Question: Is it true that some prescription drugs can damage our hearing?—K. C.
Answer: Yes, unfortunately it is true. In the course of talking with and helping multiplied hundreds of people with hearing losses, I am appalled at the enormous number of people who have lost much (or all) of their hearing from taking drugs prescribed by their doctors. Many of these unfortunate people were never told that taking such drugs could (and would) damage their ears.
There is abysmal ignorance on the part of both health care professionals and the general population concerning the many prescription drugs that can indeed damage our ears. One lady told me that when challenged, her doctor couldn’t name even one such drug! In fact, ototoxic drugs are so far removed from the stream of human consciousness that the word is not even listed in most dictionaries!
We call drugs that damage our ears ototoxic (OH-toe-TOKS-ick although some people pronounce it AWE-toe-TOKS-ick) drugs. Ototoxic just means ear (oto) poisoning (toxic). These drugs typically either damage the hair cells in the cochlea, the hair cells in the balance (vestibular) system of our inner ears or our auditory nerves. Side effects of ototoxic drugs may include such things as temporary or permanent hearing loss (generally, but not always, at the higher frequencies); deafness; ringing or other noises in our ears (tinnitus); dizziness; vertigo (where the room seems to spin around); and hypersensitivity to sounds (hyperacusis).
I personally feel that the ototoxic properties of drugs are greatly under-reported. For example, what is listed as a rare ototoxic reaction, may in fact, be much more common. This is because many people do not recognize the ototoxic side effects of the drugs they are taking. For example, a bit of hearing loss may easily go unnoticed, especially if it is in the higher frequencies. People may not connect dizzy spells or ringing in their ears to the medications they are taking. Hence such side effects go unreported. We can be certain that the problem is considerably worse than has been reported.
Did you know that, according to one study, 51% of the approved drugs being released today have serious side effects (including ototoxic ones) that had not been detected at the time of the drug release to the public?
It is so easy to assume that because ototoxic side effects have not been reported for a given drug that it is safe for our ears. A good quote to remember is, “absence of evidence does not equal evidence of absence.” In other words, just because an ototoxic side effect has not yet been reported for a specific drug does not mean that that drug will never cause ear damage.
Be careful about taking drugs. The existence of side effects is often downplayed. You need to know all the side effects of the drugs you are taking, and then decide with your doctor whether you are prepared to accept the risk of those side effects when compared to what benefits the drug is supposed to bring you. Did you know that an estimated one and a half million people in just the USA end up in the hospital each year as a result of the adverse side effects of prescription drugs? Another 100,000 people die each year from such adverse side effects! You do not want to be a part of these statistics!
There are many drugs that are ototoxic to some degree. For example, taking 6 to 8 aspirin a day can cause ringing in your ears (tinnitus) and temporary hearing loss. Some drugs will quickly and permanently damage your ears. You may be left with little or no hearing. This happened to Bonnie after she took an antibiotic to fight a life-threatening infection. Now she cannot hear any high frequency sounds. Other drugs can have both temporary and permanent effects. While taking chemotherapy, Ruby temporarily lost most of her hearing. After her treatments were over, most of her hearing returned, but she was left with permanent and annoying tinnitus.
Did you know that some drugs cause hearing/balance problems in 25 percent of the people taking them? Antibiotics are particularly notorious for this. One study of hard of hearing children in China revealed that 123 of the 154 children studied had lost their hearing from taking antibiotics. Of these 123 children, 60 of them had hearing problems due to the Aminoglycoside antibiotic Gentamicin. Nor does this just happen overseas. In one of my hearing loss coping skills classes I was shocked to find that about one-quarter of the people in that class had their hearing damaged from taking ototoxic drugs.
Unfortunately, the damage to your ears doesn’t always show up while you are still taking the prescribed drug. It may not show up until weeks or even months later. By then it’s too late for your doctor to do much about it. Also, be aware that drug damage is cumulative. When you take various drugs from time to time over many years, each different drug may have an almost undetectable deleterious effect on your ears, but eventually you may end up with a noticeable hearing loss.
Always ask your doctor or pharmacist about the possible side effects of any medications (or combinations of medications) you are taking. Have your doctor look these drugs up in their “drug bible” and show you. In the USA, doctors use the PDR (Physicians Desk Reference). In Canada they use the CPS (Compendium of Pharmaceuticals and Specialties).
Make up your own mind whether you want to risk the side effects of any drug before you begin to take it. Remember, it’s your hearing that is at risk. You are the one who will have to live with the results—not your doctor or pharmacist. Sometimes, like in the two examples I gave above, the side effects of the drugs were less severe than the result of not taking them, namely, certain death. If your options are deaf or death, the choice is easy. However, if it’s not a matter of life and death, do your research, and then make an informed decision. Don’t let your doctor railroad you.
