by Neil Bauman, Ph.D.
The Center for Hearing Loss Help has just released what is probably the most comprehensive list ever compiled of the hundreds of drugs, herbs and chemicals that have been associated with tinnitus.
Neil Bauman, Ph.D., the author of the books, “Ototoxic Drugs Exposed” and “When Your Ears Ring—Cope With Your Tinnitus—Here’s How” compiled this list. It contains 563 drugs, herbs and chemicals that are associated with tinnitus. Of this total, 529 are drugs and medications spread over 1,131 brand names, 5 are herbals under 12 different common names, and 29 are chemicals known under 125 different chemical names.
This new 30 page 2013 list of Prescription Medications, Over-the-Counter Drugs, Herbs & Chemicals Associated with Tinnitus is available free for download.
Thirty pages?!
I only take ONE medication regularly, so thank goodness for CTRL+F.
Hi Brandon:
Did I mention that there are two columns per page! LOL
But not to worry, they are all in alphabetical order.
Regards
Neil
I had a bad cold cough in January and my ears were plugged. I took antibiotic medication for a week and once my ears unplugged I have tinnitus—a high pitch continuous sound In my ears.
Is it possible it could still go away? Is there anything I can do?
Hi Shirley:
Anything is possible, but after 3 months, it would seem that your tinnitus is going to be permanent. You don’t say what antibiotic you took. Some tend to produce permanent tinnitus.
Regards
Neil
I seemed to have developed tinnitus a high pitched squeal aftert taking gabapentin and Ativan. A sinus infection was also found so was first taking augmentin, then switched the clindamycin, rifampin and prednisone. Also Flonase and mucinex D. I have discontinued prednisone and finishing other antibiotics in a few days. Due to anxiety they increased the neurontin dose which I the noticed a lower ring developed in the other ear. Please advise about ear ringing. We are discontinuing neurontin. Trying to move off Ativan. Please advise and thank you.
Hi Amber:
Gabapentin (Neurontin) is known to cause hearing loss and tinnitus so getting off it is all to the good. It also causes a lot of balance problems. Lorazepam (Ativan) is a lot less ototoxic although it can cause hearing loss and tinnitus in numbers of people.
Even if you can’t get off the drugs, reducing the dose may cause the extra tinnitus to go away since the tinnitus in your other ear only appeared after you increased the dose.
Regards
Neil
Thank you so much for your answer. We are considering a sleep aid…elavil. What is ear ringing risk for this drug? Are you familiar with melatonin and its higher dose for sleep?
Many thanks,
Ambre
Hi Amber:
Amitriptyline (Elavil) is a tri-cyclic anti-depressant. I sure wouldn’t call it a “sleep aid”. If I needed help calming down so I could sleep, my first choice would be the herbal Valerian. It works, doesn’t make you drowsy the next morning and is not ototoxic.
Back to the Elavil. I have received several reports of people getting severe tinnitus from taking Amitriptyline–so that alone would be a good reason not to make it your first choice–unless, of course, you like “screaming tinnitus” as your constant companion. Elavil causes tinnitus in more that 1% of the people taking it.
I know numbers of people take melatonin, but I don’t get into dosages. Melatonin is not ototoxic as far as I know–so it may be a good choice.
Regards
Neil
About two weeks ago I developed fever, rash and stomach pain the doctor said it could be salmonella/food poisoning he prescribed prosky (Ciprofloxacin). I took it for 7 days and tinnitus seems to appear and would not go away. It has been 5 days since I took it I am not taking any other drug now
Would this ever go away it is affecting my sleep somehow,
Thanks
Hi Phillip:
I have heard from numbers of people who have taken Ciprofloxacin and as a result, now have tinnitus (and often hearing loss). The incidence of both hearing loss and tinnitus from taking Ciprofloxacin is somewhere around 1%. The resulting tinnitus may be temporary or permanent. For some people it takes quite a while for their tinnitus to finally disappear. For others, it never goes away. I can’t predict what will happen in your case, but it may slowly go away. In any case, you do NOT want to focus on it or it can become worse (and become permanent too). So the best thing is to ignore it by focusing on the loves of your life and let it slowly fade into the background where it won’t bother you much or at all.
Regards
Neil
How does focusing on tinnitus make it worse and/or permanent?
Hi Debra:
It goes like this. If you focus on your tinnitus, that shows you have an emotional involvement. Typically, you are anxious or worried about your tinnitus so you focus on it. Your limbic system (the seat of your emotions then gets involved. Since you are anxious about this tinnitus sound, your limbic system flags it as important and thus you perceive it as even louder and more intrusive. When you limbic system sees you are getting more and more upset, it “cooperates” and you now perceive your tinnitus as still louder and yet more intrusive.
As long as you have this emotional “attachment” to your tinnitus it will persist and eventually forms an endless sound loop in your brain and this becomes permanent.
The way to take control of your tinnitus is to do the opposite and totally and completely ignore your tinnitus. You need to demonstrate to your limbic system that you do not perceive your tinnitus as a threat to your well-being in any way shape or form. When you do that, your limbic system slowly turns down the internal volume and you tinnitus slowly becomes fainter and fades into the background.
Thus, the secret to controlling your tinnitus is to treat it as “fridge noise” or some other equally-unimportant sound that you totally ignore even though it is there.
I explain all this in much more detail in my book, “Take Control of Your Tinnitus”.
Cordially,
Neil
Thanks Dr. Neil. I forgot to mention it seems that when I took Cyclobenzaprine muscle relaxer seems to exacerbate the issue. I thank you for your advice is there any other pill I could take that will help me to sleep without the concern on making tinnitus worst?
Thanks
Hi Phillip:
Cyclobenzaprine can also cause tinnitus in less than 1% of the people taking it–but I have not received any anecdotal reports about it, so I suspect it is not all that common. But if you found that it made your tinnitus worse, it probably did.
I am not a medical doctor so I don’t prescribe or recommend any “pills” (drugs) for anything. However, if you want to try a herbal, a lot of people have found that Valerian helps them relax and get a good night’s sleep. It is not ototoxic and does not make you feel drowsy the next day. You can get it at most any health food store. This is what I’d try if I were in your shoes and my tinnitus was bothering me.
Regards
Neil
Dr Neil. I hope you see this as I know this is an old thread. I am experiencing absolute searing, unimaginable nerve pain from a pinched nerve in my neck/shoulder blade area. It’s 24/7 with little to no relief. It’s wearing me down and It’s unbearable. I try and stay away from all ototoxic drugs and so that is why I have been suffering with this horrendous pain and I just can’t take it anymore. I was given medrol which I felt was the better alternative to anything else. That did not work.
I tried lidocaine cream, no luck with that. Finally I let the Dr give me a toradol shot because I was desperate. It helped a little for a few hours. I was given Diazepam 2mg and out of desperation took 3 yesterday and 1 today. Very frightening to do so as I know it is ototoxic. I need badly to try and calm and loosen my muscles. I am at my absolute wits end and can’t bare this anymore. I was given a prescription for cyclobenzaprine when I went to the ER when this first happened and have not taken it as I’m so frightened that it will cause Tinnitis but I am so desperate for this pinched nerve to get better that I am wanting to take it. It’s been three weeks of searing pain. I see in your comment that it doesn’t cause T often. On your scale, how ototoxixlc would you rate this drug? I see it only induces T in less than 1% of people. What do you think my chances are of being safe if I take this for a short time.
Also, I’ve already taken the Diazepam and Toradol shot and now have one/two ototoxic medication in my system and so will putting another one in up my chances of T. Took the Toradol shot three days ago, took 2, 2mg Diazepam yesterday, one two afternoon time. Took another today at like 1-3 am and one at about 9:30/10 am.
Hoping you will see this and respond as I am in so so much pain.
Hi BW:
From everything you have said, it looks like you are only receiving treatment from a medical doctor who is just prescribing drugs. If I were in your shoes, my first line of attack would be to visit a chiropractor. (I’ve done that many times over the years myself and have never had to take muscle relaxants or pain killers as a result.) Massage therapy also is good once the chiropractor has things back in proper alignment.
I rate Cyclobenzaprine as a class 2 (or maybe 2.5) out of 5 drug. So it is ototoxic, but not near as bad as some drugs. Since you have already taken various drugs and have not gotten tinnitus, I think that you may not get tinnitus from the Cyclobenzaprine either. But don’t take more that you need–try to fly under the ototoxic radar.
And try to remain as calm as you can. Stress an anxiety can trigger tinnitus or make tinnitus worse.
Since you are in so much pain, you have to do something. In your shoes, I think I’d take Cyclobenzaprine and then go to the chiropractor as soon as it relaxes your muscles enough for him to work on you.
If the Cyclobenzaprine makes your tinnitus worse, don’t think it has to be a life sentence. As one lady reported, “ I took Flexeril last night because I have a pinched nerve in my leg and back and my ears screamed for 2 hours before they finally calmed down and I was able to sleep a little.”
Hopefully, you will be ok.
Cordially,
Neil
Thanks so much I will give upit a try!
Thank you
hola doctor hace 5 meses que padezco de un ruido en el oido derecho y fui con el medio y me dijo que el oido derecho lo tengo tapado y que necesitaba lavarlo porque estaba muy tapado sera esto la causa del ruido.
Hi Maria:
If your ear canal is clogged with wax, it can cause some hearing loss and associated tinnitus (ringing in your ears).
The solution is simple, have your doctor clean your ear canals of all the wax and the tinnitus should go away and any lost hearing should return.
Regards
Neil
What about a .250 mg dose of alprazolam for taking the edge off. I am looking for something to help me with the anxiety of tinnitus. I don’t need it all the time, just once in awhile when it is really bad.
Hi Deb:
Probably taking Alprazolam occasionally won’t produce any ototoxic side effects, but be aware that the longer you take it, the more likely you could experience side effects such as tinnitus and hyperacusis (especially when you try to quit and get off it), as well as a number of balance problems. So you want to be careful not to get hooked on Alprazolam.
A much better solution is to learn how to deal with your anxiety–then you won’t have to take any ototoxic (or other) drugs.
Regards
Neil
I take bupropion in the morning and I feel that has a a relationship with the increase of tinnitus for me.
Are there any alternatives?
Thank You,
Jessica
Hi Jessica:
Bupropion causes severe tinnitus is some people, or an increase in existing tinnitus.
There are several alternatives. For example, you could stop taking this drug. You could choose to take herbals (that are not ototoxic) instead. You could ask your doctor for a different drug.
Regards
Neil
I have taken Doxycycline and Sertraline/zoloft for many many years and recently developed tinnitus. These 2 drugs are on your list but my question is if you have taken them for a long time with no side effect would it be more or less likely that they are the cause? Also, Sertraline is on the list as a causative drug but also on the list in the article describing drugs used to treat tinnitus. Can you explain?
Does zopiclone have side effect on tinnitus
Hi Susie:
Not as far as I know. I’ve never seen tinnitus listed as a side effect for Zopiclone, only ataxia and dizziness.
Regards
Neil
Dear Dr. Neil…
Have just had a long conversation with Dion at ATA and she suggested your website, etc. = great!
The reason I was talking with her was to share my more recent awareness of a tinnitus factor that I, and probably many others, are not aware of – or do not put together.
I have very loud ringing tinnitus (an E flat screech) and some hyperacusis. Initial tinnitus was from a firework (classic “loud sound”) as a child, then three jumps up over rest of my life (now 62), with the latest 6 months ago.
Without going into a lot of detail, the point I would like to make is that even highly “tinnitus educated” people like myself can blow it and not get this until it is too late.
Many people (general public) are aware that loud sound can cause hearing damage and tinnitus. Perhaps slightly fewer are aware that ‘time exposure’ to even somewhat loud sound can also cause damage and tinnitus.
Even fewer people are aware of ototoxicity and how widespread that really is or can be. Even doctors are remiss here in my experience. Certainly the general public hardly gives it a thought for OTC drugs like Ibuprofen bought without a prescription. “Hey it must be safe!” and eat the stuff like candy. Mostly we get away with it.
However, what I am bringing to attention here is something that I had not really heard about before or plain did not think about…The “combination”!
My most recent jump up in ringing/tinnitus was from very moderately loud sound (a meeting in a bad acoustically reflective room) AND that I was taking a very low dose of a drug (Sporanox) with a moderate to low (as far as I could tell) hearing related signature.
In retrospect I am convinced that if one or the other had occurred I would have been OK…If I was just taking the Sporanox my tinnitus would not have jumped up (I had taken it at same dose for many weeks on 7 prior occasions over the previous 3 years to no ill effect). If I had just been exposed to the sound in the meeting without having the drug as well, I would have been OK…as I had been in louder situations before – when on no medication, and been OK.
This “combination awareness” got me thinking and I asked four people I know with tinnitus (one just got it a few months ago): “When you got your tinnitus where you A. Exposed to loud sound? B. Taking any medication? C. Both?
Initially, the responses were almost all “neither”…but with pushing I found out that. “Oh, well yes, I was playing Marimba in the band I am in on weekends, but it has never been a problem before”…Me: Well maybe not, but were you also taking medication at this new time when the tinnitus started. Answer: “No, I have not seen a doctor for years”. Me: What about herbs, or aspirin or anything like that? Answer: “Well, I was taking Ibuprofen for a week or so then as my migraines were pretty bad”…BINGO! There it was.
Same pattern with the construction guy hammering and taking Ibuprofen for joint pain. Etc.
Like me, I think it was a “piggy-back effect” of the drug opening up the possibility of tinnitus, or increased tinnitus, IF EXPOSED TO SOUND THAT MAY HAVE BEEN OK BEFORE BUT NOW IS NOT WHILE ON THE DRUG!
I have a sense that this “combo” effect is just plain not on the radar. If I missed it, being so tinnitus aware and never going anywhere without two sets/types of earplugs in my pocket, then how many others are???!!!
I guess I am proposing an awareness campaign of not only “ototoxicity”, or “be aware of damage from sound”…but: “be doubly aware if you are taking a drug even with a low ‘hearing effect’, to ALSO avoid loud sounds while taking it!”
I think this awareness and knowledge is almost non-existent…as I missed it. I never put it together until it was too late and I of all people should have known better.
Sorry for the long post, and no doubt you know all this, but I am confirming through painful regret that meds AND sound can be a terrible combo.
Best, Michael M.
Dear Dr. Neil
I contracted Tinnitis afer I had a severe case of Vertigo . The Dr. perscribes Lorazepam {.5 mg 1 tab every 6 hrs} could this have caused my tinnitis?
I have stopped all meds now the Vertigo has cleared up hopefully the ringing in both ears will go away.
The Dr. also had me take 3 advil with each dose
Thank You
Al
Hi Al:
I’d think it more likely that whatever caused your vertigo also caused your tinnitus. Having said that, Lorazepam can cause tinnitus in some people. Some people get a pulsating tinnitus from taking Lorazepam.
However, few people seem to realize that taking Ibuprofen (Advil) can cause severe (and often permanent) tinnitus in good numbers of people. Taking Ibuprofen is much more likely to cause tinnitus than taking Lorazepam.
Regards
Neil
Will stopping the taking of Ibuprofen help with the ring in ears?
Hi Gary:
Often it does. You could find your tinnitus goes away, or more likely, reduces in volume when you stop taking Ibuprofen, rather than go away completely. However, for numbers of people the tinnitus proves to be permanent and doesn’t reduce in volume when you go off the Ibuprofen.
Regards
Neil
Having read all the posts here (especially Michael M’s), I’m wondering if aspirin is safer than ibuprofen as far as having a negative affect on tinnitus. How about Tylenol? I reach for ibuprofen often–took two this morning to ease the stiff neck I awakened with!
Thank you!
Ann
Hi Ann:
I’d probably agree with you that Aspirin is less ototoxic than Ibuprofen. With Aspirin, the ototoxic effects are almost always temporary. With Ibuprofen, they can be permanent. In order to get tinnitus from Aspirin, the conventional wisdom is that you’d have to take several adult Aspirin a day. So taking one Aspirin probably wouldn’t give you tinnitus. If you are very sensitive to Aspirin (those with salicylate sensitivity) even one Aspirin can be too much.
Tylenol (Acetaminophen) has recently been found to cause permanent hearing loss if taken regularly.
Of the three, just looking at it from an ototoxic perspective, I think that Aspirin would be the least ototoxic in the long run.
Regards
Neil
Hi Dr. Neil,
I’m 27 and I suffer from tinnitus and hearing loss. A doctor prescribed me Diazepam 2 mg for the ringing, and I should take them every day for 3 months. I was wondering whether it would help me, and is it safe to take those pills for such a long period of time.
Thank you,
A.
Hi Aphrodite:
The only thing Diazepam is going to do is drug you so you aren’t as aware of your tinnitus as before, and won’t care that you hear it. It will not take your tinnitus away. You should know that the FDA has NOT approved ANY drug for tinnitus–obviously because none have been proven to work.
Personally, I wouldn’t take drugs for tinnitus–never have–and I’ve had tinnitus for more than 60 years. I’d use the many other things you can do to help yourself bring your tinnitus under control. My book on tinnitus covers many of these options. You can see it at http://www.hearinglosshelp.com/products/books.htm#tinnitus.
Regards
Neil
Hi Aphrodite:
Diazepam (Valium) is a Benzodiazepine class of drugs. These drugs are dependence-forming and thus should not be taken for longer periods of time. To me, a safer limit is two weeks or less. Personally, I would never take drugs for tinnitus. The idea behind Diazepam is that your tinnitus won’t bother you so much (because you are drugged), but when you stop taking it, there is your tinnitus again. So what was really accomplished? In my opinion, it is much better to learn how to effectively deal with your tinnitus so you don’t need drugs.
Regards
Neil
Have had tinnitus for 3 years….drug related. a new occurrence is pulsation with my heart beat and the tinnitus in both ears. I need help…really bad. How long can I endure this?
Hi Judah:
Why are you insisting on taking drugs that make your tinnitus worse? Tell you doctor you want different drugs or you want off the drugs that make your tinnitus so bad.
Or maybe I read your message wrong–and that you got tinnitus from taking drugs 3 years ago, but you are not on any drugs now. Is this the case? If you want help email me privately giving me the full details of your situation. You can find my email at the bottom of any page on the Center’s website at http://www.hearinglosshelp.com.
Regards
Neil
Hi I took verapamilo (manidon) for 1 month and after 2 weeks taking this medicación I feel tinnitus in my left ear, can this medication cause tinnitus?
Hi Luis:
Yes, Verapamil can indeed cause tinnitus. One lady’s ears began ringing on the 3rd day. It didn’t take two weeks like yours did. Verapamil may cause tinnitus in as many as 1 person in every 50 who take this drug according to the PDR.
Regards
Neil
Thank you Dr. And after stoping the verapamilo Will this stop? And how many days takes
Hi Luis:
After stopping the drug, your tinnitus may or may not stop. There is no way to tell in advance whether it will be temporary or permanent. If it is going to go away, I’d think it would be within a two weeks or so.
Regards
Neil
What about Pregabalin for tinnitus, as advised to my son by a Specialist?
Claudio
Italy
Hi Claudio:
Pregabalin can cause tinnitus in numbers of people. The “official” figures are 2.9%/placebo 0. So I sure wouldn’t be using it to treat tinnitus. Besides, why use an anti-convulsant drug to treat tinnitus? Furthermore, Pregabalin is actually quite ototoxic. I classify it as a 4 out of 5. About half the people taking it get dizzy and one fifth stagger around like they were drunk. And that’s just listing 3 of the ototoxic side effects.
Regards
Neil
hello I am from australia could you please tell me does hypnotice help with tinnitus thank you yvonne
Hi Yvonne:
I’ve not heard that hypnosis works for tinnitus. However, I have heard that self-hypnosis (really a relaxation technique) does work for some people.
Regards
Neil
I have gotten a sever case of tinnitus. My ent dr want to do a steroid injection into my inner ear. I have some hearing loss also. Is this something u think will help?
Hi Scott:
I’ve never heard of steroids helping tinnitus, so that may be largely a waste of time. However, if your hearing loss is due to an autoimmune problem, then steroids may help.
If your tinnitus is the result of your hearing loss, then anything that helps bring back your hearing may have the secondary effect of reducing your tinnitus.
Regards
Neil
I have T since April 14, 2013. Probably got it from antibiotic Ceftriaxone I.V. When I had kidney infection. Yesterday I crashed my bike, cut my lip and had five stitches. Now I am .taking cephalexin 500 mg. Is this drug ototoxic that I am risking making my T get bad? I have light T which I only hear in quiet place.
Hi Ed:
I do not have Ceftriaxone listed as causing tinnitus, but it is always possible. On the other hand, Cephalexin is listed as causing tinnitus in some people. Hearing loss too. A better choice for a less ototoxic drug in the same class is Cefadroxil. It is not listed as either causing tinnitus or hearing loss. If I had to take a Cephalosporin, I’d choose Cefadroxil.
Regards
Neil
Thank you so much for the very prompt response.
My T appeared seven weeks after Ceftriaxone was stopped. Seems too long. And nothing else happened to me during the seven weeks that could possibly have caused T. I have no health issues, 53 yrs old.
I experienced tinnitus about 7 weeks after being treated with Ceftriaxone IV as well.
Are the drugs listed just the ones that can CAUSE tinnitus? Where will I find remedies that can possibly relieve tinnitus? I am 74 and have had this for almost 8 months and have been told that the only thing that I can do is get a hearing aid… I cannot afford one as they cost from $1000 to 2500 for a good one. Please advise where I can get info on remedies… Thanks
Hi Mollie:
Yes–all the drugs listed can cause tinnitus. There are no drugs that are approved by the FDA for treating tinnitus, so don’t look for a drug solution. There are lots of things that you can do however. Some things work for one person and others for other people. There is no way to know ahead of time what will work best for you.
What caused your tinnitus in the first place? Sometimes that gives a clue as to the best remedy to get it under control.
Hearing aids do not get rid of tinnitus, but for some people wearing a hearing aid lets their ears hear more sounds so in contrast, your tinnitus seems much softer–a blessing to be sure, but your tinnitus typically becomes louder at night when you take your hearing aids off.
My book, “When Your Ears Ring–Cope with your Tinnitus–Here’s How” gives a wealth of information on tinnitus, its causes and a number of different ways you can help bring it under control. You can get it at http://www.hearinglosshelp.com/products/books.htm#tinnitus.
Regards
Neil
How do I find your book?
What herbs are safe for Tenitus?
Hi Karen:
The book you want is “Ototoxic Drugs Exposed” currently in the 3rd edition. You can get it at https://hearinglosshelp.com/shop/ototoxic-drugs-exposed/ .
To see all my books, go to https://hearinglosshelp.com/shop/category/books/.
Cordially,
Neil
I have coped with tinnitus for 48 years. In the past year it has gotten much worse and I think the cause is extended use of ambien to sleep. If I can sleep I can cope in the daytime. I have started sound therapy but find it impossible to go to sleep with the sounds without a half or a whole 5mg ambien. Please tell me what I can take tp help me to get going with the sound therapy.
Bonnie
Hi Bonnie:
It could well be the Zolpidem (Ambien) as it does cause tinnitus in some people.
Zolpidem wouldn’t be my choice of a drug as it can build dependence which makes it very hard to get off it.
Personally, if I had trouble getting to sleep, I’d try the herbal Valerian. It is not ototoxic and isn’t habit forming.
Regards
Neil
Dr. Neil, You are so kind to have this website and offer personal responses! I have never had tinnitus before, but it started 5 months ago very suddenly. I had just started a new prescription for Trazodone, and within 30 minutes of the first dose my ears started ringing. It was gone by the next morning but started again maybe a month later suddenly again after waking up from a nap. It’s been with me ever since. I did go off of the Trazadone for first 3 days, then for a week, but it didn’t stop the tinnitus.
Is it possible for the Trazodone to cause tinnitus to start that quickly (within 30 minutes)? And would a week without taking the trazodone be enough time to determine if it was the cause?
Thank you again!
Becky
Hi Becky:
Some drugs can cause tinnitus within 10 minutes of taking them. Other drugs don’t cause tinnitus until you have been on them for a number of months. So there is a lot of variability, depending on the drug. I don’t have any information on how soon after taking Trazodone that tinnitus results.
I do know that in the initial studies on Trazodone, the “official” figures are 1.4% of the people taking this drug reported tinnitus, while 0% on the placebo reported tinnitus–so it does cause tinnitus.
Some drugs take longer to leave your body than others, so I’d give it a good two weeks or more to see if the tinnitus goes away. And for some drugs and some people, the tinnitus never goes away. You see, once tinnitus starts, simply removing the cause may result in the tinnitus stopping, but sometimes the tinnitus takes on a life of its own and thus taking away the initial trigger has no effect on the tinnitus.
Too bad your doctor didn’t suggest an effective antidepressant that is NOT ototoxic such as the herbal St. John’s Wort. St. John’s Wort has been shown in numerous studies to be as effective as prescription drugs in treating depression and without any ototoxic side effects (and few other side effects either). St. John’s Wort is available at many health food stores and drug stores (over the counter) so you don’t need a prescription for it. However, it is a good idea to run it by your doctor or pharmacist if you are on any other drugs to be sure they don’t negatively affect each other.
Regards
Neil
Thank you again for sharing your wisdom, The Trazodone is actually for sleeping and I have discontinued it again to see if it helps. I do take St. John’s Wort and have for many years to help ward off depression and to help with the sleeping also. I really dislike taking any drugs and always try to find a natural remedy. We’ll see what happens. I’m trusting that the tinnitus will go away. Thanks again!!
Hi Becky:
If I had trouble sleeping, I’d use the herbal Valerian rather than a prescription drug. Valerian calms your brain down so you can sleep. Besides it is not ototoxic, has few if any other side effects ,and you are not “dopy” the next morning either. You can get Valerian on-line or at most health-food stores.
Regards
Neil
Dr Neil, I just found this page, (still trying to find the list to print) however, I seeyou listed Zolpidem has the ringing in the ear side effect. I take Zolpidem as I have severe insomnia. I am lucky to sleep 2-3 hours a night, and that is with the Zolpidem, have been on it for years, I don’t know what to do. Doctors have no answer for me. I am supposed to schedule a “physical” for this month, just haven’t yet. I don’t go to doctors unless dire emergency, ears are almost to that point.
Thank you
Hi Patti:
Zolpidem can cause tinnitus in about 1% of the people taking it (placebo 0%) according to the “official” studies, but you know the reported results are always lower than what happens in the general population.
Personally, I wouldn’t take Zolpidem for more than a couple of weeks–it forms a dependence so it makes it VERY difficult to ever get off it. Since your doctors haven’t been able to help you, why not go to different kinds of doctors. My choice would be a Naturopath (ND) and see what he can do for you.
The link to the tinnitus drug list is the title in the last paragraph in the artcie. Hover you mouse over it and it turns red. Click on it and you get the list.
Regards
Neil
In the introduction to the PDF list of medicines, herbs, and chemicals known to have possible tinnitus connections, you state that some appear more frequently (association), and other rarely. Surely this is based on some kind of quantifiable statistics. It would be very helpful for people if a frequency indicator value was added to the names on the list.
For example, ABC drug 2 — JKL drug 31 —- QRS drug 72 — xyz drug 14. The values are percentages of reported tinnitus with the drug use, so I would know QRS is a high or frequent trigger, whereas ABC is very rare.
Thanks for the list — it seem everything causes tinnitus. 😉
Hi Norm:
If you want the details about frequency of tinnitus, and how bad the resulting tinnitus may be, you can get this information in my book “Ototoxic Drugs Exposed”
Regards
Neil
Neil:
I have had tinnitus for some 20 years, but it did not start effecting my quality of life until about 9 or 10 years ago. It is non-pulsitile, and up until the last 2 years was only 1 frequency(tone). Now, I can have as many as 4 sounds at one time. I know that my primary reasons for my hearing loss(B hearing aids) and tinnitus is because I have hunted since I was a teenager, without hearing protection(dumb!), and also played my music pretty loud in college.
I relocated to another state about 18 months ago, and upon having my hear checkup(including a hearing test, my Au was suprised to see how much worse my hearing had gotten in just 2 years since my last test.
I do take many meds, norvasc, atenolol, benazepril, imipramine, lexapro, lorazapam, lovastatin, finasteride, fish oil, and 81mg aspirin.
Yes, I know that 6 of these meds are on your list, but the only one that is relatively “new” is the Lexapro, which was added about 3-4 years ago.
Please advise…
Bernie
Hi Bernie:
You are taking quite a lot of drugs that can affect both your hearing and your tinnitus.
Amlodipinde (Norvasc) can cause tinnitus in up to 2% of the people taking it.
Atenolol can cause hearing loss and tinnitus. One of the weird things about this drug is that these symptoms do not necessarily occur soon after you begin taking it, but can occur a good number of years later (3 to 10 years) in some cases. This is one drug of which I’d certainly be suspicious.
