I then called my kidney dr who was actually the one who prescribed the HCTZ and he said the ringing wasn’t caused by the meds in fact he said it would help the ringing. I then went to an ENT and he instructed me to stop the HCTZ for a few days and see if it stopped. Well I tried for 3 days and no change so I started taking it again. They have since done testing on my ears and said that there is nothing wrong with my ears. Is there a time frame in which I should be off the HCTZ to see if this may be the cause or is three days enough?
Hi Saundra:
I disagree with your doctors that a) hydrochlorothiazide doesn’t cause tinnitus–it does–hundreds of cases of tinnitus from taking this drug have been reported to the FDA; and b) it helps tinnitus go away–I doubt it unless your tinnitus is caused by high blood pressure and the HCTZ brings your blood pressure down.
Normally, I suggest a person go off the drug for around 2 weeks or so to see if the drug is causing their tinnitus. It takes a while for the drug to leave your body and then some more time for the tinnitus to fade away. Some people find their tinnitus quickly goes away, and for others it takes much longer. In your case, obviously either three days was not enough, your tinnitus is permanent, or the drug did not cause your tinnitus. Personally, I’d give it more time–and in the meantime, don’t focus on your tinnitus or it can take on a life of its own.
Cordially,
Neil
Can HCTZ cause aural fullness as well? I have such a strong and irritating sense of my ears being under water and muffled hearing, and I believe it started with my regular use of HCTZ.
Hi Hannah:
Among all the other ototoxic side effects HCZT causes are things like “ears blocked”, “Ear discomfort”, “Eustachian tube dysfunction” and “ear disorders” which all could be interpreted by some as your description of “aural fullness”. So yes, I believe that HCTZ can cause aural fullness. And it can certainly cause muffled hearing which is another way of saying hearing loss (typically in the higher frequencies). Hundreds and hundreds have reported this side effect to the FDA so it is not as rare as you might think.
Cordially,
Neil
I’m taking hydrochlorizide and both ears are ringing is this a common factor in taking this med?
Hi Kendy:
I wouldn’t say it is a really common side effect, but hundreds upon hundreds of people have reported to the FDA that they got tinnitus from taking this drug—so it certainly happens to some people.
Cordially,
Neil
I have tinnitus from an ear injury on 4-7-19, i just started taking blood pressure medicine (HCTZ) on 5-10 but after researching why both ears were now high pitch ringing. i really think it is from the hydrochlorizide. I stopped yesterday and I hope it subsides soon. I know why my right ear is ringing from the trauma on 4-7 but i was confused why my left side was now ringing..
Scott
Hi Scott:
When taking drugs that can cause tinnitus such as HCZT, you can get tinnitus in both ears, or just one ear.
Hundreds upon hundreds of people have reported to the FDA of getting tinnitus from taking hydrochlorothiazide. The good news is that typically the tinnitus goes away after you stop taking this drug, or at least reduces a lot in volume.
Cordially,
Neil
I also began experiencing pulsatile tinnitus almost immediately after starting HCTZ. I didn’t know what was causing the loud whoosh in right ear. Just today, I ran out of HCTZ, having taken my last dose yesterday morning. With just missing one dose, my tinnitus went away.
Hi Heath:
Cool. I hope it stays away and this wasn’t just a bit of an anomaly.
Cordially,
Neil
Started Hydrothoro… in Dec 2019. Last week ringing in left ear started. Research indicates meds are at cause. I have a f/u with w dr next Thursday and an ENT on Wed. Is it safe to stop Hydro… on my own? Only been a month and BP is not in danger (even without).
Hi Rachel:
Remember, I’m not a medical doctor, but I’m with you–since you are not at the danger level with your blood pressure and you are having ototoxic side effects, if I was in your situation, I’d probably dump the drug and tell my doctor afterwards since taking HCTZ does not build up dependence like mind-altering drugs do.
Cordially,
Neil
I am taking a combination of HCTZ, Lisinopril and Amlodipine for high blood pressure. I have been on this combination since November and shortly after starting developed tinnitus. Could this combination be causing the tinnitus or just the HCTZ? When the HCTZ was added it also raised my heart rate.
Hi Joanne:
Actually, all three of these drugs cause tinnitus in many people. Lisinopril is the worst, closely followed by Amlodipine, and with Hydrochlorothiazide only having about half as many reports.