Your body may react differently than your doctor expects. Some drugs may build up to toxic levels in your blood if your body does not metabolize them as expected. Elizabeth found this out to her sorrow. Her doctor told her that a certain antibiotic he prescribed would only damage her hearing if taken at a high dose for a prolonged time. What happened to her? The very first (relatively low) dose permanently damaged her hearing. Now she has to wear two hearing aids just to be able to hear most of what people say.
It is most important that your doctor determine how well your kidneys are working before he prescribes various medications. This is because your body excretes many drugs through your kidneys. If they are not working properly, ototoxic drugs can quickly rise to dangerous levels in your bloodstream and cause permanent hearing loss.
Just because a drug is listed as being ototoxic doesn’t necessarily mean you will damage your ears if you take it—but be warned—it may. Each person’s body is slightly different and reacts differently. For example, Marcia has been taking Voltaren (Diclofenac) for 15 years and does not have any noticeable hearing damage although the drug she is taking is listed as having caused hearing loss, balance problems and tinnitus. She is one of the fortunate ones.
On the other hand, Flo took Prozac (Fluoxetine) for 5 years and had never been told it had ototoxic properties. Recently, when she stopped taking it, within 3 weeks she noticed a significant improvement in her hearing.
So which drugs are ototoxic? There are far too many to list in this short article. In fact there are at least 663 drugs that can damage your ears one way or another. Some classes of drugs that are ototoxic include the non-steroidal anti-inflammatory drugs (NSAIDs); many antibiotic drugs, especially the anti-bacterial drugs like the aminoglycosides; antihistamines such as the H1-blockers; several anti-cancer drugs; cardiovascular drugs including ACE inhibitors, beta-blockers, calcium blockers, etc.; diuretics, especially the loop diuretics; anticonvulsant drugs; antidepressant drugs, especially the tricyclic antidepressants; and a many others.
Instead of blindly taking drugs prescribed by your doctor, first become knowledgeable about such drugs. Learn about their ototoxic side effects. Carefully weigh their benefits versus their side effects then make your informed decision. Your ears will thank you for the rest of your life!
Trying to find a safe antibiotic .
Any suggestions?
Hi E:
I don’t know of any totally safe (non-ototoxic) antibiotic drugs. Thus, you have to choose the least ototoxic drug that will do the job.
If you want natural antibiotics, there are numbers of herbs that have antibiotic properties such as garlic.
And if you want a mineral, colloidal silver is a wonderful antibiotic.
Cordially,
Neil
If you stop taking ototoxic drugs, can hearing loss suffered from taking these drugs be reversed?
Hi Bill:
In some cases the answer is “yes” and in others, the answer is “no”. It all depends if the specific drug causes cell death or not. If, for example, hair cells die, then the hearing loss will be permanent. However, if a drug blocks ion gates so sound signals can’t get to the brain, when you stop taking the drug and your body clears the drug from your ears so the ion gates are no longer blocked, then your hearing can return to normal. And then there is everything in between where you stop taking a drug and some, but not all, hearing returns. So there is no cut and dried simple answer.
Cordially,
Neil
Excellent article! Thanks!
I had radical prostatectomy recently done. The surgeon did a perfect job. However, to reestablish normal blood flow in the affected areas, the surgeon prescribed me Viagra (generic) 100 mg six weeks after surgery. Unfortunately, right after I started taking Viagra, I got sudden sensorineural hearing loss. My life became pretty sad because I lost my right hearing. In addition due to my prostate cancer I develop urticaria. Which is a normal reaction of the body fighting cancer.
To control urticaria I take Loratadine. Unfortunately Loratadine and all antihistamines are ototoxic. At the present time I have a high volume tinnitus. It is hard to decide weather to take antihistamines or to live with urticaria.
It is true medicines cause side effects. All of us will face sooner or later the fact that we have to take medicines. Besides to the fact that good doctors are really hard to find.
My best to all of you.
Hi Dan:
Why don’t you try other antihistamines instead of the Loratadine? All of them are ototoxic to some degree–some worse than others. But you may find one that doesn’t cause loud tinnitus. If it otherwise does the job, that seem to be a better choice rather than listening to loud tinnitus all the time.
Cordially,
Neil
To which degree are they ototoxic? Is there a ranking order?
Hi Ashley:
If you want to know more details about how a drug is ototoxic see my book “Ototoxic Drugs Exposed”. It tells what I know about the ototoxicity of each drug and I rank them from 1–low ototoxicity to 5–very high risk of ototoxicity.
You can get this book at https://hearinglosshelp.com/shop/ototoxic-drugs-exposed/ .
