Did you know certain drugs can affect hearing? Ototoxic medications are a common cause of hearing loss and tinnitus—particularly among older adults. Learn about ototoxicity, which medications are ototoxic and what you can do to protect your hearing.
Otolaryngologist and research professor Dr. Leonard Rybak, Ph.D, M.D., explains, “Ototoxicity is the process by which the inner ear is damaged by a drug. It can affect either the balance system or the auditory system, or sometimes both.”
Ototoxicity literally means “ear poisoning” (“oto” = ear, “toxicity” = poisoning). Any substance that has the potential to damage the inner ear is considered ototoxic. Because inner ear organs control both hearing and balance, damage from ototoxic drugs and medicines can result in hearing loss, tinnitus and balance problems.
Many medications are known to have ototoxic effects. According to the American Speech-Language-Hearing Association, there are more than 200 known ototoxic medications in use today.
Ototoxicity symptoms may include:
Just because a medication is considered ototoxic does not mean it will have the same (or any) effects on everyone. Symptoms can vary considerably depending on a person’s age and health history, the type of ototoxic drug being ingested and the extent of exposure.
“Certain medications are very prone to damaging the inner ear and causing hearing loss,” Dr. Rybak says. “Those include mainly cisplatin and aminoglycosides.”
Common ototoxic drugs that may cause temporary hearing damage include:
Ototoxic drugs that often cause permanent hearing damage include:
Note: If you’re taking any of these medications on the advice of a physician, do not stop taking them. Speak with your doctor about any concerns you may have to determine what’s best for your situation.
There’s no specific test for ototoxicity. Doctors look at an individual’s health history, symptoms and hearing test (audiogram) results to make a diagnosis. They may also perform an ear inspection to rule out other potential hearing loss causes, such as an ear infection, ear wax buildup or a perforated eardrum.
Before starting a patient on an ototoxic drug, doctors are advised to conduct a baseline hearing test to help them monitor changes in the patient’s hearing during the treatment process. “If a patient didn’t have a previous hearing test prior to exposure to the drug, they wouldn’t know if they had hearing loss before or if it’s something related to the drug,” Dr. Rybak explains. “Before starting a patient on an ototoxic drug, doctors should do a baseline hearing test and do follow-up tests later to see if any changes have taken place.”
Treatment for ototoxic hearing loss is aimed at controlling the symptoms. Hearing aids (and, in more severe cases, cochlear implants) can significantly improve hearing for people with permanent hearing loss and tinnitus.
Researchers are working to develop ways to protect people from ototoxic medicines. At the time, there is no approved clinical method. However, there are several simple steps you can take to protect hearing: