Medications That Cause Hearing Loss: What You Need to Know

Some prescription and over-the-counter medicines can damage the ears and affect hearing. These are called “ototoxic” medications. While many people can take them safely, certain drugs increase the risk of symptoms such as hearing loss, tinnitus (ringing in the ears), or balance problems. Understanding which medications that cause hearing loss are most common, and what warning signs to watch for, can help you protect your hearing while still treating other health conditions.

What Is Ototoxicity?

Ototoxicity means “toxic to the ear.” Ototoxic medicines can damage the inner ear structures that are responsible for hearing and balance, including the cochlea and the vestibular system. For some people, this damage is temporary and improves after the medication is stopped. In other cases, it can be permanent.

Not everyone who takes an ototoxic drug will develop hearing problems. Risk depends on the specific medication, the dose, how long you take it, your overall health, and whether you’re taking more than one ototoxic drug at the same time.

Common Ototoxic Medications in the US

Below is an overview of common ototoxic medications used in the United States. This is not a complete ototoxic drugs list, but it covers many of the more frequently prescribed categories.

Aminoglycoside Antibiotics

Aminoglycosides are powerful antibiotics used mainly for serious, life-threatening infections. They are usually given in hospitals through an IV.

• Examples include gentamicin, tobramycin, and amikacin.
• They can cause permanent inner-ear damage in some people.
• The risk increases with higher doses, longer treatment, and kidney problems.

Aminoglycoside antibiotics hearing loss risk is one reason these drugs are used only when other antibiotics will not work or are not appropriate. Blood levels may be monitored during treatment to lower the risk of side effects.

Loop Diuretics

Loop diuretics are “water pills” often used to treat high blood pressure, heart failure, and swelling (edema). They help the body get rid of extra fluid and salt.

• Examples include furosemide (Lasix), bumetanide (Bumex), and torsemide.
• High doses, especially when given by IV and combined with other ototoxic drugs, can increase the risk of hearing changes.
• Hearing loss or diuretics tinnitus symptoms are usually temporary, but not always.

If you are on a loop diuretic and notice new ringing in your ears or muffled hearing, talk with your prescriber promptly.

Salicylates and NSAIDs

Salicylates (like aspirin) and nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for pain, inflammation, and fever. They are available both by prescription and over the counter.

• Examples include aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve).
• Hearing loss from NSAIDs is often linked to higher doses or long-term, frequent use.
• Symptoms may include temporary tinnitus, a sense of “plugged” ears, or reduced hearing clarity.

Many people can use these medicines safely in recommended doses. Problems are more likely if you take large doses, combine several pain relievers, or have other risk factors such as kidney disease.

Chemotherapy Medications

Certain chemotherapy drugs used to treat cancer can damage the inner ear.

• Platinum-based drugs such as cisplatin and carboplatin are among the most common.
• They can cause permanent high-frequency hearing loss and tinnitus in some patients.
• Children and older adults may be at higher risk.

Because these medications can be lifesaving, doctors weigh the cancer-fighting benefits against the potential hearing risks. Hearing tests before, during, and after treatment are often recommended.

Other Medications That May Affect Hearing

Several other groups of drugs have been linked to ototoxic side effects in some people.

• Certain antibiotics: Some non-aminoglycoside antibiotics have been associated with rare hearing changes, usually at high doses or in people with existing risk factors.
• Antimalarial drugs: Medications such as quinine and chloroquine may cause reversible or, less commonly, irreversible hearing symptoms in some individuals.
• Some heart and blood pressure medications: A few can cause tinnitus or dizziness for certain patients, though they are not always permanently ototoxic.

Your prescriber or pharmacist can review your medication list and explain whether any of your medicines are known to be ototoxic.

Drugs That Cause Tinnitus

Tinnitus—ringing, buzzing, hissing, or roaring in the ears with no external sound source—is a common side effect of ototoxic medications. Not everyone exposed will get tinnitus, and for some people it goes away after the medication is reduced or stopped.