Cordially,
Neil
Hello dr Neil
Last year was very hard for me. I’ve never had any problems with my hearing but last year I had sudden hearing loss 2 times in my right ear in a narrow frequency range (fortunately hearing loss subsided but tinnitus stayed). I also had acoustic trauma in my left ear, and after that I have mild hyperacusis. After a year I’m feeling better but still I’m afraid of louder sounds and if I’m exposed to them my left ear feels a little muffled for a few hours or days.
Is it possible that my ears are now more fragile and they can be damaged more easily?
I was a musician (but it’s not my job) and now I don’t know should I still do it or is it too risky?
Few weeks ago I was at the dermatologist and he prescribed me acidi borici (10%) ointment and Fucibet Lipid (fusidic acid + betamethasone valerate (20mg+1mg) for my skin problem. Are these ointments safe for ears?
I’ll be very grateful for answering my questions.
Thank you dr Neil
Hi Pawel:
After all you ears have been through, I’d say they are definitely less robust than they were, so you want to protect them from louder sounds in the future. There is nothing wrong with playing or listening to music, just keep the level down to around 75 dB or so. Since most music is played well above that level, you need to wear ear protectors at such events.
The ointments you are taking probably won’t hurt your ears, but Fusidic acid and Betamethasone can be mildly ototoxic.
Cordially,
Neil
I only took one Praziquentil and 1 1/2 hours later tinitis started. It has been 1 month now. Do I have a chance it van heal?
Hi Deborah:
I don’t have tinnitus listed as a side effect for Praziquantel. You’re the first person to report this side effect of which I’m aware. So I don’t have any information on whether the tinnitus is temporary or permanent.
If it stays the same for the next month or so, you could assume it will be permanent, or at least long term. If that i the case, learn how to successfully deal with your tinnitus and it won’t bother you.
Cordially,
Neil
I have urticaria and the doctors recommended that I take an antihistamine to control the symptoms of the disease (mainly itching).
What is the least ototoxic antihistamine? Loratadine or fexofenadine?
Hi John:
Of the two, Loratadine would be the safer choice by a factor of about 6 TIMES according to my calculations.
Cordially,
Neil
Hello.
So is loratadine one of the safest antihistamines? I thought newer ones like fexofenadine would be safer to use
Hi John:
I think it is one of the safer ones from an ototoxic point of view. But you might also want to consider Cetirizine.
Cordially,
Neil
And what is the least ototoxic antihistamine? I took loratadine for two days and I feel like it spiked my tinnitus
Hi John:
You might want to try Cetirizine.
Cordially,
Neil
I’ll try this one later. And herbal medicines like Quercetin are ototoxic too?
Hi John:
Few herbals are ototoxic at normal dosages. As far as I know, quercetin is not ototoxic. I take it myself daily and have never had any problems.
Cordially,
Neil
I looked in all the pharmacies in my city and I didn’t find cetirizine in any of them. Are there any other antihistamines that are less ototoxic than possible?
Hi John:
Perhaps Cetirizine is only sold as a prescription drug. Did you check with your doctor?
Since there are a number of antihistamines in several different classes, it would be better if you send me a short list of the antihistamines that would do the job for you, and I can list them in order of ototoxicity.
Cordially,
Neil
Thanks, here’s a short list of drugs I found in pharmacies in my city.
dexchlorpheniramine
loratadin
fexofenadine
hydroxyzine
bilastine
Hi John:
Of these 5 drugs, I’d put them in this order of ototoxicity–from lowest to highest risk.
Dexchlorpheniramine
Hydroxyzine
Loratadine
Fexofenadine
Bilastine is a new drug and I have no information on its ototoxicity.
Cordially,
Neil
Hi Neil:
I was wondering if you could please rank these antihistamines: Benadryl, Reactine, and Singulair, from the least Ototoxic to the most? Thank you so much.
Hi Breanne:
Here’s how I see it. Montelukast (Singulair) is the least ototoxic, then Cetirizine (Reactine) and bringing up the rear is Diphenhydramine (Benadryl).
Cordially,
Neil
Thank you very much for the response Neil.
Hi Neil,
My daughter has LVAS & has been experiencing on & off nausea ( no vomiting ). Her pediatrician said she has fluid in her ears & combined with possible allergies advised her to take allegraD or Zyrtec D with Flonase . Do the D’s make them more ototixic?
Hi Crissy:
The D in these two drugs is for the addition of Pseudoephedrine which is mildly ototoxic so I don’t think it will make much difference to the overall ototoxicity of these drugs.
How did her doctor decide she had fluid in her ears? Was this just “wishful thinking” that she may have fluid in her ears? And how did her doctor decide that taking antihistamines would stop her nausea? I don’t like the idea of throwing drugs that have ototoxic (and other) side effects at a condition without knowing for sure what the problem is and knowing the drugs will help. This can just make things worse.
