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Which Is the Least Ototoxic Anti-Inflammatory Drug?

by Neil Bauman, Ph.D.

A person wrote,

I have residual tinnitus from sudden hearing loss that occurred about ten years ago. Fortunately, most of my hearing came back. However, I was exposed to a smoke alarm about a year and a half ago that aggravated my tinnitus. That, too, is under control as long as I stay away from loud sounds.

However, I noticed after the tinnitus aggravation, when I took an Aleve for a back problem, it caused severe pain in my ears and a tremendous, thankfully temporary, escalation in my tinnitus. It was a scary event.

At this point, I’m dealing with severe muscular pain and would like to know if there are any prescription or over-the-counter (OTC) anti-inflammatories that are not ototoxic. From information I have so far, it’s my understanding that all OTC NSAIDs are contraindicated for tinnitus symptoms.

I’d be glad of any information that will help me.

It seems like a good idea to get your book on ototoxic drugs, but I’m looking for the ones that are OK to take, and take today! Can you help me?

Tinnitus from Naproxen (Aleve) can be temporary or permanent. Actually, Aleve causes tinnitus in a considerable percentage of the people taking it, so if you want to avoid tinnitus, it is NOT the drug to be taking.

I don’t know of any anti-inflammatories that are not ototoxic to some degree—and all of which I know are listed as causing tinnitus. However, that doesn’t mean that every person that takes any of this class of drugs gets tinnitus. Many don’t, but numbers do.

Thus, although it may be impossible to find an anti-inflammatory drug that is not ototoxic, you can put the odds in your favor by choosing a drug that is the least ototoxic in regards to tinnitus. For example, you could choose a drug that only causes temporary tinnitus (such as Aspirin), or choose a drug that causes tinnitus in the smallest percentage of those taking it, or choose a drug that causes the mildest tinnitus. Hopefully, you can find a drug that does all three.

This kind of information, if available, is contained in my book Ototoxic Drugs Exposed. Therefore, by carefully studying the various drugs listed, even though they are all ototoxic to some extent, it will help you choose the one least likely to make your tinnitus worse.

If chronic inflammation is causing your back pain, you need to change your diet to reduce or eliminate this inflammation as much as possible. When you do this, you won’t have to worry about taking drugs that are ototoxic (or any drugs for that matter). Pages 160-162 in Ototoxic Drugs Exposed list the foods that are the most inflammatory, and those that are the least inflammatory. Thus, eliminating as many foods as you can from the first class, and beefing up those good foods in the second class, will go a long ways towards helping you get your inflammation under control.

In addition, Ototoxic Drugs Exposed contains a wealth of information on various aspects of drugs and health although I only list the drugs that are known to be ototoxic, not the ones that aren’t. If you can find an anti-inflammatory drug that is not listed in my book, there is a good chance it might not be ototoxic (but I could have missed it, it may be a new drug, or such side effects are not reported yet).

I suggest you get a copy and study the pertinent parts that apply to you so you can make wise decisions regarding which drugs you are willing to take. The first 13 chapters deal with drugs in general while chapter 14 (the bulk of the book) lists the various ototoxic side effects for each drug and how common, severe, etc. each side effect might be. There are a lot of anecdotal stories showing what real people have experienced with taking the various drugs. If you are interested, get yourself a copy of Ototoxic Drugs Exposed.

Reader Interactions

Comments

  1. George Wadding says

    January 10, 2024 at 2:55 PM

    is menthol 4% Topical Analgesic Ototoxic? If so to what degree?

    Reply
    • Neil Bauman, Ph.D. says

      January 11, 2024 at 8:45 AM

      Hi George:

      Pure menthol is toxic, but when diluted to 4%, I doubt it will cause problems. I’d rate it as only very mildly ototoxic unless you are particularly sensitive to menthol.

      Cordially,

      Neil

      Reply

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"The wages of sin is death, but the gift of God is eternal life [which also includes perfect hearing] through Jesus Christ our Lord." [Romans 6:23]

"But know this, in the last days perilous times will come" [2 Timothy 3:1]. "For there will be famines, pestilences, and [severe] earthquakes in various places" [Matthew 24:7], "distress of nations, the sea and the waves roaring"—tsunamis, hurricanes—Luke 21:25, but this is good news if you have put your trust in the Lord Jesus Christ, for "when these things begin to happen, lift up your heads [and rejoice] because your redemption draws near" [Luke 21:28].