Do you ever hear a ringing, buzzing, or whistling sound in your ears? Tinnitus, which affects over 50 million Americans, can be an uncomfortable and persistent condition. Although it’s often caused by ear injuries, earwax buildup, or age-related hearing loss, medications can also play a significant role.
Pharmacist Ayesha Gulzar has identified 11 common medications that can trigger tinnitus. While tinnitus has no cure, understanding its potential causes can help manage its impact.
What is Tinnitus?
Tinnitus is the perception of sound when no external noise is present. It may occur in one or both ears and is commonly described as ringing. However, some people report buzzing, roaring, or even whistling sounds.
Although tinnitus itself is not a disease, it often signals underlying conditions. Causes range from earwax blockages to more serious issues like nerve damage or prolonged exposure to loud sounds.
How Medications Contribute to Tinnitus
Certain medications, known as ototoxic drugs, can damage the inner ear and trigger tinnitus. Depending on the drug and its dosage, the effects can be temporary or permanent. Ms. Gulzar explains that understanding the potential side effects of your medications is an essential first step in managing tinnitus.
Below are the medications most commonly associated with tinnitus and how they can affect your hearing.
1. Acetaminophen (Tylenol)
Acetaminophen, a widely used pain reliever, is a common culprit for tinnitus. Prolonged use, especially in high doses, can lead to hearing issues.
Research has found that acetaminophen depletes glutathione, a protective antioxidant in the inner ear. Without enough glutathione, the ear becomes more vulnerable to damage from noise and environmental factors.
2. NSAIDs (Aspirin and Ibuprofen)
Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen can also cause tinnitus. High doses are particularly problematic.
These medications affect blood flow to the inner ear, leading to temporary ringing or buzzing. Thankfully, symptoms usually resolve when the medication is stopped or the dosage is reduced.
3. Antidepressants
Antidepressants, including SSRIs (Selective Serotonin Reuptake Inhibitors) like Zoloft, Lexapro, and Prozac, are sometimes used to treat tinnitus. Ironically, they can also worsen the condition.
Ms. Gulzar explains that increased serotonin levels may exacerbate tinnitus symptoms. This makes it important to discuss potential side effects with a healthcare provider when starting antidepressants.
4. Anti-Seizure Medications
Anti-seizure drugs, or anticonvulsants, can have toxic effects on the inner ear. This damage, known as ototoxicity, can lead to tinnitus, hearing loss, and balance issues.
These side effects occur because the drugs interfere with the signals between neurons and neurotransmitters. Depending on the damage, symptoms may be temporary, long-lasting, or permanent.
5. Anti-Malarial Drugs
Anti-malarial medications, including quinine and hydroxychloroquine (Plaquenil), can trigger tinnitus when taken in high doses over long periods.
Short-term use rarely causes issues, but prolonged treatment increases the risk. Monitoring symptoms closely during treatment is essential.
6. Benzodiazepines (Xanax and Valium)
Benzodiazepines, used to treat anxiety and panic disorders, can cause tinnitus if stopped abruptly. Sudden withdrawal disrupts neural pathways involved in hearing, leading to ringing or buzzing sounds.
Healthcare providers recommend tapering off these medications gradually to minimize withdrawal symptoms.
7. Blood Pressure Medications
Several blood pressure-lowering drugs can trigger tinnitus or hearing loss, particularly in older adults. These medications may alter blood flow to the ears, causing temporary or permanent damage.
If you notice tinnitus after starting blood pressure medication, consult your doctor about possible alternatives.
8. Antibiotics (Aminoglycosides)
Certain antibiotics, such as aminoglycosides, are highly ototoxic. These drugs, used to treat severe infections, can damage the delicate hair cells in the inner ear.
Common aminoglycosides include amikacin, neomycin, kanamycin, and tobramycin. Healthcare providers carefully monitor patients on these medications for early signs of hearing loss.
9. Cancer Drugs
Chemotherapy drugs, particularly platinum-based medications like cisplatin, can cause tinnitus and permanent hearing loss.
Ms. Gulzar highlights studies showing that up to 40% of patients receiving platinum-based and taxane-containing drug regimens develop tinnitus. These medications are vital for cancer treatment, but hearing monitoring is crucial during use.
10. Isotretinoin (Accutane)
Isotretinoin, an oral medication for severe acne, has been linked to tinnitus in rare cases. Patients experiencing hearing changes while on this medication should notify their healthcare provider immediately.
11. Proton Pump Inhibitors (PPIs)
PPIs, commonly used to treat acid reflux and gastric issues, can also cause tinnitus in rare cases. While the risk is low, individuals experiencing symptoms should discuss alternative treatments with their doctor.
What You Can Do
If you suspect a medication is causing your tinnitus, don’t stop taking it without consulting a healthcare professional. Abruptly discontinuing some drugs, like benzodiazepines, can worsen symptoms.
Ms. Gulzar advises asking your doctor about alternative options or adjusted dosages. Healthcare providers can help find treatments that minimize side effects while addressing your health needs.
Conclusion
Tinnitus can be a frustrating and disruptive condition. While it has no cure, understanding its causes—including medications—can help manage its impact.
Ms. Gulzar emphasizes the importance of awareness. “Ask your healthcare provider about possible side effects,” she says. Monitoring symptoms and seeking professional advice are key steps to protecting your hearing.
With proper care, many people can reduce the effects of tinnitus and improve their quality of life.
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