You may want to check this out before deciding on the drugs.
LVAS itself can cause dizziness and resulting nausea.
Cordially,
Neil
Hi Neil!
I took her to her pediatrician ( who knows nothing about LVAS) & he looked at her ears with his otoscope. He did an exam & asked her questions about any other symptoms. She only has on & off nausea but it has been consistent for 8 days. Last year she had this same thing but it went away by a week. Now, she did have a cold the week prior & had a cough so could it be from that since she has fluid remaining ? I have felt from the first day that this is caused by her ears . Do you have any suggestions? Thanks so much for your reply!!
Hi Crissy:
If you feel that this is due to the aftereffects of her cold, I’d just wait another week and see if it goes away like it did last year. Did she have a cold last year too that caused it?
If her ears are clear and she still has problems with balance, then it could be chronic and have something to do with LVAS, but rule out the cold first.
Cordially,
Neil
Yes, it was a couple weeks after having covid with her previous episode but it didn’t last as long & didn’t cause as much disruption with school. I saw your above list of antihistamines. To clear up the fluid should we try the first one listed with pseudoephedrine ? Or is there anything natural that would help?
Hi Crissy:
My philosophy is to let your body heal itself–not try to drug it into submission. Thus, I’m not in favor of using antihistamines to “dry up” a cold. Rather, support your body’s efforts to recover from the cold such as lots of rest and things like the proverbial chicken soup.
I don’t know which classes of antihistamines work for colds, so can’t recommend a given drug.
Cordially,
Neil
Hi Neil, I was wondering if Chlorpheniramine Maleate with Phenylephrine HCL would be low risk for ototoxic effects?? Or if there is a natural remedy that is safe to help resolve the fluid in her ears. Thanks for your words of wisdom!
Hi Crissy:
Chlorpheniramine/Phenylephrine is a relatively low risk drug as far as ototoxicity goes, so give it a try if you feel so inclined.
When you have fluid (gunk) in your middle ears/Eustachian tubes, you want it to drain out. In order to do that, it has to be “wet” enough. In other words drying out the gunk makes it thicker and thicker and that is harder to drain out than thin fluid. So it seems to me that trying to dry out your middle ears/Eustachian tubes is counterproductive to the results you really want to achieve.
In the colds I’ve had from time to time over the many years I’ve lived, I’ve never used drugs to get rid of any fluid. I let my body take care of it.
Cordially,
Neil
Hi Neil,
Thanks for the advice. It’s just what we did & she is much better now. It cleared on it’s own.
Thank you,
Crissy
Is topical minoxidil ototoxic? How much ototoxic compared with other medicines like anti-histamines?
Minoxidil is mildly ototoxic. It has about the same ototoxic risk as most of the H1 Receptor antagonist class of antihistamines with the exception of Loratadine and Fexofenadine which are more ototoxic.
Cordially,
Neil
Dear Dr. Bauman,
I’ve found here that some antihistamines can cause tinnitus. I didn’t know it and yesterday I used a nasal spray of Allergodil (Azelastini hydrochloridum) and my tinnitus got much worse. Do you think it could do some irreversible damage? And may I ask you if you could recommend some nasal spray for allergies that is safe for ears and also what kind of medication for allergy is safe?Thank you so much.
Sincerely,
Hana
Hi Hana:
Probably all antihistamines can cause tinnitus, so the trick is to find one that is least likely to cause tinnitus, or other ototoxic side effects.
As far as tinnitus goes, not a lot of people report tinnitus from taking Azelastine, but obviously you are one of them.
There are numerous other antihistamines in this same class of drugs that you could try. Not all of them are available in every country. Thus, the best way to approach this is to ask your doctor which antihistamines he thinks would work for you. Get a list of 3 or 4 or so. Then send them to me and I’ll tell you which would be the least likely to cause you tinnitus (in my opinion).
Cordially,
Neil
Dear Dr. Bauman,
I’m sorry for the additional message, I hope it is not too much from me. It’s been more than a year since I can’t sleep (first because of dysautonomia after Pfizer, then tinnitus after bisoprolol, and a bad reaction to CT scan with contrast). Life is very difficult without sleep and tinnitus is unbearable. I’m worried that because of lack of sleep, I made my tinnitus permanent. I can still see changes when I get rarely better sleep sometimes but from March when I took trazodone for sleep, my tinnitus got worse and I don’t see much improvement anymore. But it can be because my sleep is even worse since that time. Do you think when tinnitus has the chance to heal but there is no sleep, it can cause additional damage or changes on the brain and make tinnitus permanent?