However, who knows what this combination does?
So, theoretically, the HCTZ should not be the culprit, but because each person’s body is different, who knows how it acts on your body.
I think you are your doctor need to re-evaluate the drugs you are taking.
Cordially,
Neil
I’ve been taking Hydrochlorothiazide for a few months now. Because I developed an allergic reaction to Lisinopril so they switched me to Hydrochlorothiazide. I’ve also been suffering from ringing in my ears. I chose to ignore it but the other day it was so bad I decided to do research and I’ve found that water pills can cause ringing in the ear. Never had it until I started Hydrochlorothiazide. So I’m on day 2 of not taking the medication and it seems to be getting better.
Hi Robert:
Hydrochlorothiazide causes tinnitus in hundreds and hundred of people, but the good news, at least for numbers of them, is that when they stop taking the Hydrochlorothiazide, their tinnitus goes away or greatly reduces in volume.
Cordially,
Neil
I’ve been on Hydrochlorothiazide for a month. Went to ENT for constant buzzing in ears. All day non stop. Told me to get off of it. Driving me crazy. Hopefully it’ll help
I have been on HCTZ for years and have dealt with the ringing in my ears because I thought I had to be on this (not for heart). Anyway, with the COVID quarantine, I could not go to the doctor to get it refilled and guess what? The ringing has completely stopped! I cannot believe I no longer have this issue! Thank you Neil for your responses!!
Hi Steffnie:
That’s great that your tinnitus stopped when you went off the Hydrochlorothiazide. Shows the tinnitus from this drug doesn’t have to be permanent–even after taking it for “years”.
Cordially,
Neil
Hi, just last week I’ve been diagnosed with hypertension and was put on HCTZ 25mg. From the night of taking the pill I started having loud ringing in my ears and also palpitations. Doctors think that it might be due to BP and not with the drug. My BP is under control now but these two (ringing and palpitations) are killing me. Is there any alternative drug that can help me here? Thanks in advance.
Hi Sri:
There are other drugs that might work such as Bendroflumethiazide, Chlorothiazide, Chlorthalidone, Hydroflumethiazide, Methyclothiazide, Metolazone, Polythiazide, Quinethazone, Trichlormethiazide. These are all in the same class of drugs as hydrochlorothiazide.
Cordially,
Neil
I have been taking 25mg of hydrochlorothiazide for about 5 months. About 1 month ago the ringing started in my left ear, now it is both ears. It is so loud and so high pitched I am really not coping with life. It is debilitating. The worst torture I can imagine. I wondered if it was this drug after Googling but doctors told me no. I am so so desperate for help.
Hi Rebecca:
The doctors you consulted are obviously ignorant of the truth. Conservatively around 82,000 people per year in the USA experience tinnitus from taking this drug based on reports of tinnitus side effects to the FDA database. That may not seem like many when you consider that 42,000,000 prescriptions are written each year–but to the people that get screaming tinnitus it is a lot.
The good news is that if you stop taking it for a couple of days you may find your tinnitus completely goes away, as it has done for several people that have contacted me after doing just that.
Cordially,
Neil
Thank you. I have stopped taking it and I hope it works. I also take Micardis 80mh (telmisartan) but have been on that for about 2 years. I was having a series if headaches also when the tinnitus started. I am just racking my brains as to what caused this so I can fix it. No one is helping me. Doctors have started saying learn to live with it. I noticed the ringing early December 2020 but it wasn’t until the 27th December 2020 that it became dibilitating and life changing. Thank you.
Hi Rebecca:
Was there anything else going on in your life just before Dec 27th that might have precipitated the loud tinnitus? Any difference in your emotional status for example–more anxiety, stress or depression?
Did you take any other drug–even just one pill back around then?
Cordially,
Neil
I was having headaches that started late November. I was taking Ibuprofen probably once or twice a day but not max daily dose on any day and I wasn’t taking it every day. In fact, the week before the tinnitus started the headaches disappeared. I have no real stress or anxiety in my life. I have never suffered depression but I feel this is sending me that way really really quickly.
