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The Ultimate Tinnitus Treatment Guide

Medications That Can Cause And Worsen Tinnitus

Drugs that can cause or worsen tinnitus

By Doug Morris

More than 600 prescription drugs have been reported to cause or worsen tinnitus.

Below you will find a list of the most common ones that could be triggering the ringing in your ears.

For more than 50 million Americans, tinnitus is a frustrating problem with few treatments available.

You’ve probably heard that tinnitus starts because of being exposed to loud noises.

Or a serious injury like a concussion or whiplash.

It can also be started because of different diseases or even high blood pressure.

But did you know that tinnitus could also be caused by a doctor-prescribed medication?

Any medication that could cause tinnitus is called ototoxic which literally means “toxic to the ear” (“oto” means “ear” in Ancient Greek).

These drugs are all over the map.

From helping your heart disease, to relieving anxiety or depression, or even as a pain reliever, you could be starting or worsening tinnitus when you take these prescriptions that are meant to help a different health issue you are trying to solve.

Discover 12 natural tinnitus remedies and 8 physical treatments for quick relief! Get Your FREE Tinnitus Treatment Guide here.

Knowing which prescription drugs are common tinnitus triggers will help you when you meet with your tinnitus specialist. 

The truth is, not everyone will have a tinnitus side effect from these medications.

But if you are aware of at least the most common culprits, it could help you get your tinnitus under control.

And hopefully relieve the stress of the ringing in your ears.

1. Pain Relievers

Pain Relief Sign

Salicylate (Aspirin)

If you suffer from arthritis, the most likely cause of your tinnitus are the high doses of aspirin you’re taking to relieve your joint pain.

Studies have confirmed that taking high doses of Aspirin and similar medications posed a risk for hearing loss and developing tinnitus.

Ibuprofen (Advil & Motrin)

Taking Ibuprofen is what many Americans rely on for quick and easy pain relief.

For everything from headaches to joint pain and any kind of inflammation.

But there are risks involved.

Potential side effects from taking too much ibuprofen are:

  • Developing significant bleeding in your upper GI tract
  • Worsening heart failure
  • Developing liver and kidney problems
  • Increasing blood pressure
  • Triggering asthma
  • Dizziness
  • Eye problems
  • Developing stomach ulcers
  • Tinnitus and hearing loss

Research shows that those most at risk are:

  • Over 60 years of age
  • Taking anticoagulants
  • Have a history of upper GI tract bleeding

Acetaminophen (Tylenol)

Even taking acetaminophen isn’t without its potential issues.

Recently published studies show that the active ingredient in Tylenol caused individuals to develop tinnitus and even led to progressive hearing loss.

The good news is, with all of the above pain relievers, whether Aspirin, Advil, Tylenol or others, tinnitus will usually go away soon after you cut down or completely stop taking these drugs.

2. Anti-Depressants and Anti-Anxiety Medications

Anxiety Medication

Benzodiazepines or “Benzos”

Alprazolam (Xanax) and diazepam (Valium) are benzodiazepines that are used to treat anxiety.

The problem with these meds is that if you’ve been on them for a long time and you stop taking them, a major withdrawal symptom is tinnitus.

The best way to avoid this nasty side effect is to very gradually reduce your dose to wean you off and avoid as many side effects as possible.

This wean-off period should be done very slowly over several months, even up to a year.

Tricyclic Anti-depressants

Amitriptyline (Elavil) and nortriptyline (Pamelor) are used to help with many issues including anxiety, depression, chronic pain and even headaches and migraines.

The bad news is, both have been consistently linked to causing tinnitus.

In particular, Amitriptyline has been shown to cause tinnitus in low doses, occurring in people who have only been taking 10-mg doses for a few days.

Selective Serotonin Reuptake Inhibitor (SSRIs)

Selective Serotonin Reuptake Inhibitors are anti-depressants that deal mainly with severe anxiety and depression disorders.

Common SSRIs include:

  • Citalopram
  • Escitalopram
  • Fluoxetine
  • Paroxetine
  • Sertraline

Like tricyclic anti-depressants, SSRIs can cause tinnitus, but they can also worsen existing tinnitus symptoms.

If you’re struggling with anxiety and tinnitus, we’ve put together a list of ideas that are scientifically proven to help improve your anxiety.

3. Antibiotics

Antibiotics

Many antibiotics have been linked with triggering or worsening tinnitus.

If you have an antibiotic that is in eye drop or ointment form, there is little risk for tinnitus.

Antibiotics that you have to take orally or are injected are the ones that can be a problem for tinnitus symptoms.

Here are some of the common antibiotics that have been connected to tinnitus:

  • Azithromycin
  • Clarithromycin
  • Amikacin
  • Prulifloxacin
  • Rifampicin
  • Isoniazid
  • Vancomycin
  • Streptomycin

4. Acne Treatment

Acne

Isotretinoin

Isotretinoin is a powerful drug that can help severe acne.

Some of the brand names it’s sold under are Accutane, Absorica and Claravis.

Tinnitus and sometimes even hearing loss can happen when taking Accutane or other brands of isotretinoin.

Thankfully, it doesn’t happen in very many cases and will usually resolve when you stop taking the medication.

5. Blood Pressure and Heart Issues

Blood Pressure Check

Loop Diuretics

Loop Diuretics are used to treat heart failure, high blood pressure and kidney disease.

Tinnitus and hearing loss most frequently occur when these medications are taken in pill form or intravenously, and also have a higher occurrence rate with individuals suffering from kidney disease.

Beta-Blockers

Beta-blockers are used to treat individuals with high blood pressure and coronary artery disease.

Most of the time, these drugs work really well and usually don’t cause tinnitus.

But bisoprolol (Zebeta) and nebivolol (Bystolic) have both seen a much larger percentage of tinnitus symptoms than other beta-blockers.