I’ve tried many herbal remedies but nothing much helped because I’m getting strong chest spasms. After the experience with trazodone and mirtazapine, I’m worried to try it again. But I’ve discovered another possible medication Guajacuran (guaifenesinum). The pharmacist told me it shouldn’t cause a problem but I found this article so I’m not sure if that medication is really safe: https://www.medsafe.govt.nz/safety/ews/2015/guaifenesin-tinnitus.asp
May I ask you what you think about the safety of this medication?
And for that mirtazapine, I read in Tinnitus talk forum that people take it without problems but unfortunately I found this: http://www.psikofarmakoloji.org/pdf/EN/19_4_13.pdf
So I’m again worried. May I ask what do you think about that?
Thank you so much.
Sincerely,
Hana
Hi Hana:
You sure get in trouble when taking drugs, don’t you? That is why I recommend people seek other holistic treatments instead of drugs. That way you don’t get all the horrible side effects that drugs bring.
Lack of sleep doesn’t bring on tinnitus itself, but rather, lack of sleep stresses your body and this stress can make tinnitus worse–no doubt about it.
Whether your tinnitus is permanent or not so much depends on your mental/emotional/psychological make-up and how you deal with your tinnitus.
If your tinnitus is preventing you from falling asleep and staying asleep, you could try relaxing sound therapy to take the edge off your tinnitus and help you fall asleep.
No drugs are completely safe. They all have side effects. The drug Guaifenesin is somewhat ototoxic, but there haven’t been many reports of tinnitus (although there are a number), so I think trying it is worth the risk–although there are no guarantees it won’t affect your tinnitus.
As for Mirtazapine, that drug is moderately ototoxic in spite what the people on TinnitusTalk may say. (They can only speak for their own experiences, not the hundreds and hundreds of people that have reported to the FDA of getting tinnitus from taking this drug. Personally, I don’t think the higher risk of tinnitus and hearing loss is worth it.
Cordially,
Neil
Dear Dr. Bauman,
you are definitely right, I’m having problems with medications (though if I wouldn’t get a 3dr dose of vaccine, I probably wouldn’t even know about it). I’m sorry I didn’t read your recommendations yesterday, instead of Guaifenesin I took 0,2mg of Clonazepam (I did also on Sat night after a long time), and even such a small dose and rarely use causes a problem. In March I decided to completely stop risking with prescriptions and tried to find just a natural way how you recommend (and it’s the best recommendation that I’ve got). But then I found an article related to sleep and tinnitus and based on my experience, it makes sense. Until February when I was able time to time to get a good night’s sleep, my tinnitus was gradually improving. But from March after worsening due to trazodone, I basically don’t sleep and the tinnitus is just changing from a bit better to worse base on some circumstances (not gradual improvement anymore plus high sound and changes after trazodone and clonazepam).
Here are those articles:
https://www.dpag.ox.ac.uk/news/a-role-of-sleep-in-tinnitus-identified-for-the-first-time
https://www.healthyhearing.com/report/53340-Tinnitus-cure-slow-wave-sleep-research
“The brain also undergoes a widespread alteration of spontaneous activity when we sleep, and sleep disruption is a common symptom experienced by people with tinnitus. We also do not know how brain activity caused by tinnitus is affected by the state of being awake or asleep, nor how the effects of sleep on brain plasticity may contribute to the consolidation of tinnitus in affected people.”
“The non-dreaming stages account for about three-quarters of your total sleep time. In those periods, the brain produces different types of wave activity that slowly spread back and forth across the brain. At first, that wave activity may suppress the brain signals that create ringing in the ears. But when the wave is less intense, tinnitus signals may surge, awakening you.”
“Sleep is ultimately linked to how tinnitus develops over time. These findings will help researchers to identify a time window where delivering treatment for tinnitus will be most effective before it develops into a permanent condition. The findings also may provide information about how tinnitus affects sleep quality.”
So I´m worried that due to lack of quality sleep, tinnitus can become permanent (even one that had the potential to heal). So that’s why I was again trying to use medication because I thought it was very important to get sleep back and heal (how I was experiencing before).
May I ask what you think about this theory? I’ve also read that after 2 years is tinnitus in most cases permanent due to some brain changes: “The transition from occasional to constant tinnitus is accompanied by neuronal changes in the midbrain leading to a persisting tinnitus, which is then less likely to remit.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8884914/
But why the brain can’t get back to normal (under conditions when there is no ear structure damage) after the sleep quality would regain (and with the hope that sparingly used psychiatric medication won’t do some permanent change to the brain if it’s even possible)?
Also, I’ve read it’s not good to sleep in a silent room because then tinnitus gets louder the next day. For me, it wasn’t a problem to sleep in a silent room. When I fell asleep and got a good night’s sleep, my tinnitus used to be almost silent for half of the next day.