Benazepril can cause tinnitus in up to 1% of the people taking it.
Imipramine can also cause tinnitus in up to 1% of the people taking it.
Escitalopram (Lexapro) can cause both hearing loss and tinnitus in about 1% of the people taking it.
Lorazapam can cause both hearing loss and tinnitus in some people.
Lovastatin is not known to cause hearing loss or tinnitus.
Finasteride is not ototoxic as near as I can tell.
Aspirin can cause hearing loss and tinnitus. Typically, both are temporary while you are taking the Aspirin.
It could be that the Lexapro is the culprit, or it could be the Atenolol, or maybe the combination of the two. But I’d start with the Atenolol as I’ve have by far the most reports of hearing loss and tinnitus from people taking it for several years.
Regards
Neil
Hello Dr. Neil, is claritin 10mg on your list. Please answer. Thank you in advanced.
Hi Nidia:
All you had to do is click on the link to the list and see for yourself. But yes, Claritin is on the list.
Regards
Neil
Hello I have taken Sertraline for many many years. I have had Tinnitus since I was in the Army in the mid 70’s. About a month and a half ago I cut back the sertraline and went to 0. Around that time my tinnitus got worse, could it be connected with stopping the Sertraline?
Hi Ed:
I haven’t heard of people getting tinnitus from stopping Sertraline, but if you have been on it for a number of years and then stop too fast, your brain/body doesn’t have time to change–and getting tinnitus, or having your existing tinnitus become worse could be a result. Psychotropic drugs such as Sertraline affect brain function and it takes time to make changes. A better way is to cut down slowly–1% per day over 90 days or even 0.33% per day over 300 days–not just within a month. Few doctors seem to realize how important a slow taper is when you’ve been on a drug for years.
Regards
Neil
Can wearing insect safe clothing treated with pyrethrum or its derivatives cause or make tinnitus worse?I have had ringing in my right ear for 20 years thanks
Hi Bernie:
Pyrethrum is a natural insecticide made from the dried flower heads of two members of the Chrysanthemum family— Chrysanthemum cinerariifolium and Chrysanthemum coccineum. The active ingredients in the flowers are called pyrethrins.
Pyrethrins attack the nervous systems of insects resulting in their death, but are less toxic to mammals than many synthetic insecticides. Anything that attacks the central nervous system can result in tinnitus and pyrethrins are no different. Too much can result in tinnitus in people according to the PDR for Herbals.
I don’t know how much you’d need to result in tinnitus, nor how long you’d have to be exposed to the pyrethrins for this to occur. If you notice your tinnitus getting worse when you use pyrethrum or any compounds containing pyrethrins, that is very likely the cause.
I’d like to know more about how pyrethrum affects your tinnitus.
Regards
Neil
will wearing insect safe clothing treated with pyrethrum or its derivatives increase or cause tinnitus if used for less than a week?
I take Celebrex for arthritis. I know ibuprofen can make tinnitus worse, but what about Celebrex? Is it as bad?
Thanks, IK
Hi IK:
If you choice was only between Celebrex (Celecoxib) and Ibuprofen, then Ibuprofen is somewhat worse than Celebrex. But I rate both of these drugs as Class 3 in ototoxicity, so there is probably not all that much difference between them. You risk tinnitus when taking either of them.
Personally, I wouldn’t take either of them. I’d make dietary and lifestyle changes to deal with arthritis.
Regards
Neil
hello dr neil i am from creta greece and before 1 year i had problem at dive i went 6-7 meters in the sea and i did the compresion in these meters and i felt in my ears hi presure air inside and when i went up i felt presure to go out of my ears. after i got up to the boat i didnt hear from my left ear and i had voices
at the and of the day i started to hear again from my left ear.
i tryied gingo biloba ,bitamins, i did hyperbaric oxygen and nothing a doctor told me that i have 80 db voices and belive me the first month i wanted to die now i have used that thing but is any solution to solve that problem??????
Dr. Neil, I have recently had a cyst removed from my back and the dr has prescribed the antibiotic septra to help clear up the infection. I am wondering if this antobiotic is safe for me as I do not want to worsen my existing tinnitus. If not, could you recommend an alternative that is not in the penicillin or cephalosporin class? (I’m allergic to both of these)
Hi Scott:
Septra is a combination of Trimethoprim and Sulfamethoxazole. Trimethoprim is listed as causing tinnitus in some people, but I don’t think very many get tinnitus from this drug. I list it as a Class 1 drug (very mildly ototoxic). Sulfamethoxazole is a bit more ototoxic and tinnitus can occur in about 1% of the people taking it. I rate it as a Class 2 drug (mildly ototoxic).
As far as antibiotics go, Septra is less ototoxic than the vast majority of them, so is likely a good choice for you–especially so since your doctor thinks it will do the job.
Since there is no telling in advance whether you will experience ototoxic side effects, you need to watch for them. If you take it and find your tinnitus getting worse, then you might want to dump the drug at that point. To put the odds in your favor, my rule of thumb is to take a drug at the lowest dose that will do the job for as short a time as possible.
Regards
Neil
Thanks Dr Neil! I will procede with the medication and listen carefully for any changes in my T. Anything other than the normal day to day fluctuations and I will speak to the doc aboht discontinuing the meds. Thanks again!!
Hello Dr. Bauman. I am entering my first fall/winter with tinnitus, and have a few concerns. I tend to get a few colds each winter and always have very stuffy ears. My response to this in the past has been to take Zicam oral tablets at the first sign of a cold. This did away with the ear problems as it drastically reduced my congestion. I am wondering if it is safe for me to take Zicam with my newly acquired tinnitus? Also, is temporary worsening of tinnitus to be expected with the cold or flu?? Thanks for taking the time to respond!
Neil, I am wondering if you have any particular information on the various meds used for blood pressure control – the beta blockers and others? If so, would you let me know if there are any that are not known to cause or elevate tinnitus? Thanks, Kathleen
I have tinitus 24/7.The only medication I take is zocor for my cholesterol. I generally don’t like to take any medication. I believe I got the T (just an educated guess)when I had a severe ear wax impaction that was very painful and difficult to remove. The removal of the was took away the pain immediately, but it was a difficult procedure for the doctor to do and I think most probably caused some damage. I only noticed the T a short while after this event.The sound is definitely internal from my head and not from one of my ears. This was about 10 years ago. I am now considering a hearing aid because the T noise is really interfering with my hearing. I understand there are hearing aids with noise maskers. Do you think this is worth while since it doesn’t really cure anything? The noise is loud and seems to have gotten louder, but with my personality most of the time I can just ignore it.I do, however, often ask people to speak louder.
I have had severe Tinnitus for the past 3 years. When I wake from an afternoon nap my head is just screaming with the ringing. The same thing happens when I first wake in the morning. Is there anything I can do for relief?
Hi Bill:
How loud is your tinnitus during the day when you are up? How loud is your tinnitus when you go to bed or lay down? If your tinnitus is much louder when you wake up than when you lay down, I suspect that your neck is out of whack and when you lay down–maybe your pillow is at the wrong height–it just makes your neck worse and this in turn makes your tinnitus worse. Thus you have the loud tinnitus when you wake up. When you get up and move around, your neck moves back into the correct position (or at least a better position), and your tinnitus goes away, at least to some degree.
If this seems to be your pattern, then I’d suggest you have a chiropractor check out your upper cervical spine. Also, experiment with different pillows to find the right one for your needs. You might look into orthopedic pillows that hold your head in the correct position.
Regards
Neil
In the past few years I have taken alprazolam, pantoprazole, ibuprofen, etodolac, and cyclobenzaprine. Looking at the list of drugs associated with tinnitus, it seems to be everything I can ever remember taking for anything. Is there a short list of those drugs that have a very high correlation to tinnitus, as I would find that more useful.
Hi Peter:
If you want to know the details of how likely you are to get tinnitus from a given drug, rather than just a list of drugs associated with tinnitus, the best source is probably my book, “Ototoxic Drugs Exposed”. You can get it at http://www.hearinglosshelp.com/products/books.htm#ode.
Regards
Neil
Dr. Neil:
I notice that Diltiazem is on the list of prescription drugs that may cause tinnitus.
Is there a significant likelihood that a daily dose of 240 mg of Diltiazem would cause tinnitus?
If there is a significant liklihood that a daily dose of 240 mg of Diltiazem would cause tinnitus, would the tinnitus abate if the Diltiazem were no longer being taken?
I thank you in advance for your opinion.
Tom
Hi Tom:
Diltiazem can cause tinnitus in 1% of the people taking it (placebo is 0) according to the PDR. So obviously some people do get tinnitus from taking it. That percentage will be low as not all side effects are reported–not by a long shot. So you have to watch out.
However, having said that, I’ve not received any anecdotal reports about it, so I assume that not too many people are affected by tinnitus from this drug.
However, if you notice tinnitus starting, you might want to immediately dump this drug (run it by your doctor of course) and hope the tinnitus will go away.
Regards
Neil
I recently developed tinnitus (maybe 3 weeks ago when I really noticed it). There doesn’t seem to be any hearing loss associated, although I have an appointment with an audiologist in a few weeks. I had been taking Lisinopril and stopped when I realized that the tinnitus was sticking around, but the tinnitus is still there. I will work with my doctor to get an alternative to Lisinopril, but does the fact that I still have tinnitus even after stopping the medication suggest it is now a permanent situation?
Also, does cold weather have any impact?
I do a lot of airplane travel – is that a potential influence?
Thanks in advance for your reply,
Jeff
Hi Jeff:
No, it can take a few weeks after you stop taking a drug before the tinnitus goes away. I wouldn’t consider your tinnitus permanent until at least a month has gone by. And even if your tinnitus is permanent, it may fade into the background so it doesn’t bother you—so it can be no big deal and won’t bother you.
I’m not aware of cold weather as such affecting tinnitus. If cold weather causes your ears to become clogged, that would be a different matter.
As far as flying, it normally shouldn’t cause/affect tinnitus. However, some people have reactive tinnitus to the sound of the jets. Others have problems if they fly and their ears are congested. I’ve never found flying to affect my tinnitus though.
Regards
Neil
Dr. Neil,
I am 52 and have had T for 3 years. I am an airline pilot and limited to what I can take regarding meds. I had bypass surgery 2 ago and was put on Crestor 20mg and Niaspan 500mg also Bystolic 2.5 mg. about six months ago I started taking Meloxicam 15mg for hip pain. I noticed these things on the list and have been taking them for over 2 years, but just suddenly my T jumped up and is again a problem. My question is could it take that long to rare itself and could it be temp. If I try to use other drugs in their place? Also, I take a over the counter sleep aid that has Doxylamine succinate 25mg. Could this be a problem too?
Thank you, Rob
Hi Rob:
Crestor (Rosuvastatin) can cause tinnitus in some people according to a couple of anecdotal reports I’ve received.
Niaspan (Niacin or Vitamin B3) causes tinnitus in about 2% of the people taking it, especially if taken in higher doses like you are taking. The tinnitus is typically temporary.
Bystolic (Nebivolol) is not listed as causing tinnitus.
Mobic (Meloxicam) can cause tinnitus in about 2% of the people taking it. I’ve received several anecdotal reports of people getting severe tinnitus from this drug. The tinnitus surfaces within 2 weeks of starting this drug
Doxylamine can cause tinnitus in some people, but I don’t think it is very common.
If you’ve had tinnitus for 3 years and only have been on these drugs for 2 years (and if your tinnitus was not worse after beginning these drugs), I’d wonder if these drugs are affecting your tinnitus at all. If your tinnitus got worse 2 years ago when you started taking these drugs then that’s different.
Yes, some drugs may take a long time to reveal tinnitus and others can cause tinnitus in minutes. Furthermore, the drug mix you are taking may cause tinnitus when the individual drugs may not. Almost no research has been done on drug interactions and tinnitus so what I have listed above is for the individual drugs, not your drug combination.
Also, the size of the dose can be important. For example, a drug may not cause tinnitus when taken below a certain dose, but taking a higher dose can cause tinnitus so if you’ve changed doses just before your tinnitus got worse, that could be the problem.
Are there any other factors in your life that could have caused the big increase in your tinnitus such as recent stress, anxiety, exposing your ears to a sudden loud noise, etc., etc.?
Regards
Neil
I took allegra D and felt some tinnitus and balance problems, left the medicine and went totally fine. Then I took zyrtec and didn’t notice any thing and left it. After about one week and half I got cold and about one week after that I felt congestion in my left ear and ane day I had a severe attach of Tinnitus and balance problem. Tinnitus went away in few days and balance problem also dissipated. Now a days Tinnitus has sort of become permanent which is very mild can’t hear tinnitus if fridge is running. But my balance problem gets bad if I step in cold or take a warm shower.
Hi Fahd:
I think your balance system has been permanently damaged to some degree–that is why you experience balance problems when your ears get either hot or cold. In fact, using the caloric test (hot and cold water in your ears) is one way they test for balance problems. If you get dizzy, then you have balance problems.
Regards
Neil
Doc,
Thanks for all of your hard work on behalf of all of us sufferers. I have a perfect storm of causes for tinnitus – I have participated in every loud activity under the sun and over the past few years have managed to acquire some of the most uncommon medical conditions – coccidiomycosis, sarcoidosis, and SMV Thrombosis. (Used to be strong as an ox and am only 50 years old)
I downloaded the list and am going to purchase a couple of the books. Question – I have recently seen some claims about TMS (magnetic…) being used for tinnitus. I have experienced great relief for PTSD by way of neurofeedback and am going to investigate TMS and possibly give it a try. (I can get it done locally by at a clinic owned by a friend)
Do you have any thoughts and if I were to give it a try would you like me to do any specific measurements before, during, and after for your information?
Thanks,
Greg in San Diego
Hi Greg:
TMS is short for Transcranial Magnetic Stimulation. Actually it is rTMS. The “r” stands for repetitive. The idea is that by using low-frequency (1 Hz) rTMS reduces the “excitablity” of the cerebral cortex and thus inhibits your tinnitus. This inhibition can last up to 6 months in some people, but only lasts up to 2 weeks in others–so it is not ready for the big time yet. Results are that it helps about half the people taking this treatment. Of those, about half have good results and the other half have partial results.
You can try it and see if it helps your tinnitus.
Regards
Neil
Is antibiotic clindamycin ototoxic?
Hi Ed:
Clindamycin is mildly ototoxic. It can cause tinnitus, dizziness and vertigo in some people.
Regards
Neil
Dr. Neil,
I see Prozac (Fluoxetine) may be associated with tinnitus. How much evidence is there regarding this? My Tinnitus never goes away and flucuates in intensity and frequency. Today my right ear is screaming! I do also have some hearing loss – hearing aids have been suggested by ENT. Too darned expensive!
Regards,
Rich
Hi Rich:
The PDR says Fluoxetine causes tinnitus in 2% of the people taking it and the placebo results were 0%. That’s pretty good evidence. You could see whether stopping your Fluoxetine for a month or so makes a difference to your tinnitus. Just be aware that sometimes stopping the drug doesn’t affect the tinnitus.
Regards
Neil
Dr. Neil, I have severe Tinnitus for 3 years. It is just about to run me crazy. I take Coreg for high blood pressure. Also Xanax for anxiety. I see both of these are on your list of ototoxic drugs in your book-When Your Ears Ring! Can you suggest other medication to help me cope?
Thank You, Bill
Hi Bill:
Did your tinnitus get worse when you started on the Coreg? Or were you on the Coreg before you had tinnitus? Coreg (Carvedilol) can cause tinnitus in up to 1% of the people taking it, although I have not received any anecdotal reports of people getting tinnitus from it. So I assume it does not cause tinnitus in many people.
If you want a beta blocker that does not have tinnitus listed as a side effect, you could try Labetalol, Levobunolol or Sotalol. Of these three, Levobunolol has the fewest and lowest risk of ototoxic side effects occurring so that would be my first choice–all other things being equal.
Why are you so anxious that you need a drug to treat it? Personally, I don’t think that drugs are the way to treat anxiety as it never gets at the root of the problem. I believe a better way to find a therapist that will help you uncover the real reason for your anxiety and help you deal with it so you don’t need any drugs. Diet can also have a big effect on anxiety.
Regards
Neil
Hi Neil,
Can you comment on Aspartame and how much of an issue it is in terms of ototoxicity?
Thanks,
Andrew.
Hi Andrew:
It’s hard to nail down exactly how common ototoxic side effects are from taking Aspartame. It is ototoxic–that much is known. I’ve seen hearing loss, tinnitus, dizziness, balance disorders and vertigo listed as side effects of taking Aspartame.
Just as with other drugs, a given person may consume Aspartame without experiencing any obvious side effects. At the same time, it is just as true that another person taking Aspartame may experience one or more adverse side effects. As always—beware. If you think that Aspartame is affecting your ears, eliminate it from your diet and see if there are any positive changes. That way you’ll know how it affects your own body.
Regards
Neil
Hola Dr Neil.- Hace 2 meses padezco de tinnitus; 3 semanas antes de padecerlo tenia mis oidos tapados de cera y me la sacaron, pero 2 semanas despues me fui a un lugar con musica muy ruidosa y a partir de unos días después, empecé con un zumbido suave fui con el Otorrino y me recetó Nimodipino 2 tabletas por dia por 1 mes y medio y además me dio 3 tabletas al día de Serc (Betahistina) por 1 mes y medio, terminé el tratamiento y mi tinnitus no me deja de sonar, siento que es mas ruidoso sobre todo en el oído izquierdo y en Enero mi Doctor me dijo que empezará un nuevo tratamiento con Ativan. Batallo para dormir, que me recomienda para dormir? Que hago? yo no quiero que mi tinnitus sea permanente. Llevo 2 meses con mi tinnitus. A veces baja la intensidad y a veces sube, sobre todo en mi oído izquierdo. Ayúdeme por favor.
Hi Dr Neil – 2 months suffer from tinnitus, 3 weeks before having it I had my ears plugged with wax and I pulled it out, but two weeks later I went to a place with very loud music and from a few days later, I started with a soft hum went with the ENT and he prescribed Nimodipine 2 tablets per day for 1 month and a half and it gave me 3 tablets daily Serc (Betahistine) for 1 month and a half, I finished the treatment and my tinnitus does not stop me ringing I feel that is more noisy especially in the left ear and in January my Doctor told me to start a new treatment with Ativan. I struggle to sleep, recommended me to sleep? I do? I do not want my tinnitus is permanent. I have 2 months with my tinnitus. Sometimes low intensity rises and sometimes, especially in my left ear. Please help me.
Hi Antonio:
You have to protect your ears from loud sounds/music or you risk having permanent tinnitus. The drugs your doctor is giving you are not going to affect your tinnitus, but they may drug you so you don’t worry about your tinnitus. But that is a different thing.
If your tinnitus makes it difficult to get to sleep, you can try listening to real sounds–a bedside radio or a fan or a CD of environmental sounds. These various sounds help numbers of people. You want it just loud enough to hear so you listen to one of these sounds and not your tinnitus.
You want to quit focusing on your tinnitus and instead, focus on the loves of your life and by default, ignore your tinnitus.
Regards
Neil
Dear Neil
Unfortunately it is only now that I discover your website and book.
My question concerns an acute case of tinnitus, which started during the use of the anti-depressant Remeron (Mirtazapine). This drug was prescribed to me by my GP as I was suffering from light insomnia.
Unfortunately I was not given any instructions with regards to the use of this medication, and I used them the same way as sleeping pills: one evening I took a tablet, the other not, sometimes 15 mg, sometimes 7,5 mg. I was trying to be prudent and wanted to use as little as possible.
After two weeks or so, I realised that something was horribly wrong: my ears starting ringing. I thought it was probably the fatigue and continued taking the Remeron for another week. After that week I stopped as I now felt that the tinnitus was clearly related to the use of Remeron. I used 11 tablets of 15 mg over a period of 3 weeks.
When I stopped taking Remeron the problems really began: the ringing became worse, to a point where I can now no longer sleep or function during the day.
I started searching the net and found out that I should have actually use the same dose of Remeron every day, and that I should have stopped the dosage gradually. I now understand that I could possibly be suffering from excitotoxidity.
The reason I am getting in touch with you is because I believe that my tinnitus is a result of nerve cells which have been damaged or killed by excessive stimulation by neurotransmitters (such as noradrenaline and serotonin), and I am hoping that you might be able to share your knowledge.
Do you have any idea if permanent damage could have been done by the way I used Mirtazapine, by not taking consistent dosages and by stopping the medication abruptly?
Are neurons able to regenerate and if not, does this mean that they could continue firing, causing permanent tinnitus? I have been hearing the same sounds for over 2 months now. My tinnitus sounds like electrical impulses, it’s terrible. It leads me to believe that I can truly hear the firing of damaged neurons? Could this heal over time, even if it takes months or years? Or am I basically ”doomed”?
I would be truly grateful for any knowledge or experience that you could share with me on this matter.
Many thanks
Mireille
Hi Mireille:
You were trying to do the right thing by taking as little of Mirtazapine as possible–and I believe you did the right thing. When your ears start ringing, that is a sign that you are beginning to damage your ears somehow and you should stop taking the drug.
I have no information on Mirtazapine regarding taking it intermittently or stopping it suddenly and tinnitus. My feeling is that since you were on it for such a short time, you shouldn’t have had any problems stopping it “cold turkey”, but your experience seems to show otherwise. The question you can’t answer now is whether by tapering off slowly you could have avoided the extra tinnitus, or whether it would have continued to get worse as you’d be taking more of the drug as you tapered off it.
You are actually the first person that has written to me about tinnitus and Mirtazapine, so your experience may be somewhat unusual and that you are particularly sensitive to the effects of Mirtazapine.
I don’t know what the future holds for you, but I do know that tinnitus is what I call a psychosomatic condition–there is a physical component and an emotional/psychological component. In spite of any physical damage done to the neurons, etc., you still have a lot of control over your tinnitus in how you treat it emotionally. If you worry and obsess over your tinnitus, it will continue to get worse. However, if you learn to ignore your tinnitus and not have ANY emotional attachment to it (meaning no negative emotions towards it) it will slowly begin to fade into the background and not seem so intrusive, nor so loud. This is called becoming habituated to your tinnitus. If you do this, even though your tinnitus may never go away, it will not bother you much or at all–it will just be there.
This is not easy to do, but it is the ONE thing you CAN do. I know it works. I’ve had tinnitus day and night for many decades now, but I choose not to let it bother me even though it is there day and night. However, whenever I think about tinnitus (like right now while I am writing this , and thus focusing on tinnitus, my ears are ringing away much louder than they were just a few minutes ago before I read your story). This is an occupational hazard in helping people with tinnitus. The good news is that when I finish writing this and go on to some other subject, probably within 10 minutes my tinnitus will fade into the background again and not be a problem.
Sure, I can wish I didn’t have tinnitus, but since I can’t make it go away, I can control my emotional response to it and choose not to let it bother me. So, focus on the loves of your life and by so doing totally ignore your tinnitus. This tells your limbic system that it is not important and over time your tinnitus will become less and less of a problem. And stay away from drugs as much as you can. You don’t want anything to start making it worse again.
Regards
Neil
How about a list of those that are safe to use?
Hi Joe:
This is an excellent question. See my forthcoming article that will address your question. I’ll put the link here when it comes out.
Regards
Neil
Dear Neil
I had a bad sinus infection and didn’t go to see the
doctor for 5 weeks then started hearing noise.
The doctor told me to take Lipo-Flavonoid but a last
few weeks are the same condition ringing everyday.
I just finishing 4 weeks now. Should I keep taking this.
Regards
Ken
Hi Ken:
First, are your sinuses clear now and your ears? You can’t expect your tinnitus to go away until some time after your ears are clear.
Second, are you taking any medications of any kind? More than 550 medications can cause tinnitus (as you probably know).
Third, lipoflavonoid may help tinnitus, but there are no studies that prove that it works. However, the ingredients are not harmful, so you can take it if you want. I’d suggest you take any herbals and vitamins/minerals for about 3 months before you conclude they don’t work for you as their action may not appear right away.
Fourth, make sure you are getting adequate amounts of magnesium and zinc. Both of these minerals can help tinnitus in some people.
Fifth, if you worry about your tinnitus, you can give it a life of its own so it will become permanent. So you’re best to learn to just ignore it and don’t have any negative emotional feelings towards it.
Regards
Neil
Dear Neil
Thank you for your response.
My sinuses are clear and I am not taking any medication right now.
I felt something setting inside ear so doctor told me to
take Guaifenesin 400mg. I took for 8 days then Amoxicillin 500mg for one week then started taking Lipoflavonoid.
I am going to have MRI exam this week because I still feel pressure behind right side ear time to time.
If I stay in quiet area then ringing is quiet also
but driving and public places my ringing become loud.
I try to keep busy but I need a little more time to adjust this my new life.
I will take herbals,vitamin and other things as you suggested.
Thank you.
Regards
Ken
Hi Ken:
Tinnitus that responds to noise by getting louder is called reactive tinnitus. Most people that have tinnitus find their tinnitus stays the same volume with varying levels of sound (unless it gets so loud that it causes tinnitus).
Let’s see what the MRI shows (if anything).
Regards
Neil
Dear Neil
My tinnitus is at night become quiet so I can sleep okay
but after started taking Lisinopril 5mg (high blood pressure) and Tamsulosin HCL 0.4mg (prostate)
I took both at night before bed but ringing started
all night. I only took for 2 days. I am going to stop
taking those now. Is it too late.
Thank you.
Ken
Hi Ken:
Lisinopril can cause tinnitus in less than 1% of the people taking it.
Tamsulosin is not listed as causing tinnitus, but who knows what synergistic effects might occur when it is taken with other drugs–in your case, Lisinopril.
I have no information to tell whether tinnitus from Lisinopril is temporary or permanent. I’d assume it is temporary unless proven otherwise. Thus, stopping taking it and seeing what happens to your tinnitus in the next few days seems to be a good idea. Run it by your doctor, of course.
Regards
Neil
Dear Neil:
I have had tinnitus for 30 years – every day! I manage very well by counting my blessings. My question: I am 69 years old and feel I should get the shingles vaccine. Will this vaccine worsen my tinnitus?
Thanks in advance.
Hi Paula:
I’ve not seen tinnitus listed as a side effect of the shingles vaccine, so I doubt it will affect your existing tinnitus, but who knows what side effects have not been reported yet?
Regards
Neil
I am going for a medical procedure and will be sedated, I have had tinnitus for over 20 years caused by loud noise. Is there a problem with sedation for my tinnitus?
Hi Joan:
I think it really depends on what drug(s) they use to sedate you. Most people don’t have a problem, so I wouldn’t expect you would either–but there are no guarantees. I could give you a better idea if you tell me which medications they are going to be giving you.
Regards
Neil
If I am taking 5 drugs for different ailments and they are all on your list, should I avoid taking any two of them at the same time. I have been taking them altogether. (Just to get it over with) I have a great deal of trouble with dizziness and balance. Also tinnitus and loss of hearing. Any suggestions?
Hi Mickie:
Since most drugs stay in your bloodstream for a number of hours or days, I’m not sure how much difference it will make whether you take the drugs separately or all at once.
Unfortunately, a LOT of drugs have balance problems as side effects, as well as tinnitus and hearing loss. Since you are experiencing these side effects, it would be wise to consider whether you really need these drugs or not (many drugs are not really necessary–there are better alternate treatments–but doctors seem to be too lazy or ignorant of them to put your on them). To me, medications should always be the LAST resort, not the first line of attack. However, if you really need medications, you need to work with your doctor to find ones that do not cause these side effects. Sometimes, just reducing the dose may be enough.
Regards
Neil
Hi Dr. Neil,
My son is 20 and has tinnitus from a close range shot gun blast about 18 days ago. He also had hypersensitivity but that seems to be getting better. He tried listening to low volume white noise through ear buds which helps but only if the ear buds are in his ears. He is wondering if he runs the risk of causing further damage by doing this. What do you think?
Thank you!
Dawn
Hi Dawn:
A 12 gauge shotgun blast close to your ears can certainly give you tinnitus and hyperacusis (hypersensitivity to sounds). Fortunately, the hyperacusis often goes away in a few days to weeks or months IF you don’t expose your ears to loud sounds during that time.
Listening to white noise is one treatment for tinnitus. There is nothing wrong to listening to it via earbuds as long as he keeps the volume down to a reasonable level. The white noise doesn’t have to be as loud as his tinnitus for it to help–as long as it is loud enough for him to hear it.
If he keeps the sound down to less than the average level of people talking, he can listen to it for hours without harming his ears. If it makes his hyperacusis worse, then he is definitely listening to it too loud.