Hi Rebecca:
Just be aware that Ibuprofen is fairly ototoxic. I’ve received more reports of people getting tinnitus from taking Ibuprofen–even just one pill–than for almost any other drug. So, since you were taking a fair amount of Ibuprofen in late Nov and Dec, I wouldn’t be surprised if the Ibuprofen might have been the culprit rather than the Hydrochlorothiazide–or the two of them together (albeit sequentially) might have caused your tinnitus.
Cordially,
Neil
Will the tinnitus go away now I have stopped taking it?
I just rememberred on December 17th 2020 I was in the emergency department and they gave me a drug through IV drip to control migrane. I don’t recall the name and it is not on my discharge report.
I had a bad ear infection about a week before I was put on hydro on December 3rd started stopped on the 8th due to ear pain and ringing in ears then was put on metropolol 50mgs a day for the last 4 and a half weeks then stopped taking everything about a week ago and the ringing is still there, is this permanent? Cause it’s still ringing but I’ve only been off drugs a short time, and was this unethical of my doctor to put me on these drugs so soon after a ear infection?
Hi Slade:
Ear infections can cause hearing loss and tinnitus if they get into the inner ear, or just into the middle ear where the symptoms are usually temporary while you have the infection.
Hydrochlorothiazide can certainly cause tinnitus but the good news is that when you stop taking it, at least for a number of people, the tinnitus goes away.
Metoprolol also certainly does cause tinnitus in numbers of people. Again, the good news is that you have a good chance of the tinnitus going away when you stop taking this drug.
I don’t see that either of these drugs had anything to do with how your ear infection progressed or not. So I wouldn’t fault your doctor in this.
Cordially,
Neil
Oh I actually meant I had a bad ear infection that was treated and cured but still with much effusion the week before, I’m sorry I wasn’t more clear, and thank you for the quick reply and clear answer Neil that gives me hope I will have some quiet again
Sorry doctor I feel I didn’t lay out my situation well enough, my ear infection started October 24th and didn’t get treated and cured until November 26th during the actual infection I didn’t have constant tinnitus , but after treatment still have lots of mid ear effusion, then on December 3rd I was started on hydro then discontinued on December 8th due to loud ringing and major pain. After stopping the ringing stopped for about 5 days till I was put on metropolol 50 mg and about 3 days later the ringing came back full force and I did not get off metropolol until January 8th as instructed by my internist because I am 25 and had high bp for my whole life and there was a probable secondary cause. It’s been 11 days since stopping metropolol the ringing is still there, but they did tell me it could take 3 months for the pressure to get back to normal , based on this more detailed info do you think it’s permanent or do you think I just need to wait and see as my ears are still healing? Thank you for all of your feedback
Hi Slade:
Based on this, it seems that the Metoprolol ultimately caused your tinnitus. The time varies how fast tinnitus goes away after stopping taking Metoprolol. It could be as fast as 2 days or a week, but it could be a lot longer too. If you still have it after a month or so unless it is continually fading more and more, I’d say it will likely be permanent. Hopefully, it drops in level soon.
Cordially,
Neil
Hi I’ve been taking hydrochlorothiazide for years and I started with ringing in my like for weeks ago can this be related with medicine I stop taking it 2 days ago can you help me
Hi Rosa:
Hydrochlorothiazide can and does cause tinnitus in numbers of people. When you stop taking the hydrochlorothiazide, some people find their tinnitus disappears in a few days. You may have to give it more time.
Cordially,
Neil
I am so glad I seen this article. I have been on hydrochlorothiazide since October. The ringing and pressure in my ears is every day on and off every day. And on top of that I get ear aches that will last for maybe just seconds and disappear. Or sometimes longer. I have had four doctors looking my ears. Every time they see nothing and look at me like I am nuts. I’m getting hold of my doctor Monday morning and asking her about switching me. I have been saying all along I thought it was from this and wasn’t sure until I was reading this. So other than the ringing in the ears the constant pressure and sometimes a touch of vertigo, has been constant ever since I’ve been put on this medication.
I forgot to mention I take hydrochlorizide along with The blood pressure Losartan.
Hi Kelly:
The good news is that generally the tinnitus and other ear symptoms go away when you stop taking Hydrochlorothiazide. You need to find another medication (if you really need one)–changing your diet is a better way to lose weight in my opinion.