Thank you really so much for your time and patience.
Sincerely,
Hana
Hi Hana:
First, thanks for the links to those articles. They are interesting as far as they go. Those studies looked at various factors in regards to tinnitus and that is good. However, they seem to have left out one VERY important factor, and that is the amount and time of stress and anxiety those participants experienced.
It’s also hard to separate anxiety from sleep. If you are anxious you’ll typically have fitful sleep, not restful sleep.
It is also tied into sleep. If you are very anxious, you’ll have fitful sleep, and tinnitus is tied to stress/anxiety and to quality of sleep so these factors are interrelated.
When it comes to various ear problems, stress/anxiety is one of the main problems. It makes things not work quite right–but there is basically no permanent physical damage.
Once your brain has formed an endless tinnitus loop, it is hard, but not impossible, to break it. That is why you want to deal with tinnitus sooner, rather than later–to prevent it from forming this endless loop. So I agree that after two years it is going to be more difficult to break it.
They tell you not to sleep in a silent room if you have bothersome tinnitus, because the contrast between your tinnitus and silence is so great that it interferes with your sleep. Having sounds in your bedroom reduces the contrast between it and your tinnitus so it helps you get to sleep and stay asleep better.
However, if your tinnitus doesn’t bother you getting to sleep and staying asleep, then adding extra sound is not necessary and indeed, if you like silence in order to sleep, can negatively affect your sleep.
All of this is a round-about way of saying that if you stay calm both in mind and body, you will avoid a lot of ear (and other) problems. So learning how to relax and calm any anxiety is the way to save yourself a lot of health problems including tinnitus.
Cordially,
Neil
Dear Dr. Bauman,
Thank you very much for your reply and all information. I will ask my doctor when it is possible and then write to you here.
Sincerely,
Hana
Hi. I just read hydroxy can cause hearing loss and not suppose to take more than 4 months . But I took it 25 mg sometimes 2 times aday for a year. Now I have hearing loss also I have noise induced loss. Is that true about hydroxyzine and even though my ENT says my ringing will never stop cause of hearing loss . Can I recover hearing from this drug . I and does otc zertec cause tinnitis? Thanks
Hi Connie:
Where did you find this information. I’d love to have the link so I can read it myself.
If you have noise-induced hearing loss, how do you know that Hydroxyzine caused further hearing loss and not excess noise?
However, it is true that numbers of people have reported both hearing loss and tinnitus to the FDAs drug database, so you could very well have hearing loss from taking the Hydroxyzine.
Since tinnitus almost always accompanies hearing loss, your ENT is right that you could expect your tinnitus to be permanent since hearing loss is permanent. Since drug-induced hearing loss is typically caused by the death of hair cells in your inner ear, at present, there is nothing you can do to bring them back to life. Although research is progressing on hair cell regeneration, it is not available to the public. It may still be years away.
Cetirizine (Zyrtec) is in the same drug class as Hydroxyzine and drugs in the same class often have similar ototoxic side effects. This is the case with Cetirizine and Hydroxyzine. The both can cause hearing loss and tinnitus (among other ototoxic side effects). So switching from one to the other won’t necessarily be safer for your ears, but you can try it and see.
Cordially,
Neil
Dear Dr. Bauman,
I’m sorry it took me a while to be back and I hope it is not a problem that I extended my question to other kinds of medication. So if you allow me, I would like to ask what is your view on the following substances.
Allergy medication
1st generation (but they are the most cardiotoxic probably):
– hydroxyzine (I could use also for anxiety and sleep if it is safe)
– diphenhydramine
2nd generation:
– cetirizine
– loratadine
3rd generation (these would be probably safest choice from other reasons but I’m not sure about ototoxicity):
– rupatadin
– bilastine
– levocetirizine
– desloratadine
If you also know about some other medication that is possible to get in the US, you can write about it. Thank you.
Hi Hana:
Here’s how I’d stack these up in regards to causing tinnitus with the one at the top being the least risk in my opinion, but all can cause tinnitus in some people.
Hydroxyzine
Cetirizine / Levocetirizine
Diphenhydramine
Loratadine / Desloratadine
Cordially,
Neil
Dear Dr. Bauman,
So Hydroxyzine will be new for me but Levocetirizine I was taking so I’m glad it is less harmful.
Thank you.
Sincerely,
Hana
Nasal drops for allergies
– fluticasoni furoas
– azelastini hydrochloridum
Pain medication
– acetaminophen
– paracetamolum
– ibuprofen
– aspirin (how much is safe? or not at all rather?)