Regards
Neil
Dr. Neil,
I am the son of the previous poster. I have a few shared concerns and questions that I’d like to run by you if you have the time:
1) I have recently been prescribed diazepam (10mg) and Zoloft (25mg) for my recent acoustic trauma. Before this, (6 days after the incident) I was prescribed prednisone for what I assume was for reparative reasons and inflammation. Unfortunately this left me quite depressed with wild mood swings. I stopped taking the steroidal after a week due to its adverse effect and am currently only taking 15-20mg of diazepam as needed intermittently per day, the 25mg of Zoloft once a day, 50mg of minocycline for acne along with a couple topical ointments in that same vein. I also take B vitamin complex and magnesium supplementally everyday as well. I am concerned with the medicinal interactions and am curious as to what I can take without exacerbating the condition further. For instance, if I have a headache what type of NSAID should i take if any?
2) My second question involves how protective I should be with my sensitive ear. The sensitivity has subsided noticeably over the last week or so which I take to be a good sign (or rather hope). I am trying to shield my ear from the worst and most damaging sounds, but being on a college campus presents many uncontrollable elements. Am I to where earplugs whenever I go out or should I begin to acclimate my ears to normal everyday sounds agains? I fear overprotecting them may cause further sensitivity issues. Your thoughts?
3) My last concern is most certainly the tinnitus. I am so very blessed to not have it nearly as bad as most to whom my heart goes out to. My immediate question is if there is any chance in the slightest that it could go away? I understand that is a near-impossible question to answer, but I noticed that it has subsided a bit since the incident and took this as positive. The night after the incident, the tinnitus stopped for 24 hours until i showered the following evening at which time it returned. I don’t know what this means but was hoping you might be able to shed some light on the matter. Maybe it’s just wishful thinking, but I’d like you input regardless of the answer.
Thank you so much for your time and comfort to this community. It’s nice to know there’s someone in our corner.
Best,
Gage
Hi Gage:
Yes, prednisone is often prescribed to bring down inflammation in the inner ear. Whether it’s effective or not, I have my doubts. In my opinion there are better non-ototoxic options if you act on them right away. See my articles at http://hearinglosshelp.com/weblog/loud-music-and-hearing-loss.php and http://hearinglosshelp.com/weblog/vitamins-a-c-e-combined-with-magnesium-help-prevent-noise-induced-hearing-loss.php for more specific information on this topic.
I don’t like all the drugs you are taking. If I were you, I would never have taken the prednisone–then I wouldn’t have had to take the mind-altering drugs to try to control the depression, etc. And, if you wanted a safe alternative for depression, the herbal–St. John’s Wort works as well as or better than prescription drugs according to a number of studies.
As for headaches, I just tough them out. I don’t have a compulsive need to drug myself over every ache and pain I get. Often, I lay down and sleep my headaches off if I can. NSAIDs are all ototoxic so they are not a wise choice.
Here’s a good article about how to treat/eliminate headaches from a natural perspective. It just came out today. Read it at http://articles.mercola.com/sites/articles/archive/2014/01/22/migraine-headaches.aspx.
Your question 2. It is a very good sign that your sound sensitivity has subsided to some degree. There is no reason to believe that it won’t continue to subside in the coming days/weeks. Just give it time. Think of it as like a bruise. It takes time to heal.
You can’t protect your ear from all loud sounds–but do as much as you reasonably can. There is a fine line you tread in protecting your ears enough so they heal and overprotecting them which will make sound sensitivity worse. Any sounds that would make your ears ring are too loud and your ears need to be protected from them. Normal levels of sounds should be ok as your ears “heal”. So only wear earplugs when you know there is going to be loud sounds, otherwise leave them out. Use prudence where you go.
Your tinnitus may or may not go away completely. If would be nice if it did–but there are no guarantees. What you want to happen is for your tinnitus to fade into the background and not bother you anymore–so even if it is there, it’s no big deal. The fact that you tinnitus stopped for some hours is a very good sign that it may go away completely. Also, that it is getting softer. These are excellent signs.
As I tell everyone with tinnitus, you need to learn to forget about your tinnitus by focusing on the loves of your life and let it fade into the background. When you think about your tinnitus, it gets louder and more intrusive. I well know this, because, thanks to all you guys that keep asking me questions on tinnitus, whenever I answer them, I have to think about tinnitus and my tinnitus comes roaring out of the background–my ears are REALLY ringing away right now. However, within a few minutes after I start doing something else, my tinnitus will again fade into the woodwork and won’t bother me although it is there day and night.
Regards
Neil
Dr. Neil,
I was diagnosed 20 years ago with hypothyroidism. Since then, i have been taking Synthroid and suffer with Tinnitus.
Could my thyroid condition and the medication be causing the Tinnitus?
Hi Joy:
I’ve never seen synthroid listed as being associated with tinnitus. I’m no expect on hypothyroidism so don’t know whether it is associated with tinnitus or not. I’ve not seen anything to suggest that it is.
Regards
Neil
Hi Dr. Neil,
I’ve had T for years in both ears and seemed to be able to push it to the background mentally most times – it was manageable. I had a dentist appointment last week which involved a needle to freeze the tooth and gums where the dentist was working on repairing a tooth. Normally, during the appointments if there is a drill involved I wear earplugs. Unfortunately for me this time I dropped one earplug on the floor and didn’t want to insert it in my ear for obvious reasons so I didn’t wear earplugs at all. The dentist assured me that the drill was not as loud as those used years ago. In hindsight I probably should have at least worn the clean earplug in my right ear which was the side the dentist was working on. I find the T in my right ear has increased in pitch and intensity since the visit.
I was wondering if dentist’s drills can increase my T and I was also wondering if the drugs used to freeze the area might have an effect on my T in general. I’m finding it harder to sleep now. My husband snores so I usually wear earplugs but I am finding the T is louder with the earplugs in. I am also more aware of the T during the day when the TV is off and the house is quiet whereas before I didn’t really notice the T at all during the day. Hopefully, I can train my brain to ignore the T once again. Thanks for offering advice to everyone,
Susan
Hi Susan:
Some people experience ear problems including tinnitus after dental work–especially if the work was done on an upper molar. The nerves of your upper molars are close to the inner ear. This may account for the tinnitus.
I’ve not had people complain of getting tinnitus from the sound of dental drills–although it can make some people’s tinnitus louder for awhile.
The pain killers dentists use (such as Procaine, Lidocaine, etc) can also cause tinnitus in a some people. I’ve never had a problem with them affecting my tinnitus though.
Hopefully, your tinnitus will fall back to normal as time goes on.
Wearing ear plugs to soften your husband’s snoring is one solution, but if it makes your tinnitus worse, I think you are using ear plugs with too great a protection factor. Instead of using ones with a high protection factor such as 30 dB, try to find ones that have 10 or 15 dB of protection. That may strike a happy balance between your tinnitus and your husband’s snoring.
Regards
Neil
Hi Dr Neil, I’ve had T for about 7 years, both ears, multiple tones & pitches. I manage it by pushing it to the background mentally or by drowning it out with other sound… radio or music. I do have a prolactinoma for which I take Cabergoline and I also have elevated HGH levels that we are monitoring but not treating at this time. I have an endo Doc. The Pituitary tumors & Tinnitus started about the same time 7-10 years ago. I am 62. I also had a partial thyroidectomy 4 years ago… seems I might be prone to benign endocrine tumors.
I guess my question is… have you come across any relationships between elevated Prolactin & or HGH levels and tinnitus (Pituitary adenomas) ?? I wonder if the onset of elevated HGH causes growth of the bones in the inner ear ?
I thank you for sharing your time & knowledge.
Roger
Hi Roger:
No, I’ve never heard anything relating to high prolactin etc and tinnitus.
The bones are in your MIDDLE ears. Bony growth is called otosclerosis and is genetic in origin. It seems to be often triggered by hormonal changes (especially in women). Do you have otosclerosis?
Regards
Neil
The sedatives I will be getting for my medical procedure are fentanyl and versed. I note they are both listed among the possible tinnitus related drugs. Hopefully they do not cause many people problems if they have tinnitus. Can you shed any further light on this? Thank you.
Hi Joan:
Fentanyl does cause tinnitus in some people. The “official” figure is “greater than 1%”. As with all incidence figures, these figures are low because few side effects get reported so they do not get into the literature and side effect data bases. Fentanyl also can cause hearing loss in around 1% of the people taking it. Sometimes the hearing loss is permanent and sometimes temporary.
Versed (Midazolam) is a benzodiazepine. I have no incidence figures on it, but from what I know, it probably doesn’t cause tinnitus in many people as only one source reports it as causing tinnitus.
Regards
Neil
Hello Dr Neil,
I used topamax for about 1 month for my cluster headache. I was on 50 mg for one week and then upped to 100 mg per day. I experienced tinnitus on my left ear since the 5th day but it got very severe when I was on 100 mg, so my neurologist advised me to cut the topamax after tapering off for a few days, 50 mg.
Now, it’s been more than one week since I am off the drug, but I still have the tinnitus, now even on both ears. Sometimes it gets so harsh that it wakes me up from sleep! Although, it’s not as severe as with 100 mg topamax!
My question, is this tinnitus caused by topamax permanent or will fade away with time? And how can I reduce it?
Hi Mohammed:
Topamax (Topiramate) can definitely cause tinnitus in some of the people taking it. As you have found, the severity of the tinnitus can be related to the dose–so taking the lowest possible dose that will do the job is wise. You will then reduce your risk as much as possible that way.
Unfortunately, there are no guarantees that the tinnitus will go away when you stop taking the drug or reduce the dose. Sometimes it will and sometimes it won’t.
I have no information as to whether tinnitus from Topamax is permanent or temporary. Just knowing that your tinnitus went down when you reduced the dose is a good indication that it may not be permanent, or at least won’t stay loud. However, I’d suggest you get off this drug or you may find that the tinnitus bothers you more than the headaches. Ask your doctor for another drug that doesn’t give you severe tinnitus.
Apart from that, learn to ignore your tinnitus as much as possible by focusing on the loves of your life. And definitely do NOT get emotionally involved with your tinnitus–treat it as a totally useless sound such as the noise your fridge makes and hopefully it will begin to fade into the background and not bother you even though it may still be there.
Regards
Neil
Dr Neil,
I can’t thank you enough for the counsel and reassurance. It means the world to have someone in a position such as your own to speak comfort to those who need it most. I’ll be praying for you so that you may continue helping others even in the face of the pain it brings you. God bless.
Many thanks,
Gage
Dr. Neil,
I have endured severe Tinnitus for 7 years. I am 50 years old, otherwise very healthy, but the severe Tinnitus remains and has had a big impact on my life and, in particular, my ability to work full-time. My multiple sounds include high-pitched squealing, shrieking, and hissing. I always have to work at hearing around my T sounds, especially out in public places. Very challenging.
I have made many adjustments to improve quality to my life with T. I no longer teach full time in an over-stimulating classroom; I focus on tutoring privately in an environment that I can more easily modify. I used to be a musician, and I am trying to play again. I attend symphony concerts on a regular basis because it is one environment that is truly soothing to me. I use earplugs, if needed. During the day I manage fairly well and do specific things to control my environment including monitoring lighting, incorporating pleasing sounds, limiting piercing noise, and incorporating a wholefood organic diet as much as possible. My T is usually a bit less noticeable when I am outside in natural sounds and natural light. My sounds are constant, and sometimes elevated (particularly in the winter), and seem to leave me more distracted and even overwhelmed at times. It has started to interfere with my hearing conversations fully. Fortunately, I do have great support from my spouse and adult children. However, extended family and my friends have a hard time understanding something that they cannot “see”.
I also use a specific form of yoga practices and meditation to support my ability to cope with the Tinnitus for which I am grateful.
I recently was given Tamiflu to combat flu symptoms and it seemed to heighten my sounds a bit.
Besides supplements, the only drug I still use is Ambien (10 mg) nightly in order to get to sleep because of my T sounds. I have used it for 5 years per my general practitioner who assures me that it is safe for me to continue. This physician uses integrative methods and is certainly more holistic in many other ways than my past physicians, including her sharing an Ayurvedic mindset and diet, but still supports the Ambien use. It works most of the time. I go through cycles of no sleep occasionally. I know Ambien is on “the list”. I had the Tinnitus long before using Ambien. I’m using the Ambien to combat the T at night, but I also recently learned about Valerian.
My questions for you: 1) If I try to switch to Valerian, should I taper off the ambien first for a few nights at maybe half the dose) and then switch exclusively to the Valerian for a few nights to assess its effects? I assume it is not safe to overlap the two. I have not used Valerian before. I will also, of course, consult my own physician.
2) I am about to have my hearing checked again after 5 years by a specialist in my city and I am feeling ready to discuss sound therapies for the first time. What are your thoughts about the S-tone therapy developed by the bioengineer team at UC-Irvine in 2010? (research.universityofcalifornia.edu/stories/2012/06/tinnitus.html). The “Mp3″type sound therapy device is marketed now as SoundCure Serenade. The sounds supposedly are modulated and produce sounds lower than the volume of a person’s T sounds, which supposedly help to cancel out or at least diminish one’s perception of sounds. The cost quoted to me by a doctor here in my city is $1800! There is a two week trial period for the patient to decide if the unit is making a difference or not. The doctor offered to write a letter to my insurance to support my case for receiving some coverage for the use of this device. Worth my time and money? or hype?
Thanks for your time and any input you can offer.
Julia
Dear Dr. Neil,
Thank you very much for your prompt feedback, it’s much appreciated!
Regards
Mohammed
Hello Dr. Neil,
I am taking Gabapentin and Duloxetine for nerve pain. They are both on the list. Would you please recommend medications that would have the same effect without being ototoxic. Thank you.
Hi Joe:
I don’t know which drugs a doctor might prescribe for your condition, so I can’t answer your request. However, if you ask your doctor for a list of drugs that might do the job, I can tell you how they stack up regarding ototoxicity, then you could ask your doctor to prescribe the least ototoxic drug.
If you don’t want anything ototoxic, then drugs are not the answer. What I’d do in that case is go to an alternate practitioner such as a Naturopath (ND) and see what he recommends.
Regards
Neil
Hello Dr. Neil,
I was diagnosed with ETD (eustacian tube dysfunction)following a dental surgery (still not confirmed if that caused the ETD) I was prescribed oral steroids for 7 days , z-pak and zyrtek initially. The condition lasted 6 weeks but then almost completly subsided. I then got a cold and it returned. It has been 12 weeks in total that I’m taking Zyrtek and 8 weeks using a beclomethasone nasal spray on and off but steady for the last two weeks. I also started taking xannax to deal with the stress and anxiety this condition has caused. Now I devolped a high pitched tinnitus for two weeks in one ear so I’m thinking it is the beclomethasone dipropiante spray.
My question is if it is the spray that caused the tinnitus, will it subside when I stop using it or does this type medication cause permanent damage?
Thank you.
Hi Dawn:
You may have Eustachian Tube Dysfunction from the dental surgery maybe putting your TMJ out of place. So that is something you should check out. I would have done that before taking all the drugs that just caused other problems.
Zyrtec (Cetirizine) itself can cause tinnitus and hearing loss in some people as well as some balance problems. So that is one possibility.
Beclomethasone can cause tinnitus in 2-3% of the people taking it (placebo 0%) so that is another real possibility.
Xanax (Alprazolam) can also cause tinnitus and hyperacusis. But it seems that most people don’t get these side effects until they have been on the Xanax for some months.
I have no information as to whether Beclomethasone side effects are temporary or permanent. Ditto for Zyrtec. However, I tend to think that the tinnitus will be temporary.
Your tinnitus may be from the Beclomethasone, or it may be from the Zyrtec, or even from a combination of both. So if you stop one, your tinnitus may not go away. You may have to stop taking both to see any difference.
Regards
Neil
I was taking Mobic (Meloxicam) 15mg. After taking it for about 5 weeks I woke up with tinnitus (e.g. the kind you can hear all the time) which hasn’t gone away. If there was any before that I didn’t notice it.
Although I stopped taking it a few days ago there doesn’t seem to be any change with my ears.
Is the tinnitus at all likely to resolve or reduce now I stopped taking it?
There doesn’t seem to be anything else that would have caused the tinnitus. The doctor claimed I don’t have any infection or wax in my ears. It seems unlikely I’d have any of the more serious ear problems that might cause it. I don’t have any ear pain or other head pain or congestion.
Does anyone know why Meloxicam can cause tinnitus anyway? Does the ear get more sensitive and damaged permanently when it would not have otherwise?
Hi A:
I’ve heard from a couple of people that took the same dose as you and unfortunately, when they stopped the Meloxicam their tinnitus stayed at the same level and is now permanent.
One man had his tinnitus reduce in volume but not go away. One lady did get tinnitus whenever she takes Meloxicam, but it goes away when she stops.
So as you can see, it may be temporary, or it may be permanent.
If you take Meloxicam, you have somewhat less than a 1 in 50 chance of getting tinnitus so you always want to be careful with such drugs.
Regards
Neil
[reply to above]
Thanks for your reply.
Do people have any idea why NSAIDs cause tinnitus? Is there anything I can do (like a supplement I can take) that might increase the chances the tinnitus will recover or at least reduce? I mean because of the recent damage from the drug, I know tinnitus itself doesn’t have any real ‘cure’.
If it is going to recover at all, how long would it take?
Hello . . . I’m on chemotherapy for advanced ovarian cancer.
Each chemo round consists of taxol delivered over 24 hours via IV, immediately followed by a platinum drug delivered over 4 hours via IP, followed seven days later by the taxol delivered over 4 hours via IP. I understand that receiving chemo via IP increases the side effects and is harder to take (but more effective for ovarian cancer).
For my first round, I had taxol and cisplatin. Shortly after that first round, I noticed slight hearing loss (can no longer hear soft high-pitched sound, such as the beep of a digital thermometer).
I couldn’t handle the cisplatin, and the doctor switched the cisplatin to carboplatin, still delivered via IP, for Round 2 and thereafter.
After Round 3, I developed really annoying tinnitus. I just finished Round 4 (out of 6), and the tinnitus continues . . . and drives me nuts.
What are the chances that the tinnitus will go away once I finish chemo?
Am I continuing to damage my hearing with every round of chemo? (My oncologist also does not want to change my chemo regime in any way, nor alter the dose. I have two more rounds/six weeks to go. )
Cisplatin is known to cause hearing loss and tinnitus; carboplatin, not so much (I believe). Therefore, is it likely that my tinnitus was caused by that very first round of cisplatin, or is it more likely that the ongoing carboplatin did the damage?
Is there hope for me? Chemotherapy and cancer have taken so much from me . . . breaks my heart if they screwed up my hearing, too . . .
Hi Maryann:
My heart goes out to you. You are in a tough place. Unfortunately, anti-cancer drugs are often very ototoxic and can take out your hearing.
Paclitaxel (Taxol) can cause both hearing loss and tinnitus. I don’t have figures on just how bad it is.
However, Cisplatin is probably the most ototoxic drug known and can cause hearing loss and tinnitus in every single person taking it according to one study. Other studies give it a lesser, but still a very significant, percentage.
Carboplatin (Paraplatin) is one of the platinum drugs like Cisplatin, and is very ototoxic too. Studies show it causes ototoxic side effects in up to 50% of the people taking it. More than 15% of the people taking it end up having high frequency hearing loss.
Unfortunately, the more you take these drugs, the worse the ototoxic side effects become. So each round will cause further damage.
I don’t think the chances of your tinnitus going away are very good. You see, tinnitus often accompanies hearing loss, so you will likely still have the tinnitus from that cause even after you stop the chemotherapy drugs. Your hearing loss may continue to progress after you have finished the therapy.
The good news, if there is any good news in this scenario, is that if you lose most/all of your hearing and hearing aids won’t help you, you could get cochlear implants. You have a very good chance of getting much of your hearing back that way, so you have a backup Plan B to give you hope in the future.
I wish you well.
Neil
Just found your list, Very Interesting! I had already found these causes of my tinnitus:
BHT (toluene), Benzoate (Benzene), BHA, TBHQ (quinine), EDTA, Erythorbate.
Eating these cause tinnitus in 1-2 days, digestive problems 3-4 days(Crohn’s flair).
Keep up the good work.
Hello,
I am going to check the list but I have pulsatile tinnitus and it is getting louder, sometimes even more of a buzz but still my hearbeat. I have high blood pressure but it is maintained with medication. I have been to an audiologist (great hearing, no issue there), an ENT (all clear), and had an MRI (also clear). I am sure it is related to my jugular because I can put my finger on it and it quiets instantly. I’m worried because it is getting louder and it is quite maddening at times. I’m not sure what else to do. I never had an injury or damage. Just frustrated, I guess. Thanks.
Hi Emily:
There’s do doubt in my mind that you have pulsatile tinnitus. Your ENT sure is ignorant about tinnitus if he didn’t refer you to a vascular doctor (cardiologist, thoracic surgeon or vascular surgeon or similar specialist) to try to resolve this issue. Typically, it is from turbulent blood flow caused by build-up of junk in your arteries in your neck/head near your ears. Your high blood pressure is another indication that this is probably happening. It is also another cause of pulsatile tinnitus.
Regards
Neil
I woke up yesterday with a terrible noise on my left ear, some sort of “washing machine” or “heartbeat”. I was prescribed levothyroxine and I took it for 4 days and then this it started. I stopped taking the pill today, to see if it goes away. I have also been very sick with a cold and cough, and I am on amoxicilin right now (started yesterday when the noise started thinking it was also cause of an ear infection) but then I started looking online and the tinnitus symptoms look more accurate.
I can’t stand the noise, Please help!
Hi Karla:
I’ve never heard of Levothyroxine causing tinnitus. Having a cold virus could be the culprit. Cold viruses can attack your ears and cause hearing loss, vertigo and other balance problems and result in tinnitus too, especially if your middle ears get clogged up.
Amoxicillin is also associated with tinnitus in a few people, but the tinnitus may be from the cold, or whatever they were taking the Amoxicillin for and not the Amoxicillin itself. I haven’t heard of enough cases to be sure it is the Amoxicillin itself.
I’d hope that as your cold clears up, and the gunk in your middle ears drains away, your tinnitus will go away on its own.
Regards
Neil
Thank you for the work you do. We just found your list and website 12 days ago, a couple weeks after my husbands tinnitus had escalated to unbearable, probably from Zolpidem he had started taking every night. Turns out 5 out of 6 of his regular meds and all four new ones doctors put him on were on the list and not helping. He went off all meds and most salt two weeks ago. His blood pressure is is better than ever, but his doctors are very concerned that he take something for new afib. T got even worse 1/2 hr after 1 Eliquis, which we hadn’t found on the list. Pharmacist suggested Xarelto. Any info on that? also Tamsulosin?
We will order your book and look for a naturopath.
Hi Mary:
As you can see, it’s hard to take even two drugs and not have at least one of them be listed as associated with tinnitus. This doesn’t mean you WILL get tinnitus, but your could–and some people DO get tinnitus from that drug.
Apixaban (Eliquis) is not listed (so far) as causing tinnitus, but maybe it does as per your husband’s experience. Maybe, in the future, it will be on the list. If I hear of another person getting tinnitus from taking it, I’ll add it to the list myself.
Rivaroxaban (Xarelto) is also not listed as causing tinnitus (at least so far).
Tamsulosin can cause dizziness and vertigo, but I do not have it listed for tinnitus.
So presumably, neither of these drugs should cause tinnitus–but as always, there are no guarantees.
Regards
Neil
I was wondering does Arches Tinnitus Hurt or Help. I am tired of spending money on these herbs. Does anyone have something they take to help reduce the 24 hour loud sound.
Hi Irene:
I can’t see it hurting your ears. It may help IF your condition is something that it works with. It’s not going to help with every kind of tinnitus. If you gave it a three-month’s trial and your tinnitus is the same, then I’d suggest it’s not going to help you if you take it longer.
As I said, not all tinnitus is helped by taking herbals.
Regards
Neil
First of all, thank you for all the work you do.
I am going to try to make this as short as I can, but hard to do with all the questions I have. And I know that there is a lot of subjectivity surrounding tinnitus, so I am aware that most of your feedback will be more in line with responses than with clinically proven answers. And I am incredibly appreciative of both.
I have been suffering from tinnitus for about four years and know that there is no known remedy. Over the past year or so, it has gotten louder, however, to the point of having a hard time concentrating and falling asleep.
I also have hearing loss, but that hasn’t worsened over the years, and was happy to learn that the two are not related to each other.
A brief history. I moved from MN to South Bend, IN about 10 years ago. Since moving here, I developed allergies, which I never suffered from before. Over the past 10 years, I have taken every OTC and prescribed medication I could for allergies because nothing seemed to work for me, many of which are on your list, such as: Allegra, Allegra-D, Benadryl, Claritin, Claritin-D, and Zyrtec. I am currently taking Stahist-AD, Flonase and Singulair. Question #1: Is it possible that one or a combination of these are more ototoxic than the other, and what are my alternatives (besides moving, although I would consider it if meant a cure) for allergies?
Over the past year I have been taking Lisinopril for high blood pressure, which was recently increased in dosage. I feel like there might be a positive correlation to this and my ringing getting louder. Question #2: How does Lisinopril rank in the field ototoxicity?
I also take a lot of Ibuprofen due to soreness (I’m 45 years old and play a lot of tennis, which don’t always mix well). Based on many of the previous postings, Ibuprofen seems to be quite ototoxic, so I’m planning on just dealing with the soreness, and only take aspirin as needed for things such as headaches. Question #3: Am I correct on the ototoxicity of Ibuprofen, and, if yes, is aspirin the way to go?
Staying with this thread of pain and stress, I have heard that stress is potentially associated with tinnitus. I have seen chiropractors that have claimed the sure cure is acupuncture (didn’t do a thing over 2 months); physical therapists that massaged the knots out of my neck muscles in an attempt to relieve stress running to my ear canals (after first visit I swear that night it was gone, but came back again; ENT’s both here in South Bend and at Washington University, the latter asking me to be a part of a Mindfulness Based Cognitive Therapy clinical trial, which I would have done if not for the logistical challenges of going to St. Louis once a week for 12 weeks. Question #4: Knowing that your responses are more medicinally-based, what are your thoughts on the above attempts for a cure?
In addition, I have a case of hyperacusis, and don’t know if that is further exacerbating the tinnitus. Question #5: Is that a possibility.
Finally (I think), I had an MRI that was clean, and ruled out TMJ. I am in contact with Northwestern, the Mayo Clinic, the University of Michigan (which was really hard since I’m a Notre Dame fan) in order to conduct further evals and/or participate in any clinical trial possible for any answer or possible relief, including rTMS, TRT or anything else. Final question: What are your thoughts on the above being just one big waste of time on my part?
I know this was long, so thank you for sticking with me until the end. I’m desperate. I’m sick of saying “what?” all the time (my wife is too, by the way). Any input would help. Any at all.
Thank you so much doctor. You’re a blessing to many.
Dan
does using 2mg clonazepam nightly cause ringing of the ears? I also take one per day B Complex along
with a multi vitimin. Thanks
Hi Jerry:
I don’t have Clonazepam (Klonopin) listed as causing tinnitus–so that shouldn’t be the cause. But there are no guarantees–maybe it just hasn’t been reported yet. The vitamins shouldn’t cause tinnitus either.
Regards
Neil
I have had a very mild case of tinnitus for the past 4 years. Some days it it was very mild and other days nothing at all. But just recently it has gotten worse. I just discovered that I had a B12 deficiency which I am now receiving shots for, but also a VitD deficiency as well. It has to be one of the two, just trying to figure out which. I started the B12 shots first, then started the Vitamin D. I noticed on your list that you have Vitamin D2, but not Vitamin D3 – is there a difference or is Vitamin D as a whole. I actually thought the B12 would help with the tinnitus because it is one of the side effects of being deficient, so just curious if you have any info on the shots. P.S. Great source of info – Thank you so much.
Hi Stacy:
I do not have vitamin B12 listed as causing tinnitus, although it can cause ataxia and dizziness)
Vitamins D2 and D3 are different to some degree. D2 is ergocalciferal while D3 it cholecalciferal. I’ve seen a report that overdoses of D2 can cause tinnitus (and ataxia and vertigo too).
I’ve not heard of D3 causing tinnitus and you can take up to 10,000 IU a day which is a pretty high level.
I can’t “prove” that either of these are causing your tinnitus or not. It’s always possible that they may be, or your tinnitus could be from an entirely different cause.
Regards
Neil
I’ve noticed increasing levels of tinnitus lately. I’m on 1/2 tab of Clonazepam .5 mg and have been for awhile (years) since it helps me to sleep. Could this be causing the problem and is it likely to stop if I get off the med? Thank you.
