If you’ve recently started a new medication and noticed ringing, buzzing or hissing in your ears, there may be a connection. Certain medications are known to be “ototoxic” — meaning they can affect your hearing or trigger tinnitus as a side effect. Understanding which medications carry this risk, and what to do if you’re affected, is an important part of managing your hearing health.
What Does Ototoxic Mean?
Ototoxicity refers to damage to the inner ear caused by a chemical substance. This can result in hearing loss, tinnitus, balance problems or a combination of all three. The NHS lists medication side effects as one of the recognised causes of tinnitus. Not everyone who takes an ototoxic medication will experience symptoms — the risk depends on the drug, the dosage, how long you take it, and individual factors such as kidney function and pre-existing hearing conditions.
Common Medications Linked to Tinnitus
The following categories of medication have been associated with tinnitus in clinical research. This is not an exhaustive list, and experiencing tinnitus while taking one of these medications does not automatically mean the drug is the cause.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Aspirin, ibuprofen and naproxen are among the most commonly used medications linked to tinnitus. At normal doses, the risk is low, but high doses or prolonged use can increase the likelihood of tinnitus developing. In most cases, tinnitus caused by NSAIDs is reversible once the medication is stopped or the dose is reduced.
Certain Antibiotics
Aminoglycoside antibiotics (such as gentamicin and streptomycin) carry a well-documented ototoxicity risk. These are typically used for serious infections and are usually administered in hospital settings where hearing can be monitored. Some macrolide antibiotics (such as erythromycin at high doses) have also been linked to temporary tinnitus.
Loop Diuretics
Furosemide (Lasix) and other loop diuretics, used to treat fluid retention and heart failure, can cause temporary tinnitus, particularly at higher doses or when administered intravenously. The effect is usually reversible.
Chemotherapy Drugs
Platinum-based chemotherapy agents (particularly cisplatin) are among the most ototoxic medications in clinical use. Patients receiving these treatments are usually monitored for hearing changes. The effects can unfortunately be permanent in some cases.
Quinine-Based Medications
Quinine, used for malaria treatment and sometimes for leg cramps, has a long-established association with tinnitus. Even tonic water, which contains small amounts of quinine, has been anecdotally linked to tinnitus in some individuals, though the concentration is typically very low.
Antidepressants
Some antidepressants, particularly certain SSRIs and tricyclic antidepressants, list tinnitus as a possible side effect. It’s worth noting that the relationship can be complex — stopping an antidepressant abruptly can also trigger tinnitus in some cases.
What Should You Do If You Suspect Your Medication Is Causing Tinnitus?
This is important: never stop or change your medication without speaking to your GP or prescribing doctor first. Some medications are essential for managing serious health conditions, and stopping abruptly can be dangerous.
Speak to your GP about the tinnitus and mention which medications you’re taking, including over-the-counter drugs and supplements.
Ask whether an alternative medication with a lower ototoxicity risk might be suitable for your condition.
If the medication is essential and cannot be changed, discuss strategies for monitoring and managing any hearing changes.
Consider booking a hearing assessment to establish a baseline. This gives you and your healthcare providers a reference point for tracking any changes over time.
Can Ototoxic Tinnitus Be Reversed?
In many cases, tinnitus caused by medication is temporary and resolves once the drug is discontinued or the dose is adjusted. However, some medications — particularly certain antibiotics and chemotherapy drugs — can cause permanent changes to the inner ear. Early detection through regular hearing monitoring gives you the best chance of catching and addressing any changes before they become irreversible.
Protecting Your Hearing While Taking Medication
Always read the patient information leaflet that comes with your medication and check for hearing-related side effects.
If you’re taking multiple medications, discuss the combined ototoxicity risk with your pharmacist or GP.
Avoid combining ototoxic medications with loud noise exposure, which can compound the risk.
If you have pre-existing tinnitus or hearing loss, make sure your prescribing doctor knows. They can factor this into their prescribing decisions. Custom ear protection can also help reduce additional noise-related risk.
Frequently Asked Questions
Can over-the-counter painkillers cause tinnitus?
At standard doses, the risk is very low. However, regular high-dose use of aspirin or ibuprofen has been linked to tinnitus in some patients. If you’re taking these medications frequently and notice any hearing changes, speak to your GP.
How quickly does medication-related tinnitus appear?
It varies. Some people notice tinnitus within hours of taking a new medication, while others develop it after weeks or months of use. If you’re starting a medication known to carry ototoxicity risk, it’s worth being aware of any hearing changes from the outset.
Should I get a hearing test if I think my medication is affecting my ears?
Yes. A comprehensive hearing assessment can identify whether there are any measurable changes to your hearing and provide a baseline for future monitoring. This is especially important if you’re on a long-term medication with known ototoxicity risk.
Can supplements cause tinnitus?
Some supplements, particularly those containing high doses of salicylates (similar compounds to aspirin), have been anecdotally linked to tinnitus. Always mention supplements to your GP when discussing hearing concerns.
Will my tinnitus stop if I switch medications?
If the tinnitus is directly caused by the medication, it often improves after switching. However, this depends on the drug, how long you’ve been taking it, and whether any permanent changes have occurred. Your GP can advise on the safest approach to any changes.
Is there a list of all ototoxic medications?
The RNID (Royal National Institute for Deaf People) and the British Tinnitus Association both provide resources on ototoxic medications. Your pharmacist can also check specific medications for ototoxicity risk.
Concerned that a medication might be affecting your hearing? Book a hearing assessment at Hear With Ish and we’ll establish a clear picture of your hearing health, discuss any concerns, and advise on next steps.