Nasal drops for cold
– oxymetazoline HCl
– xylometazolini hydrochloridum
Cough drops and sprays
– bromhexini hydrochloridum
– hexetidinum
– butamirati citras
– guaifenesinum
Nasal rinse NeilMed (sodium chloride, sodium bicarbonate)
Hi Hana:
If the choice is between Azelastine and Fluticasone, there are fewer reports of tinnitus from people taking Azelastine, but that could be because fewer people take that drug.
For pain medications, note that Acetaminophen and Paracetamol are the same drug. The latter name is used in Europe. I have more anecdotal reports of people getting tinnitus from taking Ibuprofen than for almost any other drug.
Aspirin has more reports of tinnitus than Acetaminophen, but tinnitus from taking Aspirin is typically temporary so it has the edge in that respect. Normally, you only get tinnitus from taking 5 or 6 adult aspirin a day, but if you are sensitive to aspirin, it can be MUCH less of a dose to set off tinnitus.
I don’t know, but I suspect that Oxymetazoline and Xylometazoline are about the same in regards to tinnitus, but I don’t have specific information on Xylometazoline. There are not very many reports of Oxymetazoline causing tinnitus so it may be relatively safe for you.
Guaifenesin is another drug that doesn’t have a lot of reports of tinnitus, so you may want to try it. I don’t know the other 3 drugs you mention so can’t speak to them.
Sodium chloride and sodium bicarbonate also have relatively few reports of tinnitus, so probably would be safe for you.
But remember, if you are sensitive to drugs, all the above could affect your tinnitus.
Cordially,
Neil
Dear Dr. Bauman,
I’m very glad to know that Ibuprofen can be very problematic because I’ve read how mainly Aspirin is bad and Ibuprofen safe. I just will be rather very careful with everything as you said.
Thank you so much for the information.
Sincerely,
Hana
Also, I would like to ask if people who got tinnitus from medication are more sensitive to medication and probability their tinnitus will get worse from other medication is higher than for people with tinnitus caused by acoustic trauma. I have bad experiences even with a single dose of trazodone (25mg) for sleep. It made tinnitus much worse and didn’t go back to level before (it’s been 2 months). But sometimes I’m confused because I’ve read some other opinions (from MDs) that for example trazodone or benzodiazepines are not ototoxic in the sense to cause damage of ear structures. They told these medications just change some brain chemicals and due to that cause tinnitus. Or it can be because they cause excess release of some chemicals in the brain that are ototoxic. I also got a spike from a single dose of 3,75mg mirtazapine (but it went back in a week). I also tried St John’s-worthand I was surprised how bad tinnitus it can make, even from tea. But before I got tinnitus from bisoprolol, I was taking 30 years (daily or all spring and summer) 2nd and then 3rd generation antihistamines (pills and nose sprays – antihis.+ corticosteroids) and I never experienced tinnitus.
Thank you so much for your time and help.
Sincerely,
Hana
Hi Hana:
Generally, I’d say that some people are more sensitive to ototoxic medications than other people. Those that are sensitive to drugs and get tinnitus from taking a certain drug will more often than not be more sensitive to other drugs too. You seem to be one of those people.
Some doctors define ototoxicity differently than others. Thus, if you take a given drug and you get tinnitus, some doctors would say the drug is ototoxic, while others would say no because as you said, it doesn’t physically damage the ear itself, but the changes occur in the brain.
I think most audiologists and doctors would say that if it results in tinnitus, it would be ototoxic even though it hasn’t physically damaged your ear structures but has “messed up” your auditory system somewhere along the line–either in your ears, your auditory nerves or in the auditory processing centers in your brain.
The way I define ototoxicity is any drug side effect that affects your hearing or balance systems whether in your ears or the auditory parts of your brain.
Tinnitus may or may not have something to do with your ears, but it always has something to do with your brain.
Obviously, the Bisoprolol changed something, somewhere along the line that has resulted in you becoming some sensitive to tinnitus when taking other drugs, even ones you had taken for decades previously without any problems.
Cordially,
Neil
Dear Dr. Bauman,
This is very interesting what you are saying about different views on the term. I was often confused. I wish there is at least hope when structures in the ear were not fully damaged, they can recover and when the problem was from some psychiatric medication, then in time the brain can get “healthy” too. But probably people who are healed from tinnitus are lifelong sensitive to sounds or ototoxic medication and they can very easily get the problem back. I wish it would be possible to heal fully back to normal before tinnitus onset.
Thank you so much for such detailed information and your time.
Sincerely,
Hana
Dear Dr. Bauman,
I’m sorry it’s again me. But I’m extremely sleep deprived, tried all herbal remedies with no success or causing me heart problems. I really need some medication that would help but not hurt. I thought a tiny dose of mirtazapine but I’m not sure if it can help or at least not hurt. Or what about quetiapine (it’s probably newer so I’m not sure if there is enough data)? I’m really desperate. Recently also the wind slammed the door in front of me and my tinnitus got even worse. Also, it’s been worse how I’m not sleeping. Is there, please, some safe medication for sleep and anxiety that doesn’t hurt ears (in very small doses), or haven’t some psychiatric side effects?