Hi Ana:
I do not have Clonazepam listed as causing tinnitus–so it shouldn’t be the cause of your increasing tinnitus, but you never know. Since you have been on Clonazepam for so long, if I were going to get off it, I’d taper off VERY slowly because some people GET tinnitus when they try to get off a Benzo after being on it for a long time. Just a heads up there.
Perhaps there is something else going on in your life that is causing the tinnitus to increase.
Regards
Neil
Can you advise whether Carbamizole for Graves disease is an issue for tinnitus. Thank you.
Hi John:
Carbamizole (more commonly spelled Carbimazole) is not ototoxic as near as I can tell. I’ve not seen it listed as causing tinnitus so it should be ok for you.
Regards
Neil
I just want to say thanks for the incredible resource this page represents and the effort put into your informed (and frank!) answers. It’s some comfort for this newly-afflicted tinny, albeit while learning about a condition for which there sadly mainly only seems the potential for relief rather than cure. Dang!
i had a ringing sound in both ears and i,m on hydrochlorothiazade does it have a side effect ,i had tinnutis for three weeks both ears were clugged ,but have been washed and cleared of waxes and i still have the ringing ,but before the ringing i used to take one acetominaphene 500 mg for small headache
Hi Lou:
Hydrochlorothiazide does indeed cause tinnitus in some people. I don’t think it is too common, but it does happen. It appears that the tinnitus is temporary in most cases and stops a day or two after the person stops taking the hydrochlorothiazide.
Larger doses of acetaminophen can cause hearing loss, but I do not see it listed as causing tinnitus.
Regards
Neil
are anti oxident tea good for tinnitus
Hi Lou:
I’m sure they won’t hurt, but I’ve not seen them used as a treatment for tinnitus. I think your better bet is to get of the hydrochlorothiazide and see if your tinnitus goes away.
Regards
Neil
Hi Dr. Neil I have had a constant ringing and terrible pain in my ears for months now. I am ashamed and have not told Dr.s that i was taking Oxycodone/acet 325mg tablets just 1 a day for many years and when i stopped taking it this all started.I did not notice ear problems when taking it. I am so scared and it’s ruining my life! I cant stand the pain and sensitivity in my ears! How can I make the pain stop? I fear this is now a perm problem! I don’t what to do and I know i did this to myself! Any advice, will this every die down? Is there any treatment for this pain im in?
Hi Jeff:
How many months is “months”? Also, how many years is “years”? What were you taking the Oxycodone/Acetimenophen for? Pain management? or? Why did you stop taking them? Did you stop “cold turkey”, or did you taper down? How long after stopping did the tinnitus and pain begin? Did they both begin at the same time? What is this “sensitivity” in your ears you are talking about? Are your ears more sensitive to sound now?
As you can tell, I need to know much more about your situation before I can even begin to be able to answer your questions.
If you want to, you can email me privately at neil at hearinglosshelp dot com.
Regards
Neil
Ok I will thank you. Listen I was having headaches and general soreness from work but honestly it was more idiotic thought that I could do this and not have repercussions.I feel like i’ve let my family down and i’m getting desperate. I was taking them maybe 6 yrs i guess just 1 a day in the morning. I started getting bad headaches and for a time the ringing was so bad right around a month after I stopped taking them cold turkey. These issues have been going on now for about a yr. the headaches are up n down but now since about Dec of last yr my ears have started to actually hurt. I cant stand even a little loud sound without having my ears ringing even louder and the pain worsen. It’s killing my quality of life and i’m scared to tell Dr.s. I worry i’m not gonna get any help because I brought this on myself and they were not prescribed. Idk what to do?
Hi Jeff:
When you say “I started getting bad headaches” was this before or after you quit taking the drugs?
Also, when you say, “my ears have started to actually hurt” are you meaning that you have constant physical pain in your ears, or that you now perceive normal sounds as being so loud that they hurt?
If your tinnitus get worse in response to sounds, then you have what is called reactive tinnitus.
You need to get over your fear and see the appropriate doctors. This is part of being a man–you admit you messed up and now you need help. Just go to your doctor and say, “Look, I messed up and wrecked myself. I need your help to put things right.” Hiding things is only making your situation worse and you are not getting any help. People (doctors included) are willing to help you when you admit you messed up. It’s when you hide things, that makes it difficult to get help.
You reached out to me. So you can go to a doctor and say the same thing. You’ve already done the hardest part.
Regards
Neil
The headaches started after I stopped takin them. Ya the tinnitus gets worse after the loud sounds but its always there and I feel the pain like deep in my ear and even when im at my best my ears like ache then when it’s at its worse i feel the pain actually making the side of head hurt. It gets debilitating.
I think its physical pain I mean my ears hurt/ache even when theres no sound!
Hello, Doctor
I have been applying 0.75% metrogel topically for at least five years as a treatment for rosacea and I was diagnosed with tinnitus a little over two years ago. Lately, the ringing has gotten a little worse. Is there a connection with the metro gel use?
Many thanks.
Denis
Hi Denis:
Metronidazole (Metrogel) can cause tinnitus in some people. I suspect it is not a very common side effect of this drug judging by the paucity of information on it.
The little information I have on Metronidazole indicates that any resulting tinnitus (and hearing loss) are probably temporary and will go away in 4 to 6 weeks after stopping this drug.
If you want to experiment with this, you could stop taking Metronidazole for 6 weeks and see if during that time, your tinnitus reduces or fades away. If so, then that is a good indication that Metronidazole is responsible for your tinnitus.
If your tinnitus doesn’t go away, it could mean that either your tinnitus is a permanent side effect of Metronidazole, or that your tinnitus wasn’t caused by this drug i the first place. There are lots of other drugs and conditions that could have caused your tinnitus.
Regards
Neil
Hello Dr. Neil, I have just gotten tinnitus about a month ago, I have been taking antibiotics and inflamatory medicinesto help my ear drum heal up, I have gotten this annoying never ending whisttleling or ringing,but my question is, im not sure what caused it if it was the ear infection or the noise at work since I work at refineries, or could it have been both? Please let me know if there is any suggestions as what I can take to help clear my left ear so I wont hear it as loud, and if it was caused by the infection will it go away, I used ether pearls sold at Mexican farmacies and I found them very helpful to kill the infection, can I keep using them or can they hurt me more?
Hi Ray:
You could have gotten the tinnitus from the antibiotics, from the anti-inflammatories, from your ear problems or a combination of any or all of them. In addition it could be from noise exposure.
You say you got the tinnitus about a month ago. Was this before, during or after your ear problems?
There is no magic pill to take to fix it. If your left ear is still clogged, then you have to give it time to drain away which could take 3 months or so. After your ear is back to normal, then you can assess whether your tinnitus has gotten better in the process or not.
I suspect it may be due to the effects of the drugs you took.
Regards
Neil
Hello, Dr. Neil,I just discovered your blog and I thank you so much for your information and dedication. I am 62 years old I have been taking Zolpidem for about 5 years for insomnia. I stopped taking it three nights ago as I suspected it might have had something to do with my relatively mild tinnitus. I read in the comments that Zolpidem can cause tinnitus. I will explore this further. My question is: can tinnitis be reversed if the drug (Zolpidem) is stopped? I would appreciate a reply.
Hi Despina:
Zolpidem can indeed cause tinnitus and it can be permanent. Now, here’s the thing. Zolpidem can cause dependence just like the Benzodiazepines can. Therefore, you want to be careful how fast you stop. If you stop “cold turkey” you could leave yourself open in a number of ototoxic side effects including making your tinnitus worse and causing hyperacusis. I think it would be better for you to taper off slowly over a matter of a couple of months or so to try to avoid such side effects.
I don’t have enough information to know how often tinnitus can be reversed by stopping Zolpidem. I know of one man that got permanent tinnitus from taking this drug.
I’d suggest tapering off this drug slowly and then see whether your tinnitus goes away or not. If it does, let me know so I can add your experience into my database for future reference.
Regards
Neil
Hello again, Doctor and thanks for responding so quickly. One more question for you — I also have been taking atorvastatin for about a year and am wondering about its side effects, particularly tinnitus. Do you have any insights?
Regards,
Denis
Hi Denis:
Atorvastatin (Lipitor) can indeed cause tinnitus in some people. The good news is that it appears to be temporary. Your tinnitus may drop in volume in the weeks/months after you stop taking it. Atorvastatin can also cause hearing loss and dizziness in some people.
Regards
Neil
Glad to find your site. I’ve had a baseline low case of tinnitus for many years.
I have been diagnosed with frontal lobe epilepsy, after three distinct seizures over 24 mos or so. The diagnosis also explains a chronic condition I have suffered with for 30years — leg spasms that range in severity from simply annoying to knocking me to the floor, and even once in the ER. After MRIs, multiple sleep studies, neurologists who prescribed Valium as a solution. None of that worked until the epilepsy doc asked me to show her what the leg spasm was like & I showed her, she knew right away it was frontal lobe. As soon as I started on the meds for the seizures, both the leg spasms and the seizures have stopped completely. As critical as it is to prevent my seizures, having relief from these crazy leg spasms after the last 30 years such an amazing side benefit. There is a point to all this background…)
She put me on 200mg of Lamictal in Nov 2012. At my 4 month med check in Mar 2013 I reported that I was experiencing more & louder ear ringing. Because I had one leg spasm during that period, she upped my dosage to 250mg, which is what I’ve been taking since.
About 3 months ago, or so, I began to get a siren sound on top of my increased ringing volume. 12 days ago I got a horrible head & chest cold, ears plugged. I took normal OTC remedies — NyQuil, cough med, then sudaphed, and today was told to try mucinex D.
The ear ringing increased dramatically one day into taking the OTC meds.
Other things to note–
I just diagnosed on Friday with significant hearing loss. (Audiologist took the ear congestion and tinnitus into consideration in the ear test. )
I was taking 20 mg of Lexapro for a couple of years and just weaned off over the last 6 mos or so. (I’ve been considering going back on it and if there’s a chance it could help the tinnitus, I wouldn’t hesitate.).
I take naproxen for aches & pains 2-4x week, alcohol & cannibis use is moderate.
I have experienced one bad bout with TMJ that lasted about 2-3 weeks. TMJ symptoms now returning in the last 2 weeks, but still relatively mild.
It seems like there is a direct correlation between the Lamictal and the increased ringing, but the benefits are not anything I really want to start messing with.
Where would you recommend I start to eliminate one at a time to see which is causing the worsening tinnitus? ( now extremely loud and it is affecting work and life).
Any help, thoughts ideas you have are greatly appreciated.
Thank you.
Hi Michele:
Lamotrigine (Lamictal) is moerately ototoxic and can cause hearing loss and tinnitus in some people. It also causes a lot of balance issues in many people.
You may find that the increased dose of Lamictal is causing more problems. Some drugs have a “magic threshold” below which you have few/no ototoxic side effects, but raising the dose above that level results in problems. It may be wise to revert to the lower dose and see if that helps your tinnitus.
The OTC meds may have increased your tinnitus, but I think more likely it was the result of reduced hearing from your middle ears getting plugged up.
Your hearing loss could be the result of your ears being plugged up (although you say your audiologist compensated for that); it could be because the cold virus attacked your inner ear resulting in the hearing loss; and it could be that any of the ototoxic drugs you have been taking caused the hearing loss. It’s a bit difficult to say at this point.
Escitalopram (Lexapro) can CAUSE tinnitus, hearing loss and a number of balance problems, so it sure wouldn’t be my choice of a drug to try to get rid of tinnitus.
Naproxen is QUITE ototoxic and causes hearing loss and loud tinnitus in numbers of people.
So the two likely culprits are the Naproxen and the Lamotrigine.
Since you think it is the Lamotrigine, I’d suggest going back to your old dose level and see whether that lowers your tinnitus, etc. while still largely controlling seizures. (Run it by your doctor of course.)
And I’d suggest you dump the Naproxen and see what happens. If your tinnitus drops dramatically in a week or so, you know it is the Naproxen. Unfortunately, the side effects of Naproxen can be temporary or permanent so if your tinnitus doesn’t drop, it doesn’t mean it wasn’t cause by the Naproxen, but that in your case that side effect may be permanent. Let’s hope your tinnitus drops if it is the Naproxen.
Regards
Neil
A couple of questions and a comment:
I’ve had tinnitus for years which has slowly been increasing. But during the last month it has become much worse. I see that Botox is listed as potentially causing tinnitus. I suffer from chronic migraines not responding to other treatments, so approximately one month ago I received my first round of Botox inections–which requires 26 injections in the muscles in the head and neck. Is tinnitus secondary to Botox rare? What do you think the chances are that there may be a connection between my injections and worsened tinnitus?
Also, I’ve been on Plaquenil for years at 200 mg. My rheumatologist said she’d never seen a case of the med causing tinnitus. How common is it?
Now for my comment. You discussed causes of pulsatile tinnitus, but did not mention a rare condition which has been identified only in the past 10 years– Superior Semicircular Canal Dehiscence (SCCD). It causes a loud, pulsatile sound of blood rushing in the ear, vertigo and miscellaneous other symptoms. The pulsatile tinnitus is intermittant, set off by various stimuli. I was diagnosed by a head and neck surgeon at Stanford who has a sub-specialty in neurosurgery. He used a very high definition CAT scan used for studying the inner ear canal. I had a surgical repair of the defect and a complete resolution of the pulsatile tinnitus and vertigo. Naturally, it did not cure my chronic tinnitus, since it is unrelated to the SCCD.
Thanks for your blog!
Rita
Anyway, although this condition is very rare, it is something to keep in mind for people who have loud pulsatile tinnitus, particularly if it occurs in only one ear. (By the way, it occurs intermittantly under certain circumstances
Hi Rita:
On the average, I don’t think tinnitus from taking Botox is very common–there is not all that much information on the subject. However, you are not the average person. You are you–and you could be particularly sensitive to tinnitus from Botox (or not).
Hydroxychloroquine (Plaquenil) is listed in both the PDR and CPS as causing tinnitus, as is Botox. But in both cases there are no percentages given, leading me to believe in is not all that common.
I really don’t have enough information on the drugs or on your tinnitus to make an educated guess what the cause is.
Thanks for the info on pulsatile tinnitus and Superior Canal Dehiscence Syndrome. I knew it could result in vertigo and balance problems, but not that it could cause pulsatile tinnitus. I’ll update that article to reflect your new information.
Regards
Neil
Hello, Doctor:
Thank you for your April 22 response to my question regarding Atorvastatin. How would you recommend ceasing to use Atorvastatin? Should I go “cold turkey” or gradually wean myself off of it?
Regards,
Denis
Hi Denis:
You really need to run that question by your doctor or pharmacist. I don’t know what effects this drug has on the rest of your body, apart from your ears.
Regards
Neil
LOCATION: Charleston, SC
AGE: 40
WGHT: 185lbs
BP: Always good, no problems.
BLOOD: (Recent) Good overall except Cholesterol was a little high. (GP not concerned)
MEDS (Past 6 weeks): Ventolin (lifetime mild asthma), occasional Advil 200mg and as needed allergy meds. Have never relied on meds (OTC or Rx) unless necessary. Vitamins. Prednisone 40mg 10days. Antibiotics 7 days. Nasal spray (Dymista or Nasacort).
LIFESTYLE: Health, diet and fitness has always been a priority. Married with 2 children, never-a-smoker, no drugs and a very low alcohol consumption for more than 10 years.
For the past 6 weeks I’ve been experiencing an increased but now steady low ringing in my both ears with an every other day high frequency in my left ear and a slight pulsation. It only changes during sleep at night even though I wake up about every 2 or 3 hours. My levels also increase and stay louder as soon as my head hits the pillow. Also it changes when I bend over, turn my head, extend my jaw or press behind my ears. It all started after a 2 week upper respiratory congestion from allergies cleared up. A few days later, I woke up with loud ringing in both ears but it has slowly decreased in intensity …or I’m just becoming used to it. On a scale of 1-10, I think I started out as a 6 and now I’m a 4 on a bad day and a 3 on a good day. I’ve NOT experienced any recent loud events (shooting guns, concerts, etc…) or head trauma. I’ve been trying to piece this puzzle together and have come to a conclusion of hope that my T may be aggravated by (tested) allergies especially if I experience a sinus infection from allergies during a dry (tree) pollen season. My ears and sinus’ have been clear and dry since after a recent sinus infection in mid March. I never felt as though my ears where clogged (GP, ENT and Allergist said they looked clear). The ENT said I had some high frequency hearing loss but I debated bc I was experiencing higher levels of ringing at the time and said “…of course bc I can’t hear those whisper quiet tones over this high frequency ringing!”. Prescribed Prednisone and sent me home which I think suppressed my immune system even more. Prior to all this I could hear my wife’s cell phone ring in her purse from the other room when she could not and she has good hearing. I’ve had other health issues during the past 6 weeks such thrush on my tongue (Rx Nystatin mouthwash) and coxsackie virus on the roof of my mouth but it’s cleared up. I think my immune system took a beating during the URI and then went into overtime. My ears crack when I swallow and popping them takes a little careful pressure but is not instant. I’ve suspected a low grade OME w/o infection. A few medical sites claim that NO symptoms or evidence of OME does not mean it’s not there and can take up to a few months to clear all the while aggravating T the whole time. I’m not sure about ETD bc my ears never clogged up. My sinus’ have felt dry and my nose has not run once in 6 plus weeks and I’ve been off antihistamines for almost 3 weeks and other meds too. I realized they where drying me up too much, causing my T level to increase while irritating my throat and already dry sinus’. But I continue to have post nasal or ear drainage irritation on the sides of the back of my throat. No matter what extremes I do for myself or my home, I can’t escape pollen until it stops and it’s the only common denominator in this whole ordeal. For example, it’s like a friend who is allergic to your pets, takes allergy meds, comes over and still gets allergy symptoms during or after their visit. I think it’s possible that my middle ears are inflamed from exposure to tree pollen and draining constantly through my Eustachian Tubes and that’s causing my increased T levels. Below is a timeline and tree pollen seems to play a huge role in my T.
TINNITUS HISTORY:
2010
MAY: Tested “Very Allergic” to Tree Pollen (Oak, Hickory and Pecan). Pollinate mid Feb to mid May. Lots of these types of trees where I live. No food allergies.
2011
FEB: During allergy season, ruptured left ear drum while congested and developed a slight sensitivity to high pitched sounds (Hyperacusis).
2012
Local Historical Weather: (DRY) Mid March to early May ONLY 3 days of rain during tree pollination period.
FEB: Possible hearing trauma incident cutting a small piece of metal with a jigsaw while wearing only earphones (dumb). I think this kick started low level T and increased my left ear sensitivity.
MAR: Post sinus and upper respiratory congestion, complained of a slight low ringing/buzzing sound. Went to Dentist and didn’t see any thing.
APR: GP prescribed meds for slight ringing suspecting it may have been from previous congestion.
JUN: Ringing reduced to a forgettable level. Recalled duration: 6 weeks.
2013
Local Historical Weather: (WET) Mid March to early May included 11 days of rain during tree pollination period. No allergy symptoms, URI or noticeable increased ringing levels.
2014
Local Weather: (DRY) Mid March to Mid May (45 days) ONLY 7 days of short rain showers.
MAR 15: Tree Pollen is ACTIVE and reported mostly HIGH, VERY HIGH and with only a few days LOW.
MAR 20: Expelling frequently from sinus and upper respiratory congestion.
APR 1: Clearing up after 2 weeks. I sound stuffy but nose and chest breathing clearly.
APR 3: Exposed all day to the highest tree pollen day of the season.
APR 4: Woke up with extreme ringing in both ears.
APR 10: ENT prescribed PREDNISONE 40mg, 10days.
APR 11: Mild relief (not from meds) and changes in ringing from low to moderate.
(Stayed indoors for 4 days)
APR 18: Woke up with very little ringing, went outside and it progressed by the end of the day.
APR 21: Started 7 days of ANTIBIOTICS (aug/clv 875-125).
APR 22: Noticed THRUSH/Candida on tongue. (Rx mouthwash)
APR 26: Developed Coxsackie Virus in mouth. (now clear)
APR 29: Stopped all meds.
MAY 16: In 28 days, theres only been 3 days with short rain showers.
MAY 17: Ringing improved but not back to what it was prior to APR
I was hoping you could share some advice and outlook. Thanks for your help!
Hi Jay:
One thing that could be causing your tinnitus (apart from your allergies) is taking Ibuprofen (Advil). I hear from numbers of people that get tinnitus from taking this drug.
Albuterol (Ventolin) can also cause tinnitus in some people. Have you noticed any changes in your tinnitus in the past when you took it? If not, then you probably don’t have to worry about tinnitus and this drug.
You wrote, “My levels also increase and stay louder as soon as my head hits the pillow. Also it changes when I bend over, turn my head, extend my jaw or press behind my ears.”
What is it when your head hits the pillow–the reduced sound and “blank” mind as you try to go to sleep? Or is it the position of your head–your neck no longer has to hold your head up? There are two different underlying conditions that can cause tinnitus. I’m trying to determine which is which.
Also, when you bend over, turn your head, etc. indicates to me that your back and neck may be “tight”. Is that right? Chiropractic or massage can help deal with that if that is the case.
It may be that you have two or three different things that are causing your tinnitus to increase–not just one thing–allergies and related stuff.
Regards
Neil
taking restassis,tinitus seems louder. is this possible?
Hi Tony:
Cyclosporine (Restasis) can indeed cause tinnitus or make existing tinnitus louder as you are experiencing. It can also cause hearing loss and some balance problems.
Regards
Neil
Hi Dr. Neil,
I am 27 years old and I recently developed T a week ago after exposure to a loud rock concert. Prior I only went to see a rock show twice a year. I’m seeing an audiologist in a few days but I’m confident my hearing hasn’t been damaged except for the T. But still I can’t a good nights sleep due to the noise. I have a few questions.
Does allopurinol and lisinopril cause T?
Is it possible my T can still go away?
Is there anything I can do to get a good nights sleep? It’s causing me great anxiety and depression.
Do you think there will be a cure in my lifetime?
Hi Kevin:
Unless your audiologist tests your hearing all the way up to 20,000 Hz, you’ll not know whether your hearing has been damaged. (Audiologists normally just test to 8,000 Hz so a lot of incipient damage goes undiagnosed.)
Yes, both of these drugs can cause tinnitus in some people. I don’t know just how commonly that occurs, but it does happen.
Yes, you tinnitus can still go away. But the more you expose your ears to loud sounds, the less likely it is for it to happen in the future. You may be left with permanent tinnitus. So you need to protect your ears NOW.
First, you are only making things worse by worrying about your tinnitus. You need to learn to totally ignore it by focusing on other things. For example, some people find having a fan running in their bedroom is enough of a distraction that they can sleep in spite of their tinnitus. You could have a CD of environmental sounds playing while you go to sleep. This works for many people. Or have a clock radio playing for an hour while you fall asleep.
If you need help calming down, you might want to try the herbal Valerian. It is not ototoxic and helps many people sleep better without making your drowsy the next day.
No. Tinnitus is not a “disease” but a symptom of things gone wrong in the auditory system. It is not just one thing, but many things. So what works for one person won’t work for another. Furthermore, tinnitus is inextricably tied to your emotional system. Thus, YOU have the power to not let it affect your life if you so choose. The people who have the most trouble with tinnitus think of themselves as the victim of tinnitus and are prone to depression and anxiety. Those that gain control over their tinnitus take control of their tinnitus so it no longer bothers them even though they have it day and night.
Regards
Neil
hello dr. i was told that i have ocular rosacea and given restasis which you said made my tinitus worse.
when i see my dr. what should i ask him about any other
med. thatis safer for me? thank you tony
Hi Tony:
I didn’t say it made your tinnitus worse. You said it got worse after taking it. I just agreed that it could have indeed happened as Restasis can cause tinnitus.
By all means, ask your doctor for a less ototoxic drug (if on is available). Why put up with tinnitus if you don’t have to?
Regards
Neil
Hi Dr. Neil,
I am 59 years old and have suffered the effects of tinnitus since my late teens (playing in the high school band, hunting, etc., then working in high noise areas). I have learned to live with my tinnitus (multiple high pitched tones, occasional chirping) simply by ignoring it as much as possible.
However, recently my wife developed tinnitus after taking the generic for Lamisil (for toenail fungus). She only took it for about three weeks, and stopped when the tinnitus began to manifest.
It’s been about 2 months since she quit taking it and the tinnitus is still present. Is there any chance that this will not be permanent? She takes thyroid hormone and general supplements (no different than she took prior to the Lamasil).
Thanks for your help.
Jim
Hi Jim:
Numbers of people do get tinnitus (and hearing loss) from taking Terbinafine (Lamisil). Unfortunately, I don’t have any indications whether it is temporary or permanent. However, since your wife has had the resulting tinnitus for 2 months now, I’m thinking it may be permanent.
She needs to do what you have done and learn to ignore it as much as possible and hopefully it will fade into the background and not bother her.
Regards
Neil
Thanks Dr Neil
I gave gad some hearing loss and T for approx 3 months
I love your “don’t pay attention” approach and chose to yes it myself.
Likewise, I am not a big proponent of drugs, although I gave used supplements that I think have helped…Floric Acid with B12, Vinpocetine (see European studies), and Accupuncture. I do think all helps.
Do you/readers find that the sounds CHANGE throughout the day? From single sound to a Shhhh? Just wondered what that means?
Hi Janet:
Glad that the various supplements are working to some degree. Did you mean Folic acid? You wrote floric acid. Never heard of it.
I’ve not heard conclusive findings that acupuncture really works for tinnitus, but it may.
Tinnitus sounds can change from time to time. My normal tinnitus (a high-pitched hissy-whine sometimes changes to other sounds–just a few minutes ago one ear was hearing what sounds like twittering birds. I’m not sure that it is significant when tinnitus changes sounds if you’re not doing or taking anything diffirent.
However, some things you eat, drugs, herbals, spices etc. can cause another tinnitus sound that appears in addition to your normal tinnitus, or makes an existing tinnitus sound louder. So there are reasons it might change.
Regards
Neil
Hi, Dr Neil,
I am 67 and have had tinnitus for about 18th months. When it first started it was unbearable but now with new hearing aids and probably habituation it has become manageable. It does spike up before weather changes. I also have severe deafness. My question is; my blood pressure has really gone up steadily in the last 6 months. It may be genetic as my father had the same problem at my age. The doctor put me on Coversyl 5 mg, but on reading the side effects it said that 1 in 100 get tinnitus. As I really didn’t want to end up with a permanent roar and even less hearing than I already have, I stopped it. Not to mention that after a few days I was headachy and tired( another side effect).
I am on no other medication apart from low dosage HRT which keeps my osteo arthritis in check, and the odd Panadol Osteo when the arthritis is really bad..
Is there a less ototoxic blood pressure medication that I may take? I don’t tolerate them very well at all, in any case, and looking at the list of improving my lifestyle to drop my blood pressure normally, I am already there.
This is stressing me out as it feels like a Sophie’s choice: return to bad tinnitus which will make you deafer and drive you bonkers, or chance the possibility of a stroke, though I must say there has been no history of heart disease in my family.
Thank you
Olivia Manor
Hi Olivia:
All the ACE inhibitors such as Perindopril (Coversyl) can cause tinnitus in some people. If your doctor thinks a betal blocker would do the job, those that are not listed as causing tinnitus include Labetalol, Levobunolol, Nebivolol or Sotalol. The least ototoxic of these are Levobunolol and Nebivolol so those would be my first choices.
If your blood pressure is under 150, if it were me, I wouldn’t worry about it. That might be normal for your family–and as you say, there is no history of heart disease in your family, so you may choose to do nothing. Now if your blood pressure was 180 to 200 you don’t want to risk “blowing a gasket” so you need to do something.
Regards
Neil
I’ve had tinnitus for just over a year that started with a cold. I took amoxicillin and the tinnitus started about an hour later. I continued the amoxicillin for a week never realizing it could be the cause of my tinnitus. I’m finally at a point where it doesn’t bother me quite so much.
Today I pulled something off the back of my leg and discovered it was a tick. I went to the doctor and was told my Lyme disease risk is probably low but was given a prescription for 2 pills of 100mg doxycycline (to be taken as a single dose)as a precaution.
If I don’t take the doxycycline, I need to get a blood test in 4 weeks. If positive for Lyme, I’ll need 3 to 4 weeks of antibiotics.
I’m not sure which is the lessor risk, but need to make an immediate decision.
Hi J:
Getting tinnitus from taking Amoxicillin is quite rare as far as I know, but it does happen to others, just like it happened to you.
Doxycycline can cause hearing loss and tinnitus in some people so you want to be careful. As you say, you have to weigh the risks.
Here’s how I look at it. Ticks typically don’t transmit the virus for the first 24 hours or so. Therefore, if you know the tick was only on you and beginning to “bite”, then the chances of getting Lyme is quite low. (And your doctor himself says the risk is quite low.)