Drugs that cause tinnitus may include:

• High-dose aspirin and other salicylates
• Some NSAIDs used for pain and inflammation
• Loop diuretics in higher doses
• Certain chemotherapy agents, especially cisplatin
• Some antibiotics, particularly aminoglycosides

If you notice new or worsening tinnitus after starting a medication, do not stop anything suddenly without medical guidance. Instead, contact the prescribing provider to discuss options and next steps.

Symptoms of Ototoxicity to Watch For

Ototoxicity can develop quickly or gradually, and it may affect one or both ears. Common symptoms of ototoxicity include:

• New hearing loss or difficulty understanding speech, especially in background noise
• Ringing, buzzing, or roaring sounds in the ears (tinnitus)
• A feeling of fullness, pressure, or “plugged” ears
• Vertigo (spinning sensation) or trouble with balance
• Increased sensitivity to sound

These symptoms may appear during treatment or shortly afterward. In some cases, changes are subtle at first and easy to miss without testing.

Who Is at Higher Risk?

Anyone taking an ototoxic medication can be affected, but some people face a higher risk of hearing problems, including:

• People taking high doses or long-term courses of ototoxic drugs
• Those using more than one ototoxic medication at the same time
• Individuals with kidney or liver disease, which can affect how drugs are cleared
• People with existing hearing loss or ear disorders
• Newborns, children, and older adults

If you fall into one or more of these groups, your doctor may recommend closer monitoring, including regular hearing tests during treatment.

How Ototoxic Medications Are Monitored

When a medication has known ototoxic potential, especially in higher-risk situations, healthcare providers may recommend:

• Baseline hearing test (audiogram): Done before treatment begins to document your starting hearing levels.
• Ongoing hearing checks: Repeated tests during and after treatment to detect early changes.
• Medication adjustments: Changing the dose, schedule, or drug type if hearing problems develop and it is medically safe to do so.

Early detection allows your care team to respond quickly and may reduce the chance of long-term damage.

What to Do If You Notice Hearing Changes

If you think a medicine is affecting your hearing or balance:

• Contact your prescribing provider: Explain your symptoms and when they started.
• Do not stop critical medications on your own: Suddenly stopping some drugs can be dangerous.
• Ask about alternatives: In some cases, a different drug or a lower dose may be possible.
• Schedule a hearing test: An audiologist can measure your hearing and monitor changes over time.

Bring a current list of all your medications—including over-the-counter pain relievers, supplements, and herbal products—when you see your doctor or hearing specialist.

Protecting Your Hearing While Taking Necessary Medications

Sometimes, the benefits of an ototoxic medication outweigh the risks. When that happens, you can still take steps to lower the chance of hearing problems:

• Use the lowest effective dose for the shortest possible time, when appropriate.
• Avoid combining multiple drugs with known ototoxic effects unless your doctor advises it.
• Tell your providers about any past ear problems or hearing loss.
• Protect your ears from loud noise, which can add to medication-related damage.
• Keep all recommended monitoring appointments, including follow-up hearing tests.

Open communication with your healthcare team helps balance treatment goals with hearing protection.

When to Seek Emergency Care

Get urgent medical help right away if you:

• Suddenly lose hearing in one or both ears
• Develop severe vertigo, trouble walking, or sudden balance loss
• Have hearing changes along with other serious symptoms such as chest pain, severe headache, or trouble breathing

Sudden hearing loss is a medical emergency. Early treatment can sometimes improve the chances of recovery.

The Bottom Line on Medications That Cause Hearing Loss

Many widely used drugs are safe for most people when taken as directed, but some carry a known risk of ototoxicity. Being aware of medications that cause hearing loss, understanding the early warning signs, and getting regular hearing checks when needed can help you and your healthcare team respond quickly to any changes. If you are concerned about how a current or future medication could affect your ears, discuss the risks and benefits with your doctor or pharmacist and consider scheduling a baseline hearing evaluation.