Thank you so much.
Sincerely,
Hana
Hi Hana:
I sure wouldn’t recommend Quetiapine (Seroquel). Even Mirtazapine would be less ototoxic that Quetiapine in my opinion.
What is it that is preventing you from sleeping–just your tinnitus, or something else? Do you use sound therapy at night–listening to relaxing music or water sounds, etc. to take the edge off your tinnitus so you can fall asleep and stay asleep?
Cordially,
Neil
Dear Dr. Bauman,
So I’m very glad I didn’t take it, thank you so much for the information. I started to have problems with sleeping after the CT scan with contrast when I had a bad reaction due to a high dose of that substance (my heart didn’t like it; basically after my vaccine-induced dysautonomia I’m having a bad heart reaction to almost all medication even in standard doses, and supplements as well). And from that time I’m having some severe anxiety reactions (or what is that) with strong painful chest and arms spasms and when this happens at night, there is no way to get rid of it. It eases off later in the morning or later in the day, it’s pretty difficult to be with it. When I’m lucky and sleep at least until 4 am, then still this happens. When I have better and longer sleep, I haven’t this problem. But unfortunately, last 4 months I’m not able to sleep better not at all. No herbal supplements help, often they cause some heart problems that make sleep difficult or impossible again. And of course, when my tinnitus gets worse (like recently after door slamming), I’m having anxiety because it’s louder and also I’m worrying it won’t heal after so many accidents (medication, loud noises, not sleeping). That’s why I’m looking for some safe medication because I’m having this problem for one year and 3 months.
Thank you very much for your help.
Sincerely,
Hana
Hi Hana:
What kind of contrast did you get? I know that the Gadolinium contrast dyes they use with MRIs can cause some nasty side effects. But I’ve not heard too much about CT scan contrast agents. I know they use radioactive contrast agents at times that can cause problems.
If you are now sensitive to most drugs and supplements, I don’t know how to find a “safe” one for you to take. You may have to change your approach and instead of drugs, learn ways to calm yourself down and reduce your anxiety as anxiety alone can cause all sorts of health problems including tinnitus.
Cordially,
Neil
Dear Dr. Bauman,
Unfortunately, I’m not sure what contrast it was, some iodine one. It really wasn’t a good experience. And you are right – I would rather stay away from heavy medication so I hope I will heal naturally and don’t need it.
Thank you for your help.
Sincerely,
Hana
Hi Hana:
It was probably a radioactive iodine isotope of some sort, but I’m no expert on this at all.
Cordially,
Neil
Also I’ve read some people take for their tinnitus low dose naltrexone.
Hi Hana:
Since low-dose Naltrexone (LDN) (1.5 mg) acts as an anti-inflammatory agent, if you have tinnitus there is a chance that it will help your tinnitus. So feel free to try it and see how if works for you.
However, because LDN blocks opioid receptors throughout your body for three or four hours, do not use LDN if you are taking an opioid agonist (narcotic medication) such as Tramadol (Ultram), Morphine, Dextromethorphan, Oxycodone (Percocet), Fentanyl (Duragesic) or any other narcotic or Codeine-containing medication until such medicine is completely out of your body.
Cordially,
Neil
Dear Dr. Bauman,
So I try to ask my doctor if it is possible to prescribe me that. I hope it will help with my weird anxiety reaction and at the same time heal my ears.
Do you think some other substances are worth trying or even constantly using for protecting ears? I’ve read people take NAC (but some report spikes after that), vitamin C, E, B12, folic acid, Mg, Zn, MSM, and taurine, after noise exposure even aspirin (surprisingly). Also quercetin and apigenin (but if it wasn’t coincidence, it made my tinnitus worse).
Thank you so much for your help.
Sincerely,
Hana
Hi Hana:
As you know, there are a lot of different things you can try. They help some people, but not all. So much depends on their body chemistry and their psychological makeup.
NAC does cause tinnitus spikes in a few people, but I don’t think it is very common, so you might want to try it and see how it works for you.
I do not have any reports of quercetin causing tinnitus so it might have been a coincidence. I’ve no information on apigenin causing tinnitus either.
Cordially,
Neil
Dear Dr. Bauman,
So I can try NAC slowly and I will see. Currently, I’m taking Cavinton (Vinpocetinum) so I wish it helps. I’m sorry I didn’t take it a year ago, maybe will be better chance to heal.
Thank you so much for all information.
Sincerely,
Hana
Hi Hana:
Yes, try the NAC and see whether it helps or not.
Cordially,
Neil