As a general rule, I’m against taking antibiotics as a precautionary thing. There are too many risks, so in your shoes, I’d probably forego the Doxy at this point. However, I’d keep a close eye out and if any symptoms of Lyme start to appear, then you know you have to get on it right away.
My wife picked up a tick earlier this year and it was starting to “dig in”, but I pulled it out, swabbed the area with alcohol and that was it. No problems at all. (I pick up ticks every week on my walks with the dog (or he picks them up and they get on my and my wife.) But I check and find them while they are still walking around so haven’t had any problems.
Regards
Neil
WOW, I just came across this and am stunned! Four meds I’ve taken/are taking are on the list. I’ve had constant, non-stop high ringing for maybe 8-10 yrs. so I’ve assumed something I’d have to live with. Also have hearing loss and was afraid to consider hearing aids because I was afraid they would magnify the tinnitus. There are times this ringing drives me insane! I took Lunesta every night due to inability to sleep but that became hard to obtain so switched to Temazepam (also on the list). Also take a Benadryl each evening and Lipitor daily. ANY suggestions whatsoever? And when can I get those new ear hairs? LOL Thank you.
Hi Sherrill:
Eszopiclone (Lunesta) causes tinnitus in numbers of people–somewhere around 1 in 100 or so. Diphenhydramine (Benadryl) can do about the same.
Temazepam may cause tinnitus, but probably not in too many people.
Atorvastatin (Lipitor) can cause both hearing loss and tinnitus in some people (around 1 in 50 or so).
My first suggestion is to look back at when your tinnitus first started and see what changed in your life in the month or so before your tinnitus started. Did you begin a new medication or change the dose on an existing one? If so, that is likely the culprit. Were you under a lot of stress, were very anxious or depressed? Those could be triggers too.
The drugs you are on now can cause tinnitus, but if you had your tinnitus before you started them, and it didn’t get worse when you started them, then it is unlikely that any of them are the cause of your tinnitus.
Regards
Neil
I recently had a blood test and an very low in Vitamin D and am waiting to hear about Vitamin B12 level. Started 2000 mg daily of Vitamin D
How long should I wait for results? Too much or too little an issue with Vit B12?
Have you heard of the Neuromonics therapy? Sound therapy that is being used with returning Veterans.
Hi Janet:
What vitamin D are you taking? The most active form of vitamin D is vitamin D3. That is what I take. You should also know that when you take high doses of vitamin D3, you also need to take vitamin K2 or your body doesn’t use it correctly and you can have problems with what they call vitamin D toxicity–which is really a calcium problem..
When testing for vitamin D, note that there are two vitamin D tests — 1,25(OH)D and 25(OH)D.
The correct test is 25(OH)D, also called 25-hydroxyvitamin D. This is the better marker of overall D status, and is most strongly associated with overall health.
Optimal levels of vitamin D are 50 – 70 ng/ml. In order to reach that level, the average person probably needs to take about 8,000 IU of vitamin D daily. But you want to be tested regularly so you know where you are. I don’t know how often you should be tested, but if you get tested once a month while you get yourself into the correct range, then after that maybe twice a year to make sure you stay in the correct range.
I’m not up on the optimal dosage for vitamin B12. You can read up on it at http://www.mercola.com and do a search for vitamin B12. You’ll find good answers there.
I’ve written an extensive article about Neuromonics for treating tinnitus. You can read it at http://www.hearinglosshelp.com/articles/neuromonics.htm .
Regards
Neil
Are you familiar with Neuromonics? Gonna try it…has amazing results when used with Vets returning from Iraq and Afghanistan. Not an ad….but ready for relief! Retraining the brain….the results quoted are amazing! Will report back in a couple of months.
Think that it is worth it if I can sleep at night and relax! Google it folks!
I experienced fullness and tinnitus of my left ear about 2 1/2 weeks ago. I had my left ear cleared of wax but the fullness did not go away. A hearing test subsequently showed some loss of hearing. I was prescribed prednisone 40 MG a day, 30 MG for 3 days 20 MG for 3 days and 10 MG for 3 days. This relieved symptoms of fullness and tinnitus. I am now off the drug and the fullness and tinnitus has returned. My EMT prescribed the us of Afrin 3 days on 3 days off. I have not used the Afrin because it affects my sleep. Should I use the Afrin and will it solve the root cause of my issue or simply mask it? Also what would your recommend now to eliminate the fullness feeling? The ENT has ruled out any infection, fluid, or other complicating (tumor) issues.
Hi Dr. Neil
Looking at your list of Ototoxics is depressing. I’m sure I will need to take antibiotics in the future from my Dentist or from surgery, I am 62 with Tinnitus in my left ear which started last year after a bout with vertigo. What antibiotic do you recommend? Do you have a list? Also, what should I take for minor pain?
Thank you
Maximus
Hi Maximus:
I don’t recommend any antibiotics as such. Your doctor chooses one from a class that he thinks will work on the organism he is trying to kill. All the antibiotics are ototoxic to some extent. Some are a lot worse than others. So the idea is to find one that will do the job, yet be the least ototoxic in its class. As a class, the Cephalosporins are not very ototoxic. Cefadroxil is probably the least ototoxic in this class, so if it will do the job, it might be a good choice.
For minor pain, I wouldn’t take anything. Just tough it out. That’s what I am doing right now myself. Then you don’t have to worry about drug ototoxicity or any other side effects of pain killers.
Regards
Neil
Thank you Dr. Neil….One more question…. I got Tinnitus in my left ear following Vertigo, the Epley maneuver… since then I’ve had severe anxiety and used to have panic attacks. I seemed to have tried all the natural remedies but not any that really help. I wake in the middle of the night with very negative thinking that continues all day until about 6 in the evening when for some reason I feel ok. I seem to not be able to enjoy my surroundings during the day because of the negative thoughts and anxiety. I habituated with my Tinnitus but still have leftover anxiety. What should I do? Thanks …Maximus
One more question if you would please….. Does Niacin cause Tinnitus or make it worse? I want to take it or try at least, for cholesterol and depression. I’ve heard that the no-flush Niacin or Niacinimide isn’t as potent. What say you?
Hi Maximus:
Niacin or Vitamin B3 is a vasodilator. As such, it increases the flow of blood to your inner ears–and this can be good to help certain kinds of tinnitus that are caused by a lack of blood (oxygen) to the inner ears.
I don’t know about this no-flush Niacin not being as potent–but it makes sense. You see, the proof that Niacin is dilating your blood vessels is that it does that in the skin blood vessels and with more blood, your skin goes redder and gets hotter. If you take away that property, then I don’t see how it would help your inner ears. (I can’t speak to the cholesterol or depression though.)
Regards
Neil
Got T from bactrim years ago …went away…returned after lidocaine injection for skin biopsy for fungal infection…it is moderate level constant buzzing both ears…trying to ignore it ..but sleep is of concern … Lack of it causes bp and depression and anxiety..tried valerin …no Gud ….taking tryptophan one gm nightly with stops. Also tried GABA for sleep.. I am 78yr old male.. Current episode of T is since five months..any advice to add on regarding sleep supplant..thnx
I’ve had tinnitus for 10 years which has slowly been increasing. But during the last month it has become much worse. Have taken atenolol for 30 plus years and Gabapentin for the last nine months. My hearing has gotten so bad that I decided to get a hearing aid. I was given one by the audiologist to try. After wearing it about 1 hour my tinnitus started to increase, so I took it out. And the tinnitus has not calmed down since. Have you ever heard of hearing aids causing tinnitus to increase…or is this maybe a coincidence and my medications are the issue? Thoughts?
Hi Karen:
Yes, some people do report louder tinnitus when fitted with new hearing aids. I think this is because the hearing aids were set too loud to start with. When this is your experience there are two things to do. First, get the hearing aids set lower than you’d theoretically need for optimum hearing and then have them slowly moved up to the proper level over a period of a couple of months as your ears/brain adjust to louder sounds again. Second, don’t wear new hearing aids all the time to start. Wear them first in quiet places for an hour or two the first day and slowly build up the length of time you wear them–ALL in reasonably quiet situations. THEN, after your brain has adapted to that, you can start wearing them in noisier places and again start with a relatively short time and slowly lengthen it.
Having said that, you may find that the drugs you are taking are messing up your ears. Atenolol is a “funny” drug in that the side effects such as tinnitus and hearing loss may not show up for many years–typically 5 or more years. So just because you have been taking it for 30 years doesn’t mean that it isn’t now causing your tinnitus to be louder, etc.
Gabapentin can also cause hearing loss, tinnitus and hyperacusis and a host of balance problems.
It may be that the drugs combined with your new hearing aids have done a number on your ears.
Regards
Neil
Taking cipro 500mg twice a day. My tinnitus has been manageable. After taking two pills if semed worse. After taking a pill last night I woke up at 4 am with such loud tinnitus I thought I would go crazy. I’m afraid to take this medication again. I have diverticulites and this seem the only medication for this condition. Please help.
Thanks so much,
Pat
Hi Pat:
Ciprofloxacin (Cipro) causes hearing loss and loud tinnitus in numbers of people. Unfortunately, you seem to be one of them. You have several choices–don’t take any drugs for your diverticulitis, ask your doctor for a different drug (and hopefully in a different class than what Ciprofloxacin is in as all the fluoroquinolones are quite ototoxic), go to a different doctor and get a different opinion, or go to a naturopathic doctor (ND) and try a more natural approach. If it was me, I’d do the latter.
Regards
Neil
Dr. Neal:
I’ve had Tinnitus for a little over a year. I’ve been told as you have repeated in your replies that there is no know cure. I agree, and have turned my Tinnitus over to God. He is the only one that can heal Tinnitus. Hopefully, someday, there will be a medicine for curing. For now, prayer for healing is our only hope.
Dr. First I want to thank you for posting this substantial list online, thereby making it available to the world.
Did you compile this data from prescription drug data? Or from surveys /studies, or both? I’m just curious because so many of my medications appear on this list, and only recently has there been a rather large uptick in volume of the Tinnitus in my Right Ear. Yes, fortunately for me it’s unilateral but over the years I’ve had short periods of tinnitus that usually went away. Now it’s here to stay and I’m going through the requisite tests to rule out tumors etc.
For the past couple of years I’ve been taking: Altace, Toprol, Flomax, Celebrex, Lamictal, Viibryd, Zonegran 200mg/day, Gabapentin 200mg/day, Protonix, Cyclobenzoprine – when needed (not often, say 2x every other month), Victoza, Oxycodone, Fentanyl Patch, and Testopel implants every 3 -4 months. OTC I take Vitamin D3 and Folic Acid. Yeah, i retired rather young on a Disability.
The only other new ones added this year have been oral Capri earlier this year, oral Levaquin after the Cipro, and when the right ear Tinnitus blew up I was on a Levaquin/steroid (flucotosine (sic)) Nasal Wash.
Now I know Levaquin is on your list, but I took it more in an “external” way, in a nasal saline wash. I wouldn’t think that would have any effect since it’s not actually absorbed, but it’s something to consider.
I’ve had mild tinnitus for years. Have been able to just ignore it. I also have a fairly significant hearing loss sensorineural. recently I’ve had bouts of loud ringing in the middle of the night that wake me up. A couple of times it sounds like it is a phone ringing in the background which is weird. Tried using a fan to mask the ringing while sleeping but since I don’t sleep with the aids in, I can’t hear the fan. Are there maskers that have high volume? Suggestions for sleep? I can deal with the daytime.
Hi Peggy:
When you have a “fairly significant” or worse hearing loss (and I’m in that boat too), trying to mask tinnitus is just not practical at night. You’d have to have the sound so loud your spouse and all your neighbors would be moving away! Thus, you have to come up with other ways to control your tinnitus.
One possibility, but I do NOT recommend it, is to wear earphone or earbuds hooked up to a CD player or MP3 player, etc and listen to sounds (environmental, music, etc) of your choice at a level that will mask your tinnitus. If you need tho sound up, you risk damaging your hearing and causing even worse tinnitus while you sleep.
You could listen to fans, music, environmental CD sounds, not loud enough to mask your tinnitus, but loud enough to hear. This would give your brain some real sounds to listen to and you could focus on these sounds rather than your tinnitus. Again, this will only work if you can hear such sounds without disrupting the sleep of anyone around you. (It won’t work for me because again, I’d need the sound so loud that no one could stand it.)
What I do if my tinnitus is trying to bother me at night is to take my focus off the tinnitus by singing to myself (in my mind–not out loud) and concentrate on my internal music–thus ignoring my tinnitus. This works for me and I do not bother those around me with loud “real” music.
However, it would be even more productive to try to find out why you are having these new loud tinnitus sounds. One possible cause is medications you are taking. Have you added any medications recently? Or changed the dose on any existing ones? Sometimes that is the cause and changing he meds is all that it takes to dump the new tinnitus.
Regards
Neil
Thanks for the quick response. I am not on any medications, I take magnesium 500 mg. a day to ward of migraines (some what successful). I did recently have my audiologist (in an effort to finally get clear sound from one aid) add a tube to close the vent hole in the aid. That did wonders for making the sound more clear, less like I’m walking around with a wet sock in my ear. Now I’m wondering if that was a good move. Did it allow too much sound in and cause an increase? I have an appt. coming up with ENT. MRI done 2 yrs. ago, no acoustic neuroma. He’ll want to do another one. I have an autoimmune disorder, leans towards sjogrens. I do not take anything for it. Have leukocytoclastic vasculitis. Also take nothing for that (I’m drug phobic :). For many years I’ve consumed 2 or 2.5 glasses of wine a day. I’m thinking I haven’t done myself any favors with this and the tinnutis. I tried sleeping with the aids in and turning on a fan. That lasted two nights. It hurts plus it means I have plugged up ears almost 24 hrs a day. Not healthy for the inner ear I imagine. Another item, had one really bad bout of vertigo after a major ear ringing event. I really appreciate your responding so fast. Very helpful.
Hi Peggy:
How long have you been taking the Magnesium?
Blocking your vent hole should have made the sound less clear–more like talking in a barrel.
If your tinnitus gets louder because you wear your hearing aids, then I’d suggest they are set too loud. If not, then I wouldn’t worry about it.
If you have one autoimmune disease, you could also very likely have AIED (autoimmune inner ear disease). That could account for hearing loss, tinnitus and vertigo.
Regards
Neil
I have had mild tinnitus for many years. It was never really a problem. Then I started taking imipramine ( for another condition), and my tinnitus got worse. So I stopped taking imipramine, but after 2 weeks my tinnitus has not improved. Will this be permanent? While it is still tolerable, I am afraid that if I go back on imipramine, it will get still worse.
Hi Bill:
Imipramine can cause tinnitus in some people. I don’t think it is too common.
I don’t have any information as to whether tinnitus from Imipramine is permanent or temporary.
My gut feeling is that going back on the Imipramine won’t make your tinnitus louder than it was after you took it the first time–but I could be wrong.
If I was in your shoes, I’d take the herbal St. John’s Wort. Numerous studies have shown it to be as effective as prescription drugs for mild to moderate depression so it works well. And the really good news is that it doesn’t have any ototoxic side effects so it won’t hurt your ears.
Regards,
Neil
Have been taking the magnesium for about 3 yrs. now. It has made a difference with regard to how often I get migraines. Can extra magnesium have caused increased tinnitus? It has reduced the occurance of migrains considerably. I’ve never known about AIED. Will mention this to my MD. Interesting, narrowing the vent hole in the aid made the clarity so much better, less of a “wet sock” feeling in the ear. Thanks again for the quick response and so appreciate your help.
My tinnitus came on one day out of the blue about two weeks ago. I am 76 years old and healthy. I have for years had one to two alcohol(gin) drinks just before dinner almost daily. That is the limit of my drinking. What level of cause would you attribute alcohol? Could the tinnitus lessen or end with totaly stopping my habit, which I can do. Thank you
I have to tag onto Jerry’s question, for many years I’ve been a 2 glass a day wine drinker (ok sometimes 2.5) bet NEVER more. Could that have exaberated my ear ringing?
I have recently developed ringing and partial hearing loss. Was quite surprised to see that Gabapentin can lead to these problems. I took a low dosage for shingles, which lasted about three to four miserable months. That was in 2012. Could that have lead to today’s hearing issues? I take Zyrtec for allergies. Any connection to hearing loss and Zyrtec? Or a combination of Zyrtec and Synthroid, which I take since I had a thyroidectomy (cancer) in 2006? You have a helpful forum here. Thanks!
Hi I recently found your website. I have TMJ when i first was learning about it i was prescribed meloxicam 15mg. Since then i have had tinnitus, im not sure if it is related to that drug or if it is just a coincidence that as i developed tmj i developed tinnitus. The ringing gets more high pitched if i put pressure on the jaw. No medication seems to fully relieve the tinnitus. I currently take jamp cyclobenzaprine 10mg and lyrica 75mg every night before bed. It somewhat relieves the ringing in the morning/during the day. I also take lipo flavonoids which seem to help a little. Any suggestions on how to improve my situation? The tinnitus is very irritating especially on days when it is higher pitched. In addition occassionally i will have a double ringing sensation. As if two pitches are fighting in my ear, is this something to be concerned about? It happens very infrequently (once every 3-4 weeks maybe more?)
Hi Brandon:
I’ve heard from a number of people that got bad tinnitus shortly after they began taking Meloxicam. It seems very likely that your tinnitus is from the same cause.
It is quite common to be able to change your tinnitus in volume or pitch by pressing on your jaw or turning your neck–if you have TMJ or your neck is “out”.
I’d be careful with the Pregabalin (Lyrica) as I have heard from a number of people who lost hearing from taking this drug. It can also cause tinnitus. Your double tinnitus may be because you are taking two drugs that can cause tinnitus, or from one or the other (or both) of these drugs and your TMJ.
If I had TMJ, I’d go to a dentist or chiropractor that specializes in TMJ and get things straightened out. It’s cause could be because your sternocleidomastoid muscles in your neck are not in balance and thus are pulling on your TM joint causing the TMJ. A chiropractor that specializes in upper neck problems should be able to help you fix it. When everything is in place, your tinnitus from the TMJ should go away.
Whether the tinnitus from the drugs will ever go away remains to be seen. Unfortunately, numbers of people that get tinnitus from taking Meloxicam find that their tinnitus proves to be permanent.
Regards
Neil
I have read info that Golden Seal Root is beneficial for ringing in the ears. I have some tablets 500 mg. Can you tell me if this would be helpful? I have an awfully severe case of Tinnitus. It is just about to drive me crazy. I have high blood pressure. Taking Bystolic for that. Also Valiun for anxiety. Thanks for the help. Bill
Hi Bill:
Goldenseal works for specific cases of tinnitus–not tinnitus in general. If your tinnitus is the result of a cold, or congestion in your sinuses and Eustachian tubes, then Goldenseal can help by helping to reduce the congestion. When the congestion goes away, so too does this kind of tinnitus.
However, if you are not congested, I don’t think GoldenSeal will help your tinnitus.
If you want to try a herbal, you might want to try Ginkgo biloba in a therapeutic dose of 480 mg/day. The only formulation that meets this level is Arches Tinnitus Formula. So that would be what I’d try. It may or may not make a difference–but you won’t know until you try it.
Note that Ginkgo is also a blood thinner to some degree so it may even help your blood pressure problem. Just be aware that it has this characteristic.
Regards
Neil
So, does drinking wine have any bearing on tinnitus? As mentioned have had it all my life, but have adapted. A new obnoxiously bad bout has hit me. Again taking no meds. Magenssium, 500 mg per day for migrains, occasional Aleve for back pain. Am being tested for AIED currently. I’m a two glass a day person.
Hi Peggy:
It may or may not. For example, if your tinnitus is exacerbated by the presence of molds, then drinking wine could also make your tinnitus worse because there are always some moldy grapes in the wine. I know of one person that can’t drink wine for that reason.
Just drinking alcohol can make your tinnitus worse too–in some people, and in others, it has the opposite effect and helps quiet their tinnitus. Here’s the secret. If drinking alcohol stimulates you, then it can also stimulate your tinnitus and make it worse. However, if drinking some alcohol calms you down, then it may also calm your tinnitus down.
The easy way to know how alcohol affects your tinnitus (if it affects it at all) is to quite drinking for a week or so and note whether your tinnitus changes for the better or the worse, or if there is no change. Then you know what to do.
I doubt that taking 500 mg of magnesium is causing your tinnitus. In fact, magnesium is used in treating tinnitus.
Aleve (Naproxen) can cause tinnitus in some people. For some, the Aleve causes louder tinnitus that goes away in some hours, for others, the tinnitus seems to be permanent. So you might want to notice if there is any correlation between your tinnitus getting louder and your taking any Aleve.
Regards
Neil
Hi Dr. Neil,
I recently saw an ENT for assistance with a blocked feeling and diminished hearing in my left ear. I was prescribed Nasonex for a possible tube issue, which I was told to take for a few weeks possibly longer. I did this for about three weeks before I realised I was having a high pitched tinnitus issue in both ears and I stopped. I have never previously had any issues, so I assume this is the cause. The ENT is adamant that this cannot cause tinnitus. Some anecdotal evidence on the web suggest that it can, and mine definitely has . Have since had a hearing test which has shown ‘normal’ hearing, with a slight drop in one frequency. Can I get your opinion as to whether steroids such as Nasonex can cause or worsen tinnitus?
Hi Brian:
If Nasonex (Mometasone) causes tinnitus, it is VERY rare. I cannot find any “official” sources that list tinnitus as a side effect, so I can see why your doctor believes it does not cause tinnitus. As you say, there are some anecdotal reports on the Internet, but what you don’t know is whether any of these people are taking another drug that might be the culprit, but they blame it on the Nasonex, or whether their ears are blocked and thus this is the cause of their tinnitus. If they are taking Nasonex, probably their ears ARE blocked to some degree.
The most likely cause of your tinnitus is your blocked ears. When anything blocks your middle ears or plugs your Eustachian tubes, you can have tinnitus as a result until the gunk drains out and your ear returns to normal.
Regards
Neil
Hi Dr Neil,
I abruptly stopping taking sertraline 50mg from March to June 2014, I am suffering a side effect which is tinnitus caused by medication. I never had tinnitus before this med. The reason why I stopped taking due to horrible side effects and quit cold turkey. I am healthy person eating well fresh veg and don’t smoke and only drink one or two bottle of beer weely. I exercise three times a week.
How long does it symptoms last? Since I’ve been taken this med since March and started with ringings in ears, I am still suffering now not sure when it goes away? My concern is that this withdrawal symptoms becomes permanent.
I look forward to hearing from you.
Thank you.
Regards
Sonny
Dr. Neil, a huge THANK YOU to you. You suggested that I may possibly have AIED (something I never knew even existed)I brought this up with my ENT who didn’t seem to be interested or think it was an area of concern. I followed another route to my rheumatologist. She was aware of it, consulted w/yet another ENT who knew of a special blood work to detect for it Antibody 68 (I think). Turns out that is exactly what I have. Had it not been for you, your information and this site,….I and my docs would have never known to look for this. Next steps,possible steroid treatment (methotrexate). THANK You for your help!
Hi, I was wondering if having the flu shot will increase tinnitus? This year it is being given with Neomycin and polymyxin – I work in health care so I am required to have this but worried it will increase the t. Thanks
Hi Debbie:
I’ve not heard from anyone that got increased tinnitus alone from taking the flu shot, but I have heard from a good number of people who got tinnitus as a result of the hearing loss they experienced from taking the flu shot. It’s hearing loss you have to be more worried about rather than tinnitus.
Regards
Neil
So concerns over methotrexate as treatment for AIED. 10 mg. per wk. 12 weeks before I know if effective (or not). Is there data regarding percentages of whether low dose med causes more tinnitus and/or hearing loss?
Hello Doctor,
I have tinnitus. I do not know when it started and I do not know what caused it. What I do know is that at some point it became loud enough for me to consistently notice it, the pitch of the ring is a high frequency and nothing other than music does anything to stop it.
The list provided of substances that are possibly oxotoxic is so large that the probability that a person with tinnitus has taken one or more of the substances is likely to be very high. If this assumption is accepted and all of the empirically documented causes of tinnitus are are added as variables, narrowing down a particular substance as the cause of tinnitus is the equivalent of attempting to find the exact inhalation of cigarette smoke over a lifetime of cigarette smoking that caused lung cancer to develop. The fact is, we live in a loud society, we have portable music players that will cause hearing loss after less than four hours of continuous play at less that full volume and we ingest many hazardous substances, some potentially ototoxic, some by choice, some by necessity and some we are completely unaware that we are ingesting.
It makes sense to refer to the list if you have experienced rapid onset tinnitus AND recently begun taking a new medication. Unfortunately, studies show that the main cause of tinnitus is long term exposure to moderate to loud acoustic events or a short but extremely loud event. The result is high frequency hearing loss and the ringing you and I are hearing right now is within the range of frequencies we are no longer able to produce through sensory systems. It is perceived sound coming from the brain. If we removed both your cochlea and auditory nerves, we would still hear it. If we were somehow able to space walk with no helmet, we would still hear it! In space, nobody can hear you scream, except yourself, if you have tinnitus.
If you have long term, persistent tinnitus that is experienced as a high frequency tone, that interestingly sounds like a pure tone, you probably know about this already and don’t care about what made it start, but what makes it persist.
Tinnitus caused by high frequency hearing loss persists due to down regulation of GABAergic receptors in an area of the auditory cortex that develops due to cortical map reorganization triggered by acoustic trauma.
Huh?
In short, it is a neurotransmitter imbalance caused by the brains amazing abilities of neuronal plasticity.
Ever heard of phantom limb pain? Tinnitus is phantom cochlear hair cell sound.
How do we treat neurotransmitter imbalances? Medication. Possibly one of the ones on the list provided here. Tinnitus behavior in rats has already been extinguished by administering substances that block GABA reuptake or increase the amount of GABA released into the synaptic gap. So…
There may be a medication soon for many of us. We can then stop the ringing so that we can all figure out how to create a mirror box for sound.
Interested in your thoughts about this Doctor.
Here is a literature review of the studies I referenced, but did not cite in text.
Restorative Neurology and Neuroscience 31 (2013) 99–108 DOI 10.3233/RNN-120248 IOS Press
99
Hi Rauridh:
You are quite right about tinnitus and drugs. Obviously, most people that take the drugs on the list do not get tinnitus from those drugs, but numbers of them do. Thus you take your chances with drugs.
And it is also true that loud sounds are one of the most common causes of tinnitus (and the one most easily prevented if you take proper precautions). In other words, most cases of tinnitus are unnecessary if people exercised good judgement by not exposing their ears to loud sounds without adequate protection.
I also agree that the current thinking is that when too many neurons at one frequency become active and not enough other neurons around them tell them to “shut up” that you can develop tinnitus. However, depressing the GABA receptors with drugs in order to stop tinnitus is not the real answer in my opinion. Such drugs have many other unwanted side effects so the result may be worse than the condition it is set to cure. For example, how do you keep the drug from depressing the action of the many GABA receptors that regulate other parts of your body. So while in theory it sounds good, in practice, it may not be a good solution after all.
Regards
Neil
Is there ANY allergy medicine that can be used? Thanks in advance!
Hi Dee:
Just because a drug is on this list doesn’t mean you will get tinnitus if you take it. Some people do, but many don’t. You need to get my book, “Ototoxic Drugs Exposed” and look up the individual drugs to see how common tinnitus results from taking a given drug and how bad the tinnitus may be. Then you can look at all the allergy drugs that may help you and choose the one that has the lowest probability of causing tinnitus or making your tinnitus worse.
There are no guarantees, but you can certainly put the odds in your favor.
Regards
Neil
Hello Doctor Neil,
On September 30 I was diagnosed with a pulmonary embolism caused by a deep vein thrombosis in my left calf. Doctors put me on two anticoagulants Lovenox (enoxaparin) and Coumadin (actually Jantoven, the generic version) until the PT/INR exceeded the 2.0 level). Once I reached that level (October 13), the doctors advised me to cease injecting the Lovenox (80ml injections 2x/day) and to continue with the Jantoven, alternating between 7.5 mg and 10 mg every other evening. Since stopping the Lovenox on October 14, I’ve noticed my tinnitus has gotten louder and is now constant (it used to be mainly in my right ear and occasionally would flare up in my left and it is now constant in both). I also had a flu shot (0.5ml and preservative free) on October 8th. I’ve noticed that neither Lovenox nor Jantoven is on the list of ototoxic drugs, but I am wondering if perhaps the sudden stopping of the Lovenox injections or the flu shot (or any combination of the three) could have contributed to this new level of ringing in my ears.
Also, I have been taking 3mg of melatonin coupled with 500mg (and sometimes more) of Valerian Root each night to help fall asleep.