HCTZ also can cause the ear pain and the vertigo you also experience.
Losartan can also cause all the ear symptoms you are experiencing. Taking both together may be making these symptoms worse than they otherwise would.
Cordially,
Neil
Is there even a blood pressure medication out there that does not cause the ringing in the ears? Or the symptoms of the ears always feeling congested?
Hi Kelly:
I rather doubt it. All the ones that I have in my drug book–even the new, upcoming edition, list tinnitus as a side effect. I don’t think all of them list congested ears as a side effect. So the trick is to find the blood pressure meds that work for you, but are the least ototoxic.
Cordially,
Neil
I started 25 mg HCTZ for Menieres in January, and was still experiencing dizziness and fullness so my ENT put me on Triamterene which still has 25mg of HCTZ and thiazide. I’ve always had low grade tinnitus but I started experiencing loud tinnitus spikes 3 weeks after starting Triamterene, primarily in the middle of the night lasting for an hour. I’ve been off Triamterene and HCTZ for 10 days now and the tinnitus spikes are still waking me up in the middle of the night. Do you think there’s a correlation to these spikes and the HCTZ?
Hi Pina:
There is no doubt that HCTZ can and does cause tinnitus. I’ve heard from numbers of people in that boat. Triamterene can also cause tinnitus, and the drug you are now on has both drugs so you could be getting a double whammy.
For some people, the tinnitus fades away in a few days. For others it seems to be permanent.
If I had Meniere’s, I wouldn’t take drugs such as you are taking as they do not cure the basic problem. If you truly have Meniere’s and want to get rid of it, I suggest you read my comprehensive article on the subject at https://hearinglosshelp.com/blog/atlas-adjustments-alleviate-menieres-disease/
Cordially,
Neil
Hello Sir,
My doctor ordered Benicar 20mg and HCTZ 12.5mg once a day. I have been taking these drugs for about 9 years. I have experienced pulsatile tinnitus in my right ear for the past 4 years with worsening. I can barely sleep because of it. I have gone to my primary care physician, a cardiologist, the
ENT, and a neurologist. All have said that I will have to live with the tinnitus. Fortunately, I have begun listening to white noise to help me sleep. I have read the various posts and your responses about HCTZ, but concerns about taking Benicar. Could Benicar cause tinnitus too?
Hi Soji:
Yes, numbers of people have reported getting tinnitus from taking Olmesartan (Benicar), but far more have reported tinnitus from taking HCTZ.
So your tinnitus could be from the HCTZ or the Benicar, or a combination of both. And it could be totally unrelated too, since you are experiencing pulsatile tinnitus.
Cordially,
Neil
Hello neal I lost total hearing in right ear one day after taking this medicine & been having the ringing crazy bad also.. if this medicine caused me to go deaf in that ear you think itll come back after a week?
Hi Justin:
I used to thing that Hydrochlorothiazide wasn’t very ototoxic, but the more information I receive, the more I realize it can mess up our ears. One study revealed that the median time for ototoxic side effects to show up was only 3 days, so you are right in the ballpark with your hearing loss.
This is because medications affecting sodium and potassium transport in kidney tissues alter ionic homeostasis of the inner ear causing functional problems like hearing loss, tinnitus and vertigo.
Hundreds upon hundreds of people have reported to the FDA’s data base that they lost hearing after taking this drug.
The good news is that numbers of people have reported their tinnitus going away and their hearing coming back when they stopped taking this drug. So if you don’t take it anymore, you have a good chance of this happening to you too.
One stud revealed that hearing loss was temporary in 67% of the people that stopped taking this drug, but permanent in 33%. I’d assume that tinnitus would have similar results. I’d expect this to occur in the first two weeks after stopping taking this drug if it is going to happen.
Cordially,
Neil
I’ve also have been experiencing intense tinnitus when I’ve been put back on the water pill. 5 days ago.
I’ve experienced hearing loss over a course of 7 years and have been experimenting with different blood pressure meds w hctz.
Since i just added it back on 5 days ago, my tinnitus is more intense and very loud roaring sound. Unbearable.
I’m going in for a cochear implant assessment this week. So I will not take the hctz over the next 2 days and talk to my Doctor about an alternative.
I’m glad to hear others have experiences the same outcome. I’m not going crazy!