As always, thank you for your guidance.
Regards,
Denis
Hi Denis:
I have no information to indicate that Lovenox or Coumadin result in tinnitus. Therefore, I doubt your tinnitus is a result of taking either of these drugs.
The flu shot may be the most likely culprit. I’ve heard from numbers of people that have had tinnitus, hearing loss and other ear problems shortly after taking a flu shot.
I don’t think the melatonin or Valerian are ototoxic in the least.
Regards
Neil
Hello again, Doctor:
Thanks for your quick response. If the flu shot is the culprit, any thoughts on whether the increased ringing could be temporary or permanent?
Regards,
Denis
Hi Denis:
If the ringing is associated with your middle ears or Eustachian tubes becoming clogged up, then the tinnitus would tend to be temporary. and go away when the congestion clears up. However, if the tinnitus is associated with a sensorineural hearing loss, then it would tend to be permanent. However, there is no way to say for certain whether yours will be temporary or permanent. Only time will tell.
Regards
Neil
Thanks again, Doctor. I don’t want to take up all your time, so I’ll conclude for now with two more short questions:
1) I have taken about 4-5 doses of extra strength tylenol (500 mg and just one tablet, not two) over the past 3 and a half weeks. Could the tylenol be a culprit, too?
2) In looking through your ebook “Ototoxic Drugs Exposed (2010),” I see there is a good discussion about the risks associated with acetaminophen yet I don’t see acetaminophen listed in the 2013 edition of “Prescription Medications, Over-the-Counter Drugs, Herbs & Chemicals Associated with Tinnitus.” Has the view on acetaminophen changed between 2010 and 2013? By the way, I was taking tylenol for minor muscle aches and pains and because it was “permissible” under my current anti-coagulant regime.
Again, thanks for your time and consideration.
Regards,
Denis
Hi Denis:
Acetaminophen (Tylenol) is probably not the culprit unless you take it fairly regularly so that you also lose hearing. In that case, the tinnitus would be a result of the hearing loss, not directly from taking the drug itself.
The reason you don’t see Acetaminophen listed in the tinnitus drug list is because I have not found any sources listing Acetaminophen as directly causing tinnitus. You’ll notice in Ototoxic Drugs Exposed that it mentions hearing loss as a side effect, not tinnitus.
Regards
Neil
Hi Neil,
I just took the time to read every post and reply on your page here, and before I write anything else I feel the compelling need to thank you for the information and resources you’ve provided on this page here and your paperwork…
It’s by far the most comprehensive page I’ve ever stumbled upon, and so very extensive, unbiased and honest!
I’m 24 and I developed tinnitus about 2 years ago, I believe from a combination of 10-20mg Amitriptyline that I had been taking for about 4 or 5 years, and the addition of Citalopram 20mg a day.
Ironically I had started to feel better… and I was weening myself off them (appropriately and properly) in the hope of little or no withdrawal symptoms.
I have multi-tonal high and low pitched tinnitus, about 5 overlapping tones, some that change day by day as well as a couple of alternating constant tones I can hear all the time…
I also recently was taking Ibuprofen (with paracetamol) for back pain, and then briefly went onto Naproxen for 2 months… These were drugs (as always) that doctors assured me had no link to tinnitus and I suppose were therefore non otoxic.
After reporting my tinnitus, and how it has made me feel A LOT MORE anxious, depressed and occasionally suicidal (to my doctor), I was placed on a low dose of Mirtazapine, 15mg (one a night).
Since on mirtazapine, I’d like to report to you that my tinnitus has worsened,
(I see only one person reported mirtazapine on your page as possibly causing/worsening tinnitus which does sort of give me a slight trust that my doctor knows what she’s talking about),
but its hard to pin point it on Mirtazapine or if its just general deterioration (or the naproxen/ ibuprofen and occasional diazepam and codeine consumption), although i’ve only been on mirtazapine for only about 4 months…
However, I am experiencing serious weight gain now from mirtazapine!! and this is making me feel anxious and worried furthermore!!! I’ve gone from 9.25 stone to 11.5… with about a pound or two gain for every few days now!! I’m a meticulous calorie counter and I exercise in the gym 4 times a week!
So now I’m stuck with the dilemma of going back to my doctor and reporting the weight gain, and worsening of the tinnitus…
I know she would just want me to try another anti depressant next, such an bupropion or trazodone, but to be honest, I’m fed up with all ridiculously toxic substances residing themselves inside my body causing ongoing unnecessary damage to the seratonin pathways in my brain among other things!
I feel as well as if each new type of anti depressant is just damaging my ears and hearing in its own unique way each time I switch, a long with a host of other side affects…!!!! Anyway…
I’m fully aware that tinnitus is non curable, and that mine is permanent and that nerve damage in my ear is indeed apparent and will likely continue to deteriorate…
You reinforce what I’ve already learned from my browsing (etc) over the last couple of years relating to tinnitus, and that is, that it is best dealt with understanding and emotional acceptance, and I agree that although I think (or consider) my tinnitus is indeed more on the severe end of the spectrum (especially at 24 yes please pity me lol),
I do agree that when I’m feeling happier, and I’m out and about keeping busy and not worrying or feeling overly anxious, there are (small) time gaps where I don’t notice the relentless ringing… So I know it can work…intermittently
I went to see an ENT doctor where I saw an audiologist and had a hearing test, i assume it was the basic 8000hz one that you have mentioned. It was VERY hard to differentiate between the tones they played, and the tones I already hear, so I’m sure now that I gave a wrong representation of my true hearing because I was informed I have perfect hearing!
I HAD TO WAIT 3 MONTHS FOR THIS TEST! Anyway, I then saw the doctor who said I had perfect hearing, I explained my tinnitus, and I was told theres nothing they can do and exactly what you’ve said, you know, cheer up mate be happy and you won’t notice it ! GRRRR.. lol anyway they discharged me from the hospital and referred me for CBT.
So I have a few questions for you Doctor Neil 🙂 If you don’t mind, you’ve been amazing at answering EVERY question, so I actually have faith in posting here!
Have you had experience yourself with, or with anyone whom, has had CBT, cognitive behavioural therapy, for treating tinnitus, I know what its all about… I’m not sure if it will help me… Talking about it… Can i learn more than I already do?
Will being around people who POSSIBLY have louder or worser, or even tinnitus that is NOT AS worse as mine, really benefit me??
Won’t i just come away more anxious as to what…COULD or MAY be… or COULD HAVE been?
Not sure if this type of treatment is available or applied over in the states, I know we are a very liberal bunch of fellows over here in the UK, with our overburdened NHS and whatnot… (no offence intended)
And also,
Have you had experience yourself with, or with anyone whom, has had
Acoustic Neuromodulation as a method of treatment?
http://www.thetinnitusclinic.co.uk/tinnitus-treatment/acoustic-neuromodulation/
They claim to be able to help 7 out of 10 people with tinnitus….
Finally,
I suffer from depression as I’ve stated, I’ve heard a couple of mentions of St Johns Wort here, its the first I’ve properly heard it promoted or spoken of here…. Do you think I could completely rid myself forever of these horrible damaging corporate profit-driven toxic substances, and medicate with a wonderful herbal remedy of St Johns Wort and maybe the occasional 5HTP supplement?? I don’t want to appear naive that the mirtazapine isn’t the reason I feel relatively content considering the stuff I’m going through in my personal life…
Thanks again in advance for your reply and you should be very proud of yourself, this page, and your work, should be readily available ad accessable to every person suffering from tinnitus world wide…in my opinion
I hope you appreciate my effort in keeping this post short and simple for you, I assume your obviously a very busy man 😉
Best wishes from us suffering Brits!
Kind Regards,
Joel Patterson
Hi Joel:
The drugs you have been on could certainly have caused your tinnitus.
Amitriptyline does certainly cause tinnitus–“screaming tinnitus” according to some people that have it. The good news is that quite often the tinnitus is temporary while you are on it and eventually goes away when you stop taking this drug.
Citalopram is quite ototoxic and causes permanent tinnitus in many people. I’ve heard from numerous people that now have permanent tinnitus from taking Citalopram.
It’s interesting that some people don’t get tinnitus while on the drug, but get severe tinnitus when they try to stop taking a drug. This seems to be what happened in your case.
Ibuprofen also causes tinnitus in numerous people.
Acetaminophen (Paracetamol) is not listed as causing tinnitus, but it causes hearing loss, and so if that happens you may get tinnitus as a result of the hearing loss.
Naproxen can cause tinnitus in numbers of people. It may be permanent or temporary.
I don’t know why the doctors are so sure the above drugs don’t cause tinnitus when they do.
Mirtazapine can cause tinnitus in some people.
I have another acecdotal report about Mirtazapine and tinnitus.
A lady explained, “I have an acute case of tinnitus, which started during the use of the anti-depressant Remeron (Mirtazapine). This drug was prescribed to me by my GP as I was suffering from light insomnia. After two weeks or so, I realised that something was horribly wrong: my ears starting ringing. I thought it was probably the fatigue and continued taking the Remeron for another week. After that week I stopped as I now felt that the tinnitus was clearly related to the use of Remeron. I used 11 tablets of 15 mg over a period of 3 weeks. When I stopped taking Remeron the problems really began: the ringing became worse, to a point where I can now no longer sleep or function during the day.”
So you are not alone in thinking that Mirtazapine can cause you tinnitus to get worse. Maybe it doesn’t happen to a lot of people but it sure does to some people.
I’d tell you doctor to take you off the Mirtazapine as the side effects are too bad–and if he doesn’t, you can do it yourself.
I’m with you that the drugs are causing you emotional problems too and the way to fix that is not to take other drugs, but to get off the drugs you are on now.
You’ll notice in Peggy’s recent post that even research articles now show that antidepressants don’t work for tinnitus–so why take them?
You are doing the right thing in keeping busy and letting your tinnitus fade into the background for a few minutes or hours. Hopefully, as you continue to do this, the times without your being aware of your tinnitus will increase.
If you are having trouble distinguishing your tinnitus sounds from the pure tones, there is a simple solution. Just ask your audiologist to set the audiometer to one of two different settings–either the double beep sound–beep beep instead of a tone only repeated once. This makes it easier to distinguish the test tone from your tinnitus–you listen for the gap between the two beeps. Even better is to have the audiometer set to the warble tones. It is really easy to tell your tinnitus from the warble tones. I don’t know why audiologists don’t use this as a matter of course for people with tinnitus–but no, they are stuck on using the pure tones (and risking inaccurate results when you can’t tell your tinnitus from them).
Another interesting thing you may have noticed is that when you strain to hear the faint tones, your brain turns up its internal volume and guess what–your tinnitus gets louder too!
I don’t have personal experience with using cognitative behavioural therapy (CBT), but according to the literature, it works for many, but not all, people. It is currently one of the darlings of the tinnitus world.
Typically, when you think/talk about your tinnitus, it gets worse temporarily. But the good that CBT can do should outweigh this temporary inconvenience.
Yes, you need to learn about your tinnitus, but then, you need to put it out of your mind and focus on other things. Every time I help someone with their tinnitus (and it happens pretty much daily) my tinnitus gets worse. (My ears are ringing away much louder right now because I am writing this to you and thinking of tinnitus. The good news is that within 5 minutes of changing the subject, I know my tinnitus will drop to its normal level. One of the occupational hazards of helping people with tinnitus when you have it yourself.)
I’ve heard of neuromodulation for treating tinnitus, but I’ve not seen anyone that has had this done–so I can’t speak from experience. However, it is one of the newer tinnitus treatments, and like you have heard, it works for numbers of people–but not all.
Therefore, it is one of the many “tools” in your tinnitus treatment “toolbox”. You can take it out and try it. If it works for you, great! If not, put it back in the toolbox and try another tool.
St. John’s Wort really does work for depression. I’ve told numerous people about it when they complain about the side effects of their prescription anti-depressants. And the results are as good as or better than prescription drugs according to many studies. It works for my wife. The good news is that it is not habit-forming, nor is it ototoxic. And it has almost no other side effects.
I wish you well and getting off the drugs and getting your tinnitus under control at the same time. It can be done. It just take the will to do it and a bit of time. It won’t happen overnight!
Regards
Neil
Interesting thread. Dr.Neil,..you are so patient and kind to respond to all the many questions. I work in a medical office and came a cross a supplement to journal otolaryngology head and neck publication. The supplement was a guide for ENTs in treating pnts. with primary tinnitus (secondary would be as a result of a medical condition). You better believe I read that cover to cover. While much of it I did not understand since it is geared to the physician, it gave their recommendations of yay or nay. Treating with antidepressants (something my ENT recommended) is not recommended. The benefits do not outway the harm. I believe the article is now posted on the web for anyone interested, American Academy of Oto etc head and neck. I’m still trying to find info regarding AIED (which I have) and whether treating it with MTX will minimize the tinnitus. I’m in the mild hearing loss, two bouts of vertigo in 6 mo and MAJOR fluctuating tinnitus. On week two of the MTX at 10 mg. per wk. Good or Bad? All I can find in research doesn’t give it much support. However can’t let go of the fact that I have an autoimmune thing attacking my ear. Seems foolish to not address it.
Hi Peggy:
If you can find that article online, please send me the URL as I’d like to read it. Interesting it comes to the same conclusions I’ve had that antidepressants don’t work for tinnitus as such. My thinking is that antidepressants and other psychotropic drugs just make you into a zombie–you don’t care about anything including your tinnitus, but it doesn’t make your tinnitus better. And if you go off the drugs, there is your tinnitus!
Methotrexate (MTX) for tinnitus and Meniere’s disease (don’t know about it for AIED) seems to sit on the fence and fall off one side or the other. Thus it helps some people and hurts others. For example one lady that takes 15 mg of Methotrexate weekly reported that on the days she takes Methotrexate her tinnitus becomes almost unbearable.
In one study using Methotrexate for treating Meniere’s, here’s what happened with tinnitus. “Tinnitus went away in 6%, was reduced in 59%, remained unchanged in 29% and got worse in 6%.” As I said, it is a mixed bag. Thus, if it helps you, go for it. If it doesn’t, dump it before it does further damage.
Regards
Neil
Thank you very much for your immediate response 🙂
Your response has been very helpful as always!!
Kind Regards,
Joel
http://www.entnet.org/specialty-area/general-otolaryngology
here’s the link to the clinician practice guideline for tinnitus. Its’ published by the American Academy of otolaryngology/head and neck surgery. the hard copy I came across is the supplement to the October issue, volume 151, supplement 2, Oct. 2014. Thank you Dr. Neil,….you have no idea how much your quick reply and information helps so many. God bless you.
Hi Peggy:
That URL you gave was a general URL. The specific URL for this article–which I found after snooping around a bit–is http://www.entnet.org/content/clinical-practice-guideline-tinnitus then under “Physician Resources” click on “Published Guideline” and that gives you the 41 page guideline in pdf format.
Thanks
Neil
Dr. Neil
I’ve got tinnitus in my left ear and I have habituated to it. The sound is a combination of tones. And the louder tone wins sometime and then it decreases, maybe alternating 4 to 5 day intervals. I’ve been taking N-Acetyl Cysteine which I believe has diminished the Tinnitus I’ve had for a year. My problem now is that I have hip revision surgery next week, and from what you’ve said in earlier posts is that toughing it out is basically the only option other than taking a few pain pills. From looking at your list of Ototoxic drugs I’m am extremely fearful of taking any pain meds for fear my Tinnitus will become screaming. Is there not one pain medication I can take that won’t affect my Tinnitus? The first and second hip surgeries were extremely painful and I took the Hyrocodone with no problems however, that was before my Tinnitus. Can you offer me a safe option other than toughing it out?
Thanks
Maximus
Hi Maximus:
The narcotic drugs such as Hydrocodone do not commonly cause tinnitus. Since you have taken it before with problems, it is a good bet this time. The problems with such drugs arise when you take them for too long. So take the least dose that does the job for the shortest time you need it and most likely you won’t have any problems with your tinnitus.
Regards
Neil
Thanks for your input…..I’m undergoing PT and a bone scan before my hip surgery. Hydrocodone is listed as Ototoxic but you said it is a narcotic and doesnt commonly cause Tinnitus. Isn’t Hydrocodone Codeine and Ibuprofen?
Thank you sir,
Maximus
Hi Maximus:
Hydrocodone is Hydrocodone. It’s the various brands that have hydrocodone and other drugs in them. For example, Vicodin is a combination of hydrocodone and acetaminophen. Percocet is a combination of Oxycodone and acetaminophen, whereas Percodan is a combination of oxycodone and aspirin.
Cordially,
Neil
Hydromorphone
Dr.Neil,
It is nice to see your exert advice to various tinnitus sufferers. I have sudden sensorial hearing loss and tinnitus for past two years. This started all of a sudden when I went for evening walk in chill weather on 6th Jan’13
and entered in the house and while taking butter milk, ear got blocked along with the
sensation of blocked throat, though no cold was there; also there was a loud noise
ringing in head from left ear.
There was no clarity of hearing and feeling of fullness in ear and throat.
There is no pain in the ear or vertigo.
Consulted ENT doctor immediately on 7th Jan, audiometry test was done.
Doctor told that inner ear got infected and gave medicines –steroid (Prednet-
8mg), antibiotics(Mecovan) and vitamin (Duvadilan); also prescribed Nelusium tablets.
Taken the above tablets for a month- 3 times for first 10 days, 2 times next 10 days and 1 time in last 10 days and completed the course – with that, there was little improvement in hearing, but loud ringing noise was stopped
On 15th Feb 2013, after head bath, air dryer was used without covering the ear and
this triggered the ringing sound again to increased level. From then, tinnitus continues. MRI, all other tests were done and concluded that hearing loss due to partial damage of auditory nerve cells-taking nutrition tablets (Neuromet and Absolut 3G)and practicing yoga for past one year. Feeling slight improvement of hearing clarity in one year.Also started consulting homeopathy treatments recently. Please advice.
Shyamal from India
I am using a signal generator to simulate a diverse range of frequencies and frequency spectra
Is the use of this facility likely to intensify the effects of tinnitus.
I was prescribed antibiotics for 4 weeks to clear a cyst on my next that may have provoked the tinnitus
I understand the drug AM-101 should soon become available
Regards
Douglas Liddle
Hi Douglas:
I don’t think hearing various tones at various frequencies will bother your tinnitus unless you have the volume too loud.
Regards
Neil
Can you stand one more question from me 🙂 In May of 2014 i came down with pnemonia was given a 5 day course of antibiotics azithromyacin. 250mg. The label did say possible ear ringing Thankfully that did not happen. My ridiculous bad onset of new tinnitus occured in July in left ear and in Sept increased to right ear. Any correlation? CAn a delayed effect occur. Also given a antibiotic injection Ro something or other (also in May )
Hi Peggy:
Azithromycin can and does cause hearing loss and tinnitus in some people. It’s hard to tell whether your tinnitus is a delayed reaction from taking the Azithromycin or not. However hearing loss from taking Azithromycin can occur anywhere from the next day up to 20 weeks later, so I see no reason why tinnitus couldn’t do the same–especially if your tinnitus was associated with a hearing loss from taking this drug.
So there may be a correlation, or it may be from entirely different causes.
Cordially,
Neil
Thanks, I do have AIED as well. I take it any hearing loss from azithromyacin or tinnitus is notreversable. Reason I’m asking is if it was the antibiotic, then going on the MTX to treat the AIED and the possible reduction of tinnitus is worthless. I should can it then with the MTX. to make matters worse now I have a-fib and you know another med is in the future. Bummed.
I am new to this site and have not read through all of the comments, but I am really tired of the ringing and wondered if there was a strategy to follow to see if anything works. First things first, I was diagnosed with esophageal cancer in 2003, went through surgery and then in may 2004 went through chemo therapy and radiation. In my research it seemed some patients experienced side affects that varied with some saying they ended up with a ringing in their ears. I do not remember all of the cocktail that I received but I remember the most aggressive one that took my hair and made me the most sick, Carboplatin.
I survived, excellent! but I deal with this and a few other side affects. I am now on the once a day Prilosec otc.
I am looking for a strategy to at least reduce the noise.
Thanks,
yo tomo los siguientes medicamentos:
cinarizina 75mg
irbersartan 150mg
gemfibrozilo 600mg
metformina/glibenclamida 500/5mg
hidroclorotiazida 25mg
alprazolam 5mg
alguno de estos medicamentos me produce el tinnitus
gracias
What about a list of antibiotics that are NOT ototoxic? Is there such a list of medications that are not ototoxic?
Good Day,
I have taken Accupril 20 mg for 14 years for borderline high blood pressure.
I had 2 dizzy spells, blurred vision and the sound of blood rushing next to my right ear in 2013. And then ringing in my ears started. The tinnitus loudness varies daily.
I was diagnosed with high frequency hearing loss.
Could Accupril have caused this? I doubt after 14 years that I can stop this drug.
Thank you.
HELP
Have been experiencing loud high pitched tinnitus for two months now after cold turkey withdrawal from klonipin. at my wits end. I found some random info online. Any one care to chime in?
dr. Jasterboff
white noise
gradual tapering with valium
trt
vagus nerve stimulator
neoromonics
melaton
Dr. c. heather ashton
tegretol
paxil
zoloft
sulpuride+melatonin
Hello Dr. Neil,
Eight months ago I was put on amlodipine for high blood pressure and got tinnitus in my left ear. I was too scared to take another blood pressure pill so I didn’t. I recently went to see my doctor and he put me on diovan which cause me to have tinnitus in my right ear. I have since stop all medication and I dont know what to do??? Is there a blood pressure pill out there that will not give or increase my tinnitus. Please help me as I really dont know what to do – do I take a chance with my heart or try living with a devastating sound in my ears… I feel so sad.
Dr. Neil,
I compiled a list of antibiotics and anti-anxiety drugs that from your emails are non-ototoxic, however, some are on your list as ototoxic. would you reply to the following as agreeing of their non-toxicity. For non-ototoxic antibiotics: Trimethoprim, Septra, Sulfamethoxazole, Amoxicillin, and Cefadroxil, For non-ototoxic anti-anxiety meds: Sotalol, Versed, Clonazepam, and Levobunolol. Also, would you comment as to why N-Acetyl Cysteine seems to make Tinnitus less bothersome?
Thank You,
Maximus Proximo
Hi Maximus:
None of these antibiotics are non-ototoxic. However they are among the least ototoxic antibiotics out there.
For example, if you asked me if they caused hearing loss and I said no, that just means they are not known to cause hearing loss, but they may cause other ototoxic side effects such as balance problems. Thus you have to be careful whether you ask whether a drug is completely none-ototoxic, or just not ototoxic as related to certain side effects.
Now to look at your list. Trimethoprim can cause tinnitus, ataxia, dizziness and vertigo in some people. I classify it as a Class 1 drug–very mildly ototoxic.
Septra is a combination of Trimethoprim and Sulfamethoxazole so will have the ototoxic side effects of both of these drugs.
Sulfamethoxazole can cause tinnitus, ataxia, dizziness and vertigo in more people than Trimethoprim. Thus I classify it as a Class 2 drug–a bit more ototoxic than a class 1 drug.
I used to list Amoxicillin as not ototoxic, but I have since found that it is also ototoxic which the next edition of my drug book will reflect. It can cause hearing loss, tinnitus, dizziness and vertigo. I classify it as a Class 2 drug.
Cefadroxil is only slightly ototoxic and can cause dizziness and vertigo in some people. I classify it as a Class 1 drug.
Sotalol can also cause dizziness and vertigo in some people. I classify it as a Class 1 drug.
Versed (a brand name for the drug Midazolam) I consider a Class 2 drug as it can cause tinnitus, ataxia, dizziness, loss of balance, nystagmus, vertigo and a feeling of your ear being blocked.
Clonazepam is also a Class 2 drug in my opinion as it is listed as causing ataxia, dizziness, nystagmus, vertigo, ear pain and middle ear infections.
Levobunolol is only very mildly ototoxic (a Class 1 drug), listed as causing ataxia and dizziness in some people.
A truly non-ototoxic drug would we classified as a Class 0 drug. At the other end of the scale, a very ototoxic drug would be classified as a Class 5 drug.
So you can see that although none of these drugs are not ototoxic, they are just mildly ototoxic.
N-Acetyl-Cysteine is a major component of the body’s most powerful anti-oxidant–Glutathione. Glutathione reduces “oxidative stress” caused by free radicals in your inner ear. This seems to lessen new tinnitus in some people, but I don’t think it affects longstanding tinnitus much if at all.
Cordially,
Neil
Good afternoon Fromm Spain:
I’m 44 years old.Two months and half ago I started taking citalopram (I was prescribed for some pannic attacks I had), and I developed tinnitus the fourth day after I started taking it. Till now. I told my doctor, but he said it was very strange and it was caused by my anxiety. Some time after, I went to another psychiatrist and started the dicontinuation of this drug. I’ve been taking it for one month and nine days, and 24 days for discontinuation. My tinnitus is sometimes slight, others moderate, but I can sleep well at night with melatonine. I also practise Mindfullness meditation and it really helps. My question is… Is citalopram ototoxic or tinnitus can be considered as a rare side effect of it, less tan 1 in 1.000 people? I have heard and read many different versions of the story and doctors usually say they don’t really know. I have no hearing loss. A week has passed since I left citalopram and I have to say I have noticed tinnitus lower tan before for some days. Could you tell me if there is any possibility that it could go away?
I read about the clinical case of a woman with depression who took citalopram for three months, developed tinnitus and it went away two weeks after its discontinuation (I read it on a medical magazine). Thanks a lot.
Hi Jose:
Your doctor is ignorant. I’ve heard from numerous people who have gotten tinnitus when they began taking Citalopram. It is definitely not a rare occurrence in my opinion!
Citalopram is definitely ototoxic. I classify it as a class 3 (out of 5) drug as far as ototoxicity goes. Besides causing tinnitus, it can cause ataxia, dizziness, vertigo and ear pain. But it is the tinnitus that seems to bother most people that contact me.
There is always the possibility that your tinnitus will go away. It is good news that your tinnitus drops at times. So it may continue to do so. But I don’t think this is common. Of the many people that have contacted me about their tinnitus from taking Citalopram, all of them seem to now have permanent tinnitus, some from only taking 1 pill.
Your tinnitus may prove to be the exception.
Cordially,
Neil
Well, I hope so!
I’m looking for the article to show you the case of that woman I told you about before. As son as I find iy¡t, I’ll show you the link here.
Thank you, though I feel worse now for your answer.
Hello again.
This is the case I wanted to show you. So there is hope…always.
http://omicsonline.com/open-access/tinnitus_following_antidepressant_use_in_a_female_with_depression_175.php?aid=32433
I would like to say all the people affected by tinnitus that the healing power of positive thoughts is still a mystery and a powerful tool to change our mind. As Virginia Woolf said:
“Lock up the libraries if you like, but there is no gate, no lock, no bolt that you can set upon the freedom of my mind”
Another good example of hope…melatonine for those affected by ototoxicity
http://www.ncbi.nlm.nih.gov/pubmed/21673362
Dr. Neil, thank you for your response about ototoxics on your list. I have another question or 2 :>). Are there Class 0 ototoxics? Are there ototoxic vitamins or supplements? I saw where Turmeric was an ototoxic but it was a very powerful anti-oxident. I took a tablespoon of liquid minerals and within 10 minutes my tinnitus increased, but it finally returned to it’s normal level.
Thank You,
Maximus Proximo
Hi Maximus:
Class 0 drugs would be drugs that are not ototoxic in the least. I don’t list such drugs for two reasons. First, my drug book is only about drugs that ARE ototoxic. Second, drugs that are thought to be non-ototoxic now may later be found to be ototoxic. Cases in point include drugs such as Erythromycin, Vicodin, Amoxicillin and Acetaminophen.
There are some artificial vitamins that can be ototoxic when taken in large doses. I’ve not seen such figures for natural supplements. Some herbals are ototoxic, but again you’d have to use them in large quantities.
Tumeric (a component of curry powder) can be ototoxic to people with extreme salicylate sensitivity, but the amount you’d have to consume to reach the level where a normal person would experience ototoxicity would be FAR, FAR more than anyone could consume at one time. For example, if you wanted to get tinnitus, hearing loss, etc. from eating curry powder, you’d have to choke down almost 4 pounds of pure curry powder in order to get enough salycilates to cause ototoxic side effects. Now one is going to do that–so in normal doses, curry powder and tumeric are not ototoxic unless you have an extreme case of salicylate sensitivity, and even then, its not guaranteed you’d experience ototoxic side effects.
As far as minerals are concerned, the heavy metals can give you ototoxic side effects. To try and figure out which mineral was causing your increased tinnitus, you’d have to send me the label so I can see all the contents and the amount of each in a normal dose. The manufacturer’s website may also have this information. If you send me the UIRL to it, I can take a look and tell you what I think.
Cordially,
Neil
Dr. Neil
Thanks for your input, it cleared alot of things I was concerned about. The liquid minerals I took were discontinued as soon as my Tinnitus went up a few notches, so I’m not worried about them. Whenever I need antibiotics I always state that I need non-ototoxic ones and the Dr’s always comply, however, their list probably isn’t as extensive as yours. So I leave it in the Dr’s hands and pray to God that my Tinnitus in my left ear doesnt increase or mess up my other ear. One last question for you, just how high-pitched can Tinnitus get? Is there a limit? Or does the brain have a threshold?
Thanks so much,
Maximus Proximo
Hi Maximus:
I think your tinnitus can be as high as the highest sound human ears can hear–which is considered to be somewhere between 18,000 and 20,000 Hz. It will definitely not be higher than your ears have ever heard, but can be much lower.
Cordially,
Neil
Dr Neil,
Is pregabalin ototoxic?
Hi Ma Jose:
Yes, in my opinion it is very ototoxic. Hundreds of people have reported hearing loss and tinnitus and thousands of people have reported balance issues. This is definitely one drug I’d never want to take.
Cordially,
Neil
Thank you Dr. Neil for your reply, I’ve learned alot from you!
Maximus Proximo
Hello: How about Lisinopril & Terbinafine? thanks!
Hi Maria:
Lisinopril can result in a host of ototoxic side effects including hearing loss, tinnitus, ataxia, dizziness and vertigo for the main ototoxic side effects.
Terbinafine is not as bad but can still result in hearing loss, tinnitus and dizziness as the main ototoxic side effects.
Cordially,
Neil
Dr Neil,
I have been diagnosed as having mild depression and anxiety, and I suffer from tinnitus as well (due to citalopram, that I no longer have). I’m having rivotril 0,5 at night. I would like to know if Saint John’s Wort would be suitable for me, but I am not sure if I can take it togeter with rivotril (clonazepam). My psychiatrist thinks mirtazapine would be a good option for my sleep and state of mind but I’m afraid of having drugs that can affect my tinnitus or trigger it. I would like to reduce the dose of clonazepam I’m having slowly until I can substitute it by other alternatives. What do you suggest?
Thank you.
Hi Ma Jose:
I’ve had more reports of people getting tinnitus from taking Citalopram than for any other drug. So I definitely don’t recommend anyone take Citalopram (if they want to avoid tinnitus).
Clonazepam (Klonopin, Rivotril) can also cause tinnitus–although it is not as common as in people taking Citalopram. However, both are Benzodiazepines and have the risk of dependence forming and the horrible time getting off them without causing even worse side effects. In my opinion, no Benzos should be taken for longer than 2 weeks (if that). They are stop-gap medications–NOT for long term use.
If you’ve only been on the Rivotril for a short time, then you can probably stop taking it with a very brief taper and at the same time, taper up on St. John’s Wort. Remember that St. John’s Wort is for DEPRESSION, NOT ANXIETY.
Mirtazapine (Remeron) is a tetracyclic anti-depressant. You can get tinnitus from it too. Here is one lady’s story.
She explained, “I have an acute case of tinnitus, which started during the use of the anti-depressant Remeron (Mirtazapine). This drug was prescribed to me by my GP as I was suffering from light insomnia.
After two weeks or so, I realized that something was horribly wrong: my ears starting ringing. I thought it was probably the fatigue and continued taking the Remeron for another week. After that week I stopped as I now felt that the tinnitus was clearly related to the use of Remeron. I used 11 tablets of 15 mg over a period of 3 weeks.
When I stopped taking Remeron the problems really began: the ringing became worse, to a point where I can now no longer sleep or function during the day.”
As you can see, this is NOT a reaction you want either. If you need something to calm you down (reduce your anxiety) so you can sleep, then a good choice would be the herbal Valerian rather than St. John’s Wort. Neither of these are ototoxic.
Cordially,
Neil
Hello again Dr Neil,
I also want you to know I had anorexia for six years when I was 16 (until 21). I totally recovered from it but I did not have any drugs in that process. Then, at the age of 37, unfortunately I had a depression after my son’s birth mainly because it was a very traumatic experience for me (I was about to die). After that, I’ve had some problems with my anxiety in certain moments but I’ve always overcome them I felt well for a long time in my life. Now, the tinnitus I have been suffering for three months has affected my life dramatically, since I am a very sensitive person. According to my psychiatrist, I have a lack of serotonin in my brain but I think there may be alternative s to drugs, especially because of my condition of tinnitus sufferer. I’m giving you this information because I think your advice is important for me since, up to know, no doctor I have spoken to, has been able to tell me that citalopram caused my tinnitus, they always say that my anxiety was the main cause, something I don’t agree with.
Thank you very much.
Hi Ma Jose:
Any doctor that doesn’t know that Citalopram can cause tinnitus is ignorant and shouldn’t be prescribing drugs!
As for lacking serotonin in your brain, that may or may not be true. Did you know that you have more serotonin in your gut than in your brain?
Here is a quote from Dr. Mercola, “It’s important to realize that you have neurons both in your brain and your gut — including neurons that produce neurotransmitters like serotonin. In fact, the greatest concentration of serotonin, which is involved in mood control, depression and aggression, is found in your intestines, not your brain! Perhaps this is one reason why antidepressants, which raise serotonin levels in your brain, are often ineffective in treating depression, whereas proper dietary changes often help…”
Instead of taking drugs, you might find it far more profitable to your health to get your gut healthy. I suggest you read this article that explains how much of your mood (including depression and anxiety) comes from your gut, NOT your brain. Here is the link http://articles.mercola.com/sites/articles/archive/2013/06/20/gut-brain-connection.aspx
Cordially,
Neil
Dr. Neil,
It appears as if the illegal drug, MDMA, chemically stops the tinnitus. I checked the American tinnitus association and they appear to know this, but do not appear to be in a position to act upon the information. Are you aware of this? Do you know of any drug that acts on the tinnitus like MDMA, without the actual high that comes with that drug. Any information on this MDMA cure would be appreciated. Thanks Dr. Neil.
Hi Lauren:
No, I hadn’t been aware of MDMA and tinnitus so I did a bit of research on it. I’m not a fan of psychotropic drugs. The problem with most drugs is that they may work (to some degree) on your tinnitus (or whatever condition you are treating), but at the same time, they work on many other areas of your brain and body. Those are the unwanted side effects. There are many of these side effects. Most drugs have well over 100 different side effects and some of these side effects are worse than the condition for which you take them. Thus you are really playing with fire. You hope they will work for your tinnitus (or other condition) and just as fervently hope you will not get any nasty side effects, but there are no guarantees they will help your tinnitus, and there is no way to know which sides effects you will get instead.
Personally, I don’t think this is a good avenue to go.
Cordially,
Neil
Where can I find more information on the possibility of humira (adalimumab) causing or worsening tinnitus? My GI doctor wants to increase the dose and I am suspicious since tinnitus that I experience seems to have worsened about the time I started humira injections. The pharmacist found no mention of tinnitus as a potential side-effect of humira injections.
Hi Christine:
I had two sources that mentioned that Adalimumab can cause tinnitus as well as other ear problems. Unfortunately, the two links I had no longer work for some reason.
However, people have contacted me with their stories on tinnitus and Adalimumab. Here are three of them from my book, Ototoxic Drugs Exposed.
“A man who was put on Adalimumab 40 mg. shots every two weeks reported that his tinnitus was bad during this time, but he attributed it to stress. Recently, he had an injection after not having had one for about a month. He explains, “Coincidently, my tinnitus was getting better during that period. A few hours after the shot my tinnitus acted up again, and has been very loud 24/7.”
A man reported, “I started taking Humira 40 mg. Approximately 4 weeks after the first shot, I started having severe vertigo and dizziness along with tinnitus. My balance has been an issue ever since. After taking Adalimumab injections for 17 months I decided to stop taking the injections. Since stopping the injections, my symptoms have gradually subsided, although I am not completely free of them”.
A lady explained, “I have always had tinnitus since I was a baby but it’s much much louder now since I took my first two shots of Humira (yesterday). I can’t believe how loud it is now.”
So you are not alone. Your experience closely parallels these people’s experience, no matter what the doctorse say or don’t say.
Cordially,
Neil
Dr Neil,
I’m afraid you didn’t answer my questions in 293, 294.
I’m very interested in your answer. Thank you very much.
Dr. Neil, Thank you very much for your quick response about humira.
Dr. Neil,
Thank you for this blog, it is so helpful. Three weeks ago I woke up with ringing in my ears. I have had hearing loss in my right ear for 30 years, but never had ringing until recently. A week later, I had a balance issue were it was severe for a week, and has gradually gotten better but not 100%. It’s not vertigo but just lightheaded constantly. My ENT found nothing wrong in the MRI, my hearing nerves are ok. He suggested I see a neurologist to dig deeper into the issue, which I will in about a week. He says my ears are fine, but I still have this lightheaded issue. No trauma to the head, nothing out of the ordinary. I was taking predisone for 5 days for the ringing, before I started feeling lightheaded, and I stopped taking it (or I took a lower dose) the next day and then stopped it completely. Any thoughts?
Hi Carrie:
When you say “light headed” could you also describe it as “dizziness”? Prednisone is known to cause dizziness in a lot of people. Hundreds have reported dizziness to the FDA as a side effect. So possibly that is what has happened to you.
Cordially,
Neil
I did not see Stevia (a natural sweetener) on your list. My tinnitus keeps increasing. Stevia is something I use regularly.
Hi Rocky:
Stevia is a good natural sweetener. My wife uses it all the time. I’ve never heard of it causing tinnitus, or making existing tinnitus worse, hence it is not on the list. Are you sure that your increasing tinnitus is not caused by something else?
Cordially,
Neil
Dr Neil,
The “lightheadedness” can be a little dizzy-like, but it’s more of a feeling that you get going up or down in an elevator, or like being on a boat. Like I said, I felt this way really bad for a week and then it tapered off, but still not completely gone. How long does it typically take to feel better when a drug causes this sort of side effect?
Thank you very much.
The thing is that there is still much controversy among doctors about the fact that ototoxicity of some drugs, especially antidepressants it’s not an ear consideration but a brain one.
I think, tinnitus is still a mystery for science and what it’s true is that there aren’t two tinnitus patients who are the same.
Thanks a lot, doctor.
Good morning, Doctor!
Have a bad chest cold and am considering using a homeopathic medicine (Boron’s”Chestal”) and I am wondering if you know if any of the ingredients could affect my tinnitus. The ingredients are antimonium tataricum, bryonia, coccus cacti, drosera, ipecacuanha, rumen cusps, and a few others. I realize these may be a bit esoteric, but would welcome any insights you may have about their possible ototoxicity.
Many thanks,
Denis
Hi Denis:
As far as I know, homeopathic remedies are not ototoxic, and especially since they are so dilute. I have never heard of anyone having ototoxic side effects from taking any of them–even those that have ototoxic ingredients. There is a possibility that a person may experience worse tinnitus if a “healing crisis” occurs, but should go away as the healing crisis passes. Of the ingredients you listed, I don’t recognize any of them as being ototoxic.
Cordially,
Neil
Dr Neil
Could you please tell me how ototoxic is Trimipramine. I have taken this for about four years (50mg a day). I have had tinnitus for some time and it hasn’t bothered me just sometimes noticed it was there. However, recently (three months) I have noticed that it is getting worse. This began when I had a very bad period of anxiousness, insomnia and depression. Does this mean it’s permanent? I am about to slowly withdraw from the drug and having read some of your comments, I’m going to try St John’s Wort and/or Valerian. I would very much appreciate your comments.
Kind regards Cynthia
Hi Cynthia:
Trimipramine is slightly ototoxic. I rate it as a class 1 drug–the lowest level of ototoxicity. Even so, it is reported to cause tinnitus in some people. Your period of anxiety and depression could well have made your tinnitus worse–I’m almost certain it did.
Tapering down on the Trimipramine is what I would do if I were one it and switch to the herbals.
St. John’s Wort is for depression. Valerian is for calming yourself down so it should help with your anxiety and insomnia.
Cordially,
Neil
Hi Again Dr. Neil,
I’ve read through all the comments and can’t remember if this came up. I’ve habituated to my Tinnitus but occasionally hear different tones and have a fullness in my ears, however, these go away but nevertheless they bring about anxiety. My question is this…I naturally have anxiety, I’m handicapped with several physical issues. It’s like God is consistantly bringing about limitations to my body. I have tried Valerian, Lemon Balm, Passion Flower, Rhodiola, Kava, and Holy Basil. None of them has an affect that I need, they all fall short of relaxing me although at first Kava helped some but not anymore. What do you know about Phenibut ( beta-phenyl-gamma-aminobutyric acid ) It is a derivative of GABA and is a gamma receptor agonist. It is supposed to relax you almost like Xanax but isn’t a prescription drug, it can be found at nutrician stores. I’m thinking about getting some but wanted to check with you first to see if is Ototoxic. I believe you take it for anxiety and insomnia, mainly as needed but take 2 weeks then off 2 weeks….Can you tell me what you know about it?
Thank You,
Maximus Proximo
I have noticed a increase in my tinitus after taking Keflex 500 mg 4x per day for two weeks. I took it for a infection in my toe. I asked for a antibiotic that was safe for my hearing. I have hearing loss do to noise trauma. This increased volume has been notable for about a week. Any chance the volume will go back down?
Thanks
Hello Doctor Neil:
What can you tell me about polysporin? A dermatologist suggested I could use it on an area where he removed a precancerous growth that was on my ear. I don’t know much about its side effects and want to hold off using it until I know more. Likewise with neosporin.
Thanks and regards,
Denis
Hi Again Dr. Neil,
I just went to my Urologist yesterday and he said I have Prostatitus. He said I needed to go on a months worth of antibiotics. I told him it may make my Tinnitus worse or get Tinnitus in my other ear, and I told him after he gave me a list that I would look at your list of Ototoxic drugs then let him know which one I’ll take. He said the Prostate is really stubborn to antibiotics. Anyway, I went home and checked your list on these drugs, Cipro, levaquin, Doxycycline, Bactrim ( Trimethoprim ). I called him back and told him I couldnt take any of them due to their Ototoxicity and he said that no supplements would help. He told me not to let my life be ruled and controlled by Tinnitus. I saw his point but think I’ll suffer with Prostatius rather than having a screaming noise in my ears. Was I too hasty?
Thanks
Maximus
Hello Dr. Neill,
For years I took Advil and Tylenol for headaches and severe foot pain. I now have not only tinnitus but a moderate hearing loss. For years I have tried to find out why I was losing my hearing but no doctor seemed to know why. They always said it must be genetic, but I am the only one in my family that seems to have it. I am now fully convinced that the Tylenol and Advil caused my hearing loss (the tinnitus at this point is just an annoyance, hopefully it won’t get worse). I recently had a very acute infection from a tick bite and after that my hearing was worse (I don’t know if that contributed to the hearing loss or not). If I never take Advil, Tylenol or any other medicine again can I hope that my hearing loss will stop and my tinnitus not get worse? Or will the effects of the toxicity keep causing damage? I have never been around loud noises and since only recently finding out about the toxicity of both Tylenol and Advil have stopped taking anything at all for anything! I am terrified that my hearing will continue to get worse and am praying that if I NEVER touch any medications ever again that my hearing will not get worse. I know it can never improve. But if it doesn’t get worse at this point I will consider that a win situation. I am sick over the fact I have done this to myself. But of course if I had known I was doing it I wouldn’t have done it. But, I don’t consider ignorance an excuse. It was too easy to listen to the doctors.
Thank you,
Good evening, doctor,
I suffer from tinnitus in both ears since November 2014. Now I have vaginal candidiasis and I should use vaginal ovuli of clotrimazole for 6 days. I don’t know if this medicine can affect my tinnitus or worsen it.
Thank you very much.
Hi Ma Jose:
As far as I know, Clotrimazole is not ototoxic so it should not affect your tinnitus.
Cordially,
Neil
Thank you very much for your answer. Finally I was finally prescribed fenticonazole nitrate. I guess it is not ototoxic either….
Hi Ma Jose:
It would appear that Lenticonazole is not ototoxic–but I can’t find much information on this drug so I can’t say for sure.
Cordially,
Neil
I was recently given Zorvolex for neck muscle pain….Took samples of 18 mg for 6 days and started 36 mg packet for three days and have had the ringing in my ears of 3 wks….Is this going to be permanent…..it is making me soooo depressed. I have been on Norvasc, Cozaar and Ativan for sleep for years and never had these side effects…….Please help………
Hi Rosemarie:
Diclofenac (Zorvolex) belongs to a class of drugs called the Acetic Acids. They are a class of non-steroidal anti-inflammatory drugs (NSAIDs). These drugs are all ototoxic to some degree. Diclofenac can cause tinnitus and hearing loss as well as a number of balance problems.
Fortunately, the hearing loss tends to be temporary. I don’t have information as to whether tinnitus also tends to be temporary but I would tend to think so. However, when you fixate on your tinnitus and worry about it as you are doing (its causing you to be depressed), the tinnitus can take on a life of its own. Therefore, you need to learn to ignore your tinnitus and focus on other things. When you do this, your tinnitus will tend to fade into the background and if you are lucky, go away completely.
Cordially,
Neil
I just bought your book from Amazon. I lost low frequency hearing in one ear 3/14, and lost mid frequency hearing in the same ear 10/27/15. I have tinnitus in this ear – worse since the recent loss. I’ve been on Lisinopril HCTZ for 3-4 years. Reading that it can cause hearing loss, dr switched me to Benazepril HCL. I see that might not be good either. Any suggestions?
Hi Kathleen:
Lisinopril can indeed cause hearing loss. Some 51 cases have been reported to the FDA (and lots more are unreported). In addition 38 cases of tinnitus were reported to the FDA. The figures from the PDR indicate 0.3 to 1% of the people taking Lisinopril get tinnitus.
One of the reasons they think that hearing loss occurs is, “Taking Lisinopril can reduce blood potassium levels. Since the inner ear is highly sensitive to potassium levels, low potassium can result in hearing loss. Bringing potassium levels back to normal can alleviate the hearing loss.”
Benazepril is another drug in the same class of Angiotensin-Converting Enzyme (ACE) Inbibitors as Lisinopril so it has similar properties. The difference is that hearing loss is not reported for Benazepril, but it still has tinnitus as a side effect, but so far only 6 cases have been reported to the FDA although the PDR lists the percentage occurrence as 0.3 – 1%.
Since tinnitus very often is associated with hearing loss, any drug that causes hearing loss, typically also results in tinnitus. However the reverse is not true. Tinnitus does not result in hearing loss.
In any case, since you are now on Benazepril, and since drugs in the same class typically have similar properties, I’d suggest you make sure your potassium levels stay up so as not to cause further hearing loss.
Benazepril is one of the least ototoxic drugs in the ACE inhibitor class, so it is a better choice than Lisinopril in respect to your ears.
Cordially,
Neil
Thanks for your response. I’ve been reading your book, and it looks like Trandolapril might be the best choice for a Ace inhibitor. Your book has it as tinnitus less than .03%, and “class1”. Would you suggest it rather than Benazepril HCL? I’m currently not taking any BP meds – just monitoring my BP .
Will warfarin or aspirin150 mg cause tinnitus.
And will it reduce or disappear after stopping
Hi Suhas:
Warfarin is not listed as being ototoxic. I have no records of it causing tinnitus.
Aspirin 150 mg–assuming you are only taking that much a day probably won’t cause tinnitus unless you have an Aspirin sensitivity. And even if it did cause tinnitus, when you stop taking Aspirin, it almost always goes away. Typically you’d have to take 5 or 6 adult aspirin a day to cause tinnitus but this can vary between people so there are no guarantees.
Cordially,
Neil
Hello Neil,
I was taking Doxycycline for 2 weeks at high dosage of 200mg/day , all went well with no increase in my tinnitus.
Now I am taking Sporanox ( Itraconazole) and Daktacort to treat a yeast infection.
After taking 3 pills of Sporanox and applying the creme 4 times my tinnitus is significantly louder and more bothersome.
Is Sporanox ototoxic and will my tinnitus go back down to it’s base level after I stop the drug ?
Thanks.
Hi Bart:
Both Doxycycline and Itraconazole can cause tinnitus–but neither of these seem to be particularly high risk for tinnitus. This just means that many people do not get tinnitus from taking them, but some unfortunately do.
So it is possible that the Itraconazole is the culprit, or possibly because you took it in combination with the others. It’s hard to tell.
If it is the Itraconazole, it may be that your tinnitus will go back to its old level after you stop this drug. I don’t have much concrete information to go on, but it looks like it might.
Cordially,
Neil
Dear Dr Bauman,
My docotr wants me on moxifloxacin now for 10 days.
Is this drug ototoxic?
I see it in the list but I can not find any substantial reports or any reports for that matter that it indeed causes tinnitus or can worsen existing tinnitus.
What are your tought on this particular antibiotic and the duration of 10 days ?
Thanks,
Bart
Hi Bart:
Yes, Moxifloxacin is quite ototoxic, besides being harmful to the rest of your body as are all the Fluoroquinolone antibiotics. If it were me, I’d refuse to take any Fluoroquinolone drugs UNLESS that is the only class of drugs that will work.
In regards to tinnitus, Moxifloxacin can and does cause tinnitus in some people. The tinnitus may be temporary, but you also need to know that it causes hearing loss about twice as often as it causes tinnitus and the reports I have is that the hearing loss is permanent.
Moxifloxacin is one of the 4 most ototoxic drugs in its class. The others are Ciprofloxacin, Levofloxacin and Ofloxacin.
The least ototoxic appear to be Gemifloxacin and Cinoxacin in that order. I’d ask your doctor if you could take one of these if it will do the job.
Cordially,
Neil
Thanks for the fast reply ,
An alternative would be Azithromycin, a dose of 1500 mg over 5 days, but I rather not take that drug as al the the antibiotics that end in mycin should be stayed away from as far as possible.
Does it have a safer profile ?
Hi Bart:
Azithromycin is a Microlide antibiotic. The macrolides as a class are almost as ototoxic as the fluoroquinolones. It also has numbers of people reporting tinnitus from taking it–and it also has about twice as many people reporting hearing loss from it as get tinnitus. So it wouldn’t be my choice of a drug either.
Not all drugs ending in -mycin are really ototoxic. That is a misconception people have. True, they are all ototoxic to some degree, but some are much worse than others, and numbers of drugs that don’t end in -mycin are very ototoxic.
I recently wrote an article on this that you can read at http://hearinglosshelp.com/blog/drugs-ending-in-mycin-and-micin/
Since I’m not a medical doctor, I don’t know which drugs work for what conditions, but if a Macrolide like Azithromycin will work, possibly a close relative, a Ketolide antibiotic will also work. Telithromycin is a Ketolide and is only mildly ototoxic so if it works, it would be a much better choice from your ears perspective. The risk would be very low.
Cordially,
Neil
Thanks again Neil,
That is a great read and very inormative, I bookmarked it.
I stopped taking meds since Friday but my tinnitus still is louder than before, how long does it usually take to settle back down again ?
My GP tried to assure me that it can take a awhile before all the drugs are out of my system and it should settle back down again in a week or so, he thinks it is probably stress related in my case. Is that your understanding as well ?
The only drug I use atm is Daktarin oral gel and some probiotics.
Thanks.
Hi Bart:
It varies depending on the drug. Tinnitus from some drugs settles down within a few hours. Some take 2 or 3 days and others take 2 or 3 weeks. Some take months. I normally say, “Give it a couple of weeks.” but that is my generic version.
Your GP is saying your tinnitus is stress-related and not from the drugs? I don’t know how he can say that when you are taking drugs that are known to cause tinnitus. Of course, stress can make any tinnitus worse. So there could be some truth to it.
Daktarin (Miconazole) is not listed as causing tinnitus.
My choice for killing a surface infection such as athlete’s foot or yeast infections, etc. in colloidal silver. It kills on contact and is not ototoxic. In fact, I have a bottle on my desk right now in case I should ever need it.
I like the Meso silver from Purest Colloids. You can get it at https://www.purestcolloids.com/mesosilver_price_list.php
Cordially,
Neil
my tinnitus seems to only occur in the spring and fall. Started last year as ringing and now i feel it has many different sounds. currently like a roaring tornado. my ENT has scheduled me for an MRI in 7 days but what do i do in the meantime? im afraid to keep taking mucinex or any allergy meds since sometimes i blame them for the tinnitus. help please! 🙁
Hi Amanda:
It should be fairly easy to tell if one of your meds is causing the tinnitus. Just stop taking any and if your tinnitus goes away in the next few days or a week or two, then start taking one at a time again and see whether your tinnitus returns. If it does, the last one you took should be the culprit.
Once you know which drug is the problem, you can ask your doctor for a different one that will do the same job.
I can help you choose the least likely drug to cause tinnitus if you tell me the drug class of the drug you are taking.
Cordially,
Neil
i was taking singulair. last night i tried something different and took a zyrtec and a multivitamin and this morning i woke up w/ no tinnitus!! i’m so happy yet still fearful that it will return. I still woke up w/ a throbbing headache, like a sinus pressure type headache so i don’t know why the zyrtec didnt help for that but i soon took an excedrin and have been fine since then. I was trying to stay off excedrin but that is the only thing that takes these terrible headaches away. Thank you so much for replying!!
Hi Neil,
I was feeling poorly last Thursday with sudden nausea and back ache, kidneys were hurting so went to doctors. The doctor did a urine test and said there was an infection (get results back today) so she said to be on the safe side take x2 500mg of Ciprofloxacin. I fell asleep on Friday evening and about 10pm woke up with ringing in my head. I had taken 3 tabs so far, Thursday night then Friday morning and evening. I spoke to a doctor on the phone who said the tinnitus should go away after a few days, and prescribed me Trimethorprim. This was Saturday and I have not taken it yet as I am so scared an anxious of the Tinnitus getting worse. It has been here for just over 2 days now, and not really getting any better. In the day time I forget about it more as other sounds drown it out, but when it is really quiet, especially at night/morning it is unbearable.
Would this tinnitus be a side effect of Ciprofloxacin? If so, will it ever go? Can a infection of my bladder/kidney cause Tinnitus? Will Trimethoprim make the tinnitus worse/better?
Thank you
Portia
Hi Portia:
Yes, tinnitus is a known side effect of Ciprofloxacin. I hear from numbers of people get tinnitus from taking this drug. In fact, numbers of people have reported getting loud tinnitus after only taking Ciprofloxacin for 2 or 3 days. So it is not surprising that you also have tinnitus, very likely from this drug. You’re lucky you don’t also have hearing loss–as numbers of people do get hearing loss from this drug as well as tinnitus and other ototoxic side effects.
Trimethoprim is a MUCH better choice than Ciprofloxacin. It can cause tinnitus in a few people. I’ve not had any reports of people getting tinnitus from taking Trimethoprim like I have with Ciprofloxacin. And as near as I can tell, no one has reported hearing loss from taking Trimethoprim either.
If it were me, I’d dump the Ciprofloxacin and take the Trimethoprim instead. Unfortunately, there is no guarantee that your tinnitus will go away when you stop the Ciprofloxacin–hopefully it will, but you may find it will be permanent. That is why you have to be so careful when taking drugs in the Fluoroquinolone class that includes Ciprofloxacin.
Finally, I don’t think a bladder or kidney infection will cause tinnitus by itself–but the drugs used to treat kidneys are often quite ototoxic. Chinese medicine says that the ears and the kidneys are “connected” so drugs used to treat the kidneys often negatively affect the ears.
Cordially,
Neil
Thanks for all the helpful info you provide. I’m ordering the these books on Amazon prior to seeing my doctor again for a change in my prescription(s) . Is 2010 the latest edition of Ototoxic Drugs? I want to be sure to get the latest edition.
Meanwhile, I would greatly appreciate it if you could answer some questions while I wait for the books to arrive since I feel time is of the essence.
I developed tinnitus about two months ago shortly after switching to an ARB (Losartan 25 mg taken every other day) for high BP.
I immediately switched back to my ACE inhibitor (Lisinipril 10 mg) which I had taken a couple times a week for about three months previously and it hadn’t presented a problem. But the ringing intensified.
Since taking high doses of aspirin about 40 years ago which caused temporary tinnitus I’ve been sensitive to aspirin, but able to take an occasional tablet with no problems.
I stopped all bp meds after about three weeks of tinnitus. That was nearly 3 weeks ago and I still have it.
But for the last 5 years I’ve taken Norco, 10 mg with 325 mg acetaminophen once each evening so I can take my nightly walk (fibro makes it impossible to exercise without pain meds). Until the issue of tinnitus developed with my bp meds it has never caused any problems.
But I’m wondering if the tinnitus isn’t going away due to the Norco?
I read on your site that Oxycodone could also be problematic, but not the acetaminophen in it. Is this the same as HYDROcodone which is what Norco is?
I also read somewhere that taking antioxidants along with ototoxic meds can help prevent furthermore damage. (Wondering if this type of info is available in When Your Ears Ring, or Ototoxic Drugs Exposed?)
So for two nights, shortly before I took the Norco, I drank carrot/beet juice, took 3000 mg vitamin C along with 12 mg astaxanthin and by the 2nd day the ringing was almost gone.
On the third night, with almost no tinnitus, I took the same regime along with a Norco prior to my walk. Just before bed I also took some turmeric powder with 1/4 tsp black pepper (enhances absorption) for a nagging headache. It got rid of the headache but I awoke with the same massively loud tinnitus that I had just all but gotten rid of. Could the turmeric have been the problem? It’s an antioxidant though.
I’m also taking Co Q10 and ginkgo 2x day try to lower my bp naturally. Walking helps my bp too, but I can’t walk without pain meds.
I also noticed if I’m not extremely careful when I blow my nose, the tinnitus amps up and my ears feel a bit full with pressure later. (But I don’t have any sinus congestion.) Could blowing my nose be a contributing factor? Or are my ears feeling full due to damage? Does using a netty pot help relieve tinnitus?
Is there a pain med I can substitute? And which BP meds are OK?
Is this kind of info available in your two books on tinnitus and ototoxic drugs?
Meanwhile, thank you so much for responding to my many questions.
You are truly a blessing for many of us with these problems.
Hi Leslie:
Yes, the 2010 (3rd) edition of Ototoxic Drugs Exposed is the latest edition. I’m working on the 4th edition but the little time I have to work on it means that it won’t be coming out for at least two more years.
Lisinopril and Losartan both have about the same risk of getting tinnitus. However, your body may be sensitive to one and not the other. I don’t know why your tinnitus got worse when you went back on the Lisinopril. That seems a bit strange if it didn’t affect you before.
I rather doubt that your tinnitus isn’t going away because of the Norco. You’ve been on it for a long time without problems. Both hydrocodone and Oxycodone have a low risk of tinnitus with the hydrocodone probably less risk than Oxycodone.
Acetaminophen seems to have a greater risk of tinnitus than either Hydrocodone or Oxycodone. It could be that because Acetaminophen causes hearing loss, and tinnitus is very often associated with hearing loss, that the people that report tinnitus from Acetaminophen really only got it after they lost some hearing.
I mention in my drug book that when you take Acetaminophen it depletes your body of Glutathione. Glutathione is your body’s most powerful antioxidant. Thus, it is a good idea to also take Glutathione (or its main building block, N-acetyl-cysteine) to counteract the effects of the Acetaminophen.
I’ve never heard of tumeric causing tinnitus.
If your head is clear–no congestion, I can’t see a Neti pot helping your tinnitus.
I don’t know what pain meds will work for you. The best thing is to ask your doctor for a list of 3 or 4 pain meds that he thinks will work and I can tell you which is the least ototoxic of those.
The drugs you are on are all ototoxic to some degree. Thus the trick is to find the least ototoxic drug and dose that will do the job. And yes, you can figure out which one would likely be the least ototoxic by using my drug book–not the tinnitus book.
If you have other questions, you know where to find me.
Cordially,
Neil
i bought your book “ototoxic drugs” a while back. I have had tinnitus for over 35 years since i was in a bad motorcycle accident (concussion, facial fractures, temporal bone fractures, etc,etc. and lost all of my hearing. Also lost sight in one eye. Balance difficulties really started after i had a cochlear implant in ’89. I tried just about everything that was ever mentioned in various aerticles and publications to lessen the constant buzzing, hissing, roaring, rumbling, etc etc. in my head constant 24/7. cannot sleep well, cannot work due to this horrible affliction. I am in my 50’s and have a toddler son who needs me! At time si dont want to wake up in the morning if i do get some sleep cause i know the loud sounds will come on as soon as i awake. I have been on clonazepam .5mg (sometimes take half pill) for about 10 years. I notice cognitive decline and it hasnt done anything for my tinnitus. I had balance problems (heavy head) and the otoneuroloigist told me im not explaining exactly what is going on in my head. I said my head is heavy. i have balance that works. They took all kinds of tests. i have bilateral vestibular dysfunction. I hate the way i feel with my head. I pray something can be developed or done for me. Its so aggravating, and i get down a lot about my life cause of my health issues. Having constant noise in my head is pure torture!! I think i am going to at leasy ask my GP to give me something to get to sleep and stay asleep. I wake up at 3, 4 or 5 am most nights. Have to put a masking cd in and listen to that but it doesnt take away the constant noises. I wish to God i never bought a motorcycle. If you have one please get rid of it. you never know what can happen.
Hi Dan:
Whenever you are in a motor vehicle accident, you suffer from whiplash. One of the things that typically happens is that the two top vertebrae in your neck get knocked out of proper alignment. As long as this condition exists, it can affect your balance (which is your experience) as well as your hearing and tinnitus (again your experience).
Therefore, the first thing I’d do is go to a special kind of chiropractor called an upper cervical spine chiropractor and have him properly align your top two vertebrae. (Conventional chiropractors don’t have the skills to do this well.)
To find an upper cervical specialist go to http://www.upcspine.com/ , then click on “Practitioners” in the menu bar and choose North America and then your state (I’m assuming you are in the USA) and you’ll see a list of the upper cervical spine chiropractors in your state. Each chiropractor has a 10 – 15 line listing. Near the bottom of each listing is a line called “Upper Cervical Approach/Technique Used:” and following that is one of about 10 different techniques. I’m particularly partial to the “Blair Method” so if you can find a Blair chiropractor within reasonable driving distance (a couple hundred miles) that would be my first choice. But the others are also good. Pick someone that has 15 or 20 years experience, not a “newly-minted” upper cervical specialist, as they don’t have the depth of experience your situation may require.
Once you have a “clean bill of health” from such a chiropractor, then see how you feel. Whether your tinnitus is reduced and your balance is better.
If you still have tinnitus problems (you have even odds in your tinnitus going away from the upper cervical treatment), then I suggest you read my newly-revised and updated book, “Take Control of Your Tinnitus–Here’s How”. If you put into practice the principles outlined in this book, you will find your tinnitus will begin to fade into the background. I give numerous different treatments and sources of help to guide you to a successful conclusion.
You can get this book, “Take Control of Your Tinnitus” at http://hearinglosshelp.com/shop/take-control-of-your-tinnitus-heres-how/ .
Cordially,
Neil
YOU DON’T MENTION ASPARTAME
Hi Schaz:
Of course I mention Aspartame. It’s not a drug so is not mentioned in the main drug section. But if you look near the back in the Chemicals section, you’ll see Aspartame listed there.
Cordially,
Neil
Is anyone still here? I have a question about my tinnitus and Eustachian tubes. 🙁
Hi Jazmyn:
I try to answer as masy of the comments people make as I can. What is your question?
Cordially,
Neil
My Eustachian tubes have been clogged for over 3 months from having a cold on a plane. Sometimes I can get them unclogged but the still get full again. This caused tinnitus and hyperacusis and I’ve had this for a little over 3 weeks. I was prescribed steroids and Allegra d to open up my Eustachian tubes and to decongest. Every time I take the Allegra d the ringing gets louder and the steroids don’t even help, neither does the nasal spray. I am so sensitive to everyday sounds and everyday I have to go to gymnastics practice which I’m constantly around people yelling a screaming. I feel like no matter what I do my Eustachian tube just wont unplug.
Hi Jazmyn:
Since the steroids don’t work, why do you keep taking them? As for the Fexofenadine (Allegra), it is known to cause tinnitus in some people. Obviously you are one of those people. Ask your doctor to switch you to another decongestant that won’t make your tinnitus worse.
If your ears are too sensitive to sound, such as when you go to the gym, why don’t you wear earplugs while you are there? Don’t wear the earplugs more than you need to or you will make your hyperacusis worse but when you are around loud noise it would be a good idea.
One possibility for your Eustachian tubes, since they won’t unplug any other way, is to investigate whether the top vertebrae in your neck are out of proper alignment. If they are, this can pinch the trigeminal nerve which controls the proper function of your Eustachian tubes. An upper cervical chiropractor would be the person to see about this.
Cordially,
Neil
I went to the doctor yesterday. He said for me to go to an audiologist for my hyperacusis. I have to go to sound therapy now and tomorrow I will also be going to the chiropractor to see if they can help. I stopped taking the steroids and Allegra d. I stopped taking any medicine because the tinnitus and hyperacusis get worse after I take anything. I also have a lot of stress and anxiety which is not good with my hyperacusis and tinnitus. Hopefully I can get that under control.
Also I have a question. Is there any food or any drinks that can make tinnitus or hyperacusis worse. I know that there is caffeine
Hi Jazmyn:
I’m not aware of any foods that affect hyperacusis. Tinnitus is another matter. There are a number of foods that can affect tinnitus. However, a lot of people don’t notice much difference whether they abstain from these foods are not. In other words, a lot of people are not sensitive to these foods even though they can cause tinnitus in some people.
Specific foods such as red wine, grain-based spirits, cheese and chocolate can trigger or increase tinnitus in some people. So can salt, sugar, caffeine, nicotine, alcohol, mmonosodium glutamate, marijuana and some hot spices.
if you notice any of these making your tinnitus louder then be wise to cut them out. If you don’t notice any difference, then it probably makes no difference whether you eat them or not.
Cordially,
Neil
Thanks Neil! My doctor says I have the shingles virus in my ears. I took to medication last week and finished it. The ringing is still there. And yes certain foods do make my tinnitus worse. So I’m going to stop eating them for a while. Do you think the healing process will take a long time?
Hi Jazmyn:
If the shingles virus has affected your inner ears, that could explain the hyperacusis and tinnitus. You may also have some degree of hearing loss, especially in the high frequencies where they don’t test.
Only time will tell, but typically, hyperacusis takes a few months or more to go away. If you have any hearing loss, then tinnitus associated with it tends to last as long as the hearing loss. Thus, it is hard to predict what will happen in your case.
Cordially,
Neil
Hi. I’m not sure what’s going on with me. I went swimming and then about a week later I went upside down, and then after that I got non stop ringing in my ear and my ears feel clogged. A few weeks ago I feel straight on my head doing a backflip and it hurt for 2 days. Now I feel pressure in my head and nose, and more in my ears, and now even the insides of my right nostril is starting to hurt.I’ve been getting dizzy, I’m always tired and Now I always forget stuff. Sorry for the long paragraph, but do you think you know what’s wrong with me? Sorry I know this page is just for tinnitus help, but i haven’t told my mom any of this and I wanted to make sure I’m not going crazy.
Hi Angel:
Which came first, the swimming episode or falling on your head when you did the backflip? From the symptom you related, if the backflip came first, I suspect you put your neck out of whack. That can cause balance problems as well as tinnitus and a feeling of your ear being blocked or clogged, especially if the top two vertebrae in your neck are out of proper alignment.
If I were in your shoes, I would go to an upper cervical spine chiropractor and have him check out my neck. These chiropractors are a special kind of chiropractor that specialize in the upper cervical spine (UCS). They are able to work wonders for certain ailments and they are very gentle–not the bone cracker kind. They focus mostly on your top two vertebra (C1 (Atlas) & C2 (Axis). If this joint is “off” then you could have some of the symptoms you are experiencing.
You can find a chiropractor specializing in UCS by going to the following URL and entering your location. You can also read about the things these special chiropractors can do for you at this same website. Here is the URL.
http://www.upcspine.com/
Choose the “Practitioners” link along the top to find the one closest to you.
There is a lot of good information on UCS chiropractic on this page also.
Cordially,
Neil
I swam first, and after I swam my ears felt clogged already and there was ringing. And then after the backflip it would hurt my head to bend over and I hear swooshing when I bend over.
Hi Angel:
Did you have a cold or flu or any other virus active in your body at the time you went swimming or right after? It almost sounds like you had a viral attack on your inner ears.
Landing on your head could have caused other problems.
Cordially,
Neil
Yeah after I went swimming I got a reallt bad cold
Yes I’m pretty sure I have the viral. Can I still go swimming?
What should I do to make the viral process faster in order for my ears to heal faster? Should I be like doing flips and stuff?
Hi, I’ve been diagnosed with Meniere’s & vestibular migraines. Taking nortriptyline & Topamax, still get vertigo attacks & constant ringing in left ear. Also loss of hearing in left ear. I noticed when I turn or look or even move fast to the left I get dizzy. What exactly is Meniere’s? I’ve heard it’s an autoimmune disorder of the inner ear? Any other treatments for it? Thank you
Hi Elena:
What doctors think causes Meniere’s disease and what really causes it are two different things. I wrote a comprehensive article on Meniere’s disease and its basic cause and how to get rid of it. You’d do well to read it. It will answer all your questions. You can read it at http://hearinglosshelp.com/blog/atlas-adjustments-alleviate-menieres-disease/ .
Cordially,
Neil
Was in a bad time in life and started buying Oxycodone on the street.
Was taking on about a year. Besides the obvious problem with that I think I was taking fake ones, I believe they were fentanyl.
As soon as I stopped my ears started to ring to my heartbeat.
It’s been almost 3 months and now only in my right side I hear a high tone that rings to my heartbeat.
I’m a smoker, 36yrs old and have high blood pressure in my family. Did I due permanent damage and how does it happen in regards to my story? Are there any cures with how it happened to me? Thanks for reading and look forward to your reply.
Hi Barry:
I can’t tell you if you did permanent damage to your ears or not. But I can tell you this, if you take high doses of Oxycodone coupled with Acetaminophen (such as Vicodin and kindred combination drugs) for several months or more, then you can suffer sudden massive ear damage.
If you kept the dose down, there is less of a chance of ear damage, but you can still suffer from tinnitus.
If your tinnitus is slowly improving, that is all to the good. Continue to ignore it and let it fade into the background.
I’ve not heard of tinnitus in unison with your heartbeat linked to Oxycodone (or similar drugs) use.
Tinnitus in unison with your heartbeat is called pulsatile tinnitus. Typically, this can be fixed/treated by a medical doctor (vascular surgeon). It is caused by turbulent blood flow in the arteries near your ears. Sometimes it is caused by high blood pressure so treating your blood pressure my get rid of it. Smoking can also acerbate it as it also affects your vascular system.
Cordially,
Neil
One thing that I forgot to say was how I was taking these drugs. I insufflated 30mgs pills about 10 times a day. With the ears, nose and throat being so closely related could that be a reason why the ringing is in unison with my heartbeat? When I strain, move my head real fast or shallow it gets louder for a second then fades away. Thanks again.
Hi Barry:
If you can move your head/neck and your tinnitus gets louder, even for just an instant, that tells me you have somatic tinnitus–tinnitus related to body movements. It basically means that your cervical vertebrae are out of proper alignment, as well as possibly your TMJ, your neck and facial muscles, and associated structures. This may or may not be related to your pulsatile tinnitus, but it could be given your history.
Cordially,
Neil
Dr. Neil, a couple weeks ago I had a bad cold. Lots of fluid in ears and congestion. A doc put me on amoxicillin and a methylprednisolone pack. I took the first days dose of the methylprednisolone. I hated how I felt. I was up almost 24 bird and had a panic attack so I discontinued it. 2 days later I got a chirp in my right ear. Was only there when I spoke or my children spoke, like an annoying high pitch feedback. 9 days later is is worse. I go to an ent and my ears have no fluid and “look good” however I have slight conductive hearing loss in said ear. I’m 36 and heathy. I was taking acetaminophen during cold and some ibuprofen as well. What did this to me? The ent says it is likely permanent but wouldn’t diagnose or give any explanation. Not sure they could give me an answer besides try some Flonase.
Hi Patricia:
The virus could have given you both hearing loss and tinnitus. You may have more hearing loss in the high frequencies above 8,000 Hz where they don’t bother to test–but this can result in tinnitus.
All of the drugs you took–Amoxicillin, Methylprednisolone, Acetaminophen and Ibuprofen could have caused hearing loss and tinnitus either singly or in any combination of the above.
My best guess is a viral attack and one or more of the drugs messed up your ears. It could be permanent, or it might get better or partially better over time.
The conductive loss may improve over time as your ears get back to normal.
Cordially,
Neil
Could it’s be hyperacusis? Because it is not “constant”. It’s like the high pitched sounds like my own voice or my young children’s voices, or certain noises that have high frequency, they cause that sound in my right ear. Like a tinny feedback. Hard to explain. Is that from the hearing loss? I’ve taken all of those drugs before, except for the methylprednisone. Sad to think that could have changed my life forever. Thanks you for replying to me. It’s nice for someone else to listen. This is new to me and I am young. Devasted doesn’t even cover it.
Hi Patricia:
Sometimes viral attacks cause distorted hearing (and what you are experiencing is a form of distorted hearing). Often this goes away in time. You may find in another couple of weeks its gone and things sound more normal again. What you describe doesn’t sound like hyperacusis. With hyperacusis certain sounds are too loud–but not distorted like you describe.
Cordially,
Neil
So I just tried something. When I cover my “good ear”, I can hear not so well out of the right and the kids and my voice soind completely robotic (distorted). This is from the hearing loss I assume? I pray it is temporary. I thought virus only attack the inner ear. The ent said the hearing test showed conductive loss, which is an issue with the middle ear. She said the audio nerve didn’t show damage. Thoughts?
Thank you Neil, you have been more helpful than anyone I have seen.
Hi Patricia:
It’s probably from the hearing loss, or more correctly, from damage to the hearing mechanism that could produce hearing loss and/or hearing distortion.
Yes, viruses attack the inner ear. So viruses don’t cause conductive losses. But distorted hearing may not show up on any hearing test–you could have normal thresholds, but what you hear is distorted. That would still be an inner ear thing.
I don’t know what your conductive loss is from, but conductive losses typically don’t cause distorted hearing–just reduced hearing.
Cordially,
Neil
Well Dr. Neil, after much more reading today I have discovered diplacusis. Hearing two different pitches in each ear. How I am so unlucky I don’t know. I hear it’s doom and gloom from here. Not sure how I can live with this as I hear it in my own voice as well as my babies. This will be a very difficult one to accept. Do you know more about this condition? Sounds like what I have correct?
Hi Patricia:
I’ve written about diplacusis and answered a number of questions about it. I’m surprised you didn’t run across my article. It’s at http://hearinglosshelp.com/blog/diplacusisthe-strange-world-of-people-with-double-hearing/
After you have read it, let me know if that fits your situation.
Cordially,
Neil
Yes sir. I read your article, I think it does. Although the ent said I had conductive hearing loss. It’s most annoying my voice and high pitch voices. I don’t know what to do. Praying it goes away, my cold is gone, no fluid in ears, I’m able to “pop my ears”, and it’s been 12 days of this now. Voices have a tinny reverb.
Hi Patricia:
I think it will go away in time. You’ll just have to be patient. I don’t know what to suggest that will speed the process. I do know that if you are low in zinc and magnesium, it can affect your ears, so you might want to check and be sure you are getting adequate amounts of those minerals.
Cordially,
Neil
Thank you Dr. Neil, unfortunately the internet is flooded with unsuccessful stories of diplacusis. I pray too that it is temporary. The ent does not want to give me any more prednisone due to the panic I had when taking the Medrol during the cold. I was opting that could reverse my situation and the conductive hearing loss. Is there any other sort of anti inflammatory that is not ototoxic. How about turmeric? Or cbd oil?
Could a round of 60mg prednisone bring back some of the conductive hearing loss?
Hi Patricia:
I doubt it. If you know exactly what is the cause of your conductive loss, your ENT may be able to fix it.
Cordially,
Neil
Ok then that must be the course for the Other type of hearing loss? Thank you for everything doc. I have a ct scan today to see the temporal bones. Unfortunately ENT has no clue. Primary mentioned something wrong with the Eustachian tubes and bought I should try sudafed for 5 days (the kind behind the pharmacy counter). My “split gland” under my ear on the jaw is also tender.
They a re worried I have otosclorosis. I have had vertigo in the past.
What about Eliquis blood thinner? I have been on for a year because of Afib. I have started having tinnitus hi pitch on both ears.
Hi Sheree:
So far, I’ve only heard of one man that found that taking Eliquis made his tinnitus worse. So it is probably unlikely (but not impossible) that Eliquis caused your tinnitus.
Cordially,
Neil
What a kind (and smart) person you are. I just started with tinnitus. Just reading your responses is comforting. Thank you.
Hi Anon:
Thanks for the kind words. It’s better than what someone once said to me many decades ago, “Boy, you are good and kind!” Then he added, “good for nothing and kind of stupid”. Ha Ha. I like your version much better!
Cordially,
Neil
Hello
My Dr prescribed Dosulepin (Dothiepin) Hydrochloride for dizziness, anxiety and mild depression. Within five days my ears were screaming. I have been off the drug now for about two weeks and the ringing has calmed down but still bothers me most of the time. Do you think there is any hope that is will keep getting better overtime and do you think St Johns Wort is a good alternative for anxiety and depression? Thank you. Carol
Hi Carol:
My information on Dothiepin is that it can cause tinnitus, but not all that often. Obviously, you are one of the people who do get tinnitus from taking this drug.
The good news is that your screaming tinnitus has calmed down a lot. This is a good sign. If you learn to ignore your tinnitus and not focus on it, there is a very good chance it will continue to calm down even more and in time may become so soft you don’t even notice it much of the time.
St. John’s Wort is probably a good alternative for your depression, but it is not the solution for anxiety. For anxiety, I usually suggest that people try the herbal Valerian.
Cordially,
Neil
I was given singulair for my allergies, I have Tinnitus in my right ear. I took it one day and it seems like it got louder. does Singulair effect Tinnitus. I told my ent about it and she said that it shouldn’t be a side effect. What should I take in it’s place alongside of my allergy shots? Thanks in advance for your input.
Hi Kelly:
Montelukast (Singulair) can indeed affect tinnitus. Hundreds of people have reported this side effect. Tinnitus SHOULDN’T be a side effect, I agree. No drugs should have side effects, but they do and Singulair is one of them that can cause tinnitus or make existing tinnitus worse.
I can’t answer your question of what you should (or should not) take in it’s place. That is a question for a medical doctor–I’m not an MD.
Cordially,
Neil
Thank You so much for responding to my question. I have stopped taking it. Because of my Eustachian tube dysfunction, I am taking allergy shots so they wanted me on an anti inflammatory allergy pre med during my first rounds of the shots , but I just couldn’t take it. In your opinion do you know of any other over the counter sinus or allergy meds that don’t really affect Tinnitus that is an anti inflammatory? I mean to take as a pre med that may help? Thanks again for what you do sir.
Turmeric 🙂
Hi there,
I see this is a very old post so I hope you see this. I was on artemisinin (another form of artemether) for its anti-parasitic effects and the next day my ears felt clogged and ringy. I didn’t make the connection between the artemisinin and ear issues until a little while later so I was on the medication for about 2 months. Upon stopping it, it’s gotten slightly better but sometimes it gets worse and it’s very hard not to get caught up on it. I do not have any hearing loss according to 2 ENTs so I’m still hoping this is an issue that will resolve but I feel like it’s so multi faceted due to the fact artemisinin seems like it can cause gut disruption and I am already dealing with a slight Candida overgrowth. I feel like I have no direction here.
Hi Kate:
I have no information on the ototoxicity of Artemisinin, so can’t help you with this. Sorry.
Cordially,
Neil
I’m taking Lupron injections. I’ve been on it for 6 years. A year and half ago I got tinnitus. I was also on prednisone.5 ml/daily and metformin 500mg but not anymore.
I was also on
Xgeva and Zytiga. Any of those Ototoxic?
Hi Todd:
Leuprolide (Lupron) can, and does, cause tinnitus in some people. Under the right conditions, Prednisone can also result in tinnitus. Metformin certainly causes tinnitus in good number of people. Denosumab (Xgeva) and Abiraterone (Zytiga) can also cause tinnitus, but they seem to be low risk.
Of the above drugs, Metformin is probably the most likely culprit.
Cordially,
Neil
So we know Carbamazepine is quite ototoxic.
The next question I’d be interested in asking would be: Which anti-epileptic drugs are not ototoxic or at least much less ototoxic than carbamazepine?
I would be interested to know. I have heard lamotrigine is better but I have not really found out whether it is still quite ototoxic or not.
If by any chance you know more about this category of drugs, I would be most appreciative of your input.
Cheers,
Ben
Hi Ben:
When compared to Lamotrigine, Carbamazepine is 4 TIMES more ototoxic, so Lamotrigine would be a much better choice from our ears point of view.
In order for me to compare this to other drugs, you need to give me a list of the drugs your doctor thinks would work for your epilepsy. Then I can then put them in order of ototoxicity as I see it.
Cordially,
Neil
Dr. Bauman,
I began taking lamotrigine in November 2020 after having a psychotic episode and receiving a bipolar diagnosis. This is a one-time incident, and I’m not all that confident in the diagnosis, but that’s neither here nor there.
As I was being ramped up on the medication, I noticed a ringing in my ears. Though it took me a while to make a possible connection between the medicine and the tinnitus.
My psychiatrist has said there’s nothing in the literature about tinnitus as a side effect of lamotrigine. But I have found some reports of personal experiences online. And in your forum here, you indicate that lamotrigine is moderately ototoxic. I am relieved to have found a possible explanation.
When I went to see the ENT, I had a hearing test done and there was very slight hearing loss in my right ear at high frequency, which I understand could just be due to age.
I’m currently tapering down my dosage from 150mg to 50mg hoping to get back under the “magic threshold” you mentioned above. If that doesn’t make a difference, I’m going to discontinue the medicine completely to see if that does the trick.
My question is this. How long should I stay at the lowest dose to see if the threshold effect kicks in? And then if I do get off the meds completely, how long would you expect it to take for the ototoxic tinnitus to disappear?
Thank you so much for your help!
Hi Charles:
I guess your psychiatrist has never heard or read of the Physicians’ Desk Reference–the drug book for doctors or the AhFS the drug book for health care pharmacists then. Tinnitus is listed as a side effect in both of those books Not to mention the many hundreds of reports in the FDA’s database.
Certainly Lamotrigine is not the most ototoxic drug to be sure, but it is a 2 or 2.5 out of 5 according to my rating system.
I don’t have any reports about how long the tinnitus lasts–whether it is temporary or permanent.
I’d hope that by the time you reach 50 mg, you’d be under the ototoxic radar–but as you know, everyone is different, so can’t tell you for sure.
Nor can I tell you how soon your tinnitus should go away, if it is not permanent.
I would think that once you get down to 50 mg, and are there for a month or two, you should have some idea whether you are below the magic threshold and your tinnitus will go away.
I’d give it a couple of months (or more) after you are completely off the drug to see whether your tinnitus will go away, or drop to a lower level. I don’t have any hard data on this to help me answer these questions.
Cordially,
Neil
Thank you for your quick reply! I can’t tell you what a relief it is to confidently identify the cause.
Follow up question. I’ve also been experiencing ear fullness in my right ear. Could that also be an ototoxic effect that might disappear?
Hi Charles:
A feeling of fullness, your ear feeling blocked or your Eustachian tubes not working correctly can all be ototoxic side effects of taking Lamotrigine. I actually have 23 different ototoxic side effects listed for Lamotrigine.
Cordially,
Neil
Hi Dr Neil
Recently my new dentist prepped 6 teeth (ie. shaved them back), for crowns. He painted them with a foul tasting solution with an orange favor, because the nurse wasn’t suctioning enough the solution went up my E tubes and burnt them. For two days afterwards both my tubes where aching. My dentist wouldn’t tell me what the solution was, but I think it might have been iodine? Is this ototoxic?
Kind regards
Jane
Hi Jane:
I doubt it was iodine, but to answer your question, iodine is slightly ototoxic. It mostly causes balance issues if anything, but it also can cause tinnitus.
Cordially,
Neil
Dr.
Cabergoline and gadolinium RMN contrast are ototoxic? Can produce hearing loss or tinitus?
Hi Brenda:
Cabergoline is only mildly ototoxic so there is a good chance you won’t have any ototoxic side effects (but there are no guarantees).
As far as gadolinium goes, all the gadolinium based drugs are ototoxic to some extent–some of them moreso than others, but in my opinion, you only want to have contrast dyes if it is absolutely essential as sometimes the gadolinium dyes can lodge in your brain and cause nasty problems. Often, these contrast dyes are not really necessary–the doctors just like them as they give sharper pictures. So, if I were you, I’d tell your doctor you don’t want the dyes unless they are absolutely essential. This is what I do. Then you don’t have to worry about ototoxicity or any other nasty effects.
Cordially,
Neil