ACE Inhibitors and Angiotensin Receptor Blockers

ACE inhibitors and Angiotensin Receptor Blockers such as lisinopril, enalapril, ramipril and irbesartan are used to lower blood pressure and can result in tinnitus.

Irbesartan is the biggest culprit – it frequently afflicts patients with bouts of tinnitus.

6. Anti-Malarial, Rheumatoid Arthritis and Lupus Drugs

Anti-Malarial Tablet

Chloroquine and Hydroxychloroquine

Chloroquine and hydroxychloroquine are used to treat malaria and autoimmune diseases like rheumatoid arthritis and lupus.

Both chloroquine and hydroxychloroquine have caused tinnitus and hearing loss in patients.

For most medications, tinnitus symptoms only occur while you’re taking the drugs.

But when it comes to these two, the damage to your hearing can be permanent.

Conclusion

Any medication you take will run the risk of side effects.

Knowing which drugs might be the reason you’ve started or worsened your tinnitus can be a big help in getting tinnitus relief.

Other things that can help tinnitus are knowing which foods to stay away from, getting enough good quality sleep and learning how to manage anxiety related to tinnitus.

You can also try cutting down your salt intake, reducing caffeine and sugar, and start some easy exercises to help improve the ringing in your ears.

References

Han, B. I., Lee, H. W., Kim, T. Y., Lim, J. S., & Shin, K. S. (2009). Tinnitus: characteristics, causes, mechanisms, and treatments. Journal of clinical neurology (Seoul, Korea), 5(1), 11–19. https://doi.org/10.3988/jcn.2009.5.1.11

Lee, S. J., Bae, C. H., Seo, J. P., & Jang, S. H. (2019). Diagnosis of Tinnitus Due to Auditory Radiation Injury Following Whiplash Injury: A Case Study. Diagnostics (Basel, Switzerland), 10(1), 19. https://doi.org/10.3390/diagnostics10010019

Shargorodsky, J., Curhan, G. C., & Farwell, W. R. (2010). Prevalence and characteristics of tinnitus among US adults. The American journal of medicine, 123(8), 711–718. https://doi.org/10.1016/j.amjmed.2010.02.015

Kim, H. J., Lee, H. J., An, S. Y., Sim, S., Park, B., Kim, S. W., Lee, J. S., Hong, S. K., & Choi, H. G. (2015). Analysis of the prevalence and associated risk factors of tinnitus in adults. PloS one, 10(5), e0127578. https://doi.org/10.1371/journal.pone.0127578

Barbieri, M. A., Cicala, G., Cutroneo, P. M., Mocciaro, E., Sottosanti, L., Freni, F., Galletti, F., Arcoraci, V., & Spina, E. (2019). Ototoxic Adverse Drug Reactions: A Disproportionality Analysis Using the Italian Spontaneous Reporting Database. Frontiers in pharmacology, 10, 1161. https://doi.org/10.3389/fphar.2019.01161

Sheppard, A., Hayes, S. H., Chen, G. D., Ralli, M., & Salvi, R. (2014). Review of salicylate-induced hearing loss, neurotoxicity, tinnitus and neuropathophysiology. Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale, 34(2), 79–93.

Pan, T., Tyler, R. S., Ji, H., Coelho, C., & Gogel, S. A. (2015). Differences Among Patients That Make Their Tinnitus Worse or Better. American journal of audiology, 24(4), 469–476. https://doi.org/10.1044/2015_AJA-15-0020

Risser, A., Donovan, D., Heintzman, J., & Page, T. (2009). NSAID prescribing precautions. American family physician, 80(12), 1371–1378.

Jenkinson, M. L., Fitzpatrick, R., Streete, P. J., & Volans, G. N. (1988). The relationship between plasma ibuprofen concentrations and toxicity in acute ibuprofen overdose. Human toxicology, 7(4), 319–324. https://doi.org/10.1177/096032718800700404

Kalinec, G. M., Thein, P., Parsa, A., Yorgason, J., Luxford, W., Urrutia, R., & Kalinec, F. (2014). Acetaminophen and NAPQI are toxic to auditory cells via oxidative and endoplasmic reticulum stress-dependent pathways. Hearing research, 313, 26–37. https://doi.org/10.1016/j.heares.2014.04.007

Mendis, D., & Johnston, M. (2008). An unusual case of prolonged tinnitus following low-dose amitriptyline. Journal of psychopharmacology (Oxford, England), 22(5), 574–575. https://doi.org/10.1177/0269881107082126

Langguth, B., Landgrebe, M., Wittmann, M., Kleinjung, T., & Hajak, G. (2010). Persistent tinnitus induced by tricyclic antidepressants. Journal of psychopharmacology (Oxford, England), 24(8), 1273–1275. https://doi.org/10.1177/0269881109106929

Md Daud, M. K., Mohamadl, H., Haron, A., & Rahman, N. A. (2014). Ototoxicity screening of patients treated with streptomycin using distortion product otoacoustic emissions. B-ENT, 10(1), 53–58.

Barbieri, M. A., Cicala, G., Cutroneo, P. M., Mocciaro, E., Sottosanti, L., Freni, F., Galletti, F., Arcoraci, V., & Spina, E. (2019). Ototoxic Adverse Drug Reactions: A Disproportionality Analysis Using the Italian Spontaneous Reporting Database. Frontiers in pharmacology, 10, 1161. https://doi.org/10.3389/fphar.2019.01161

Rosende, L., Verea-Hernando, M. M., de Andrés, A., Piñeyro-Molina, F., Barja, J., Castro-Castro, S., & Fonseca, E. (2011). Hypoacusia in a patient treated by isotretinoin. Case reports in medicine, 2011, 789143. https://doi.org/10.1155/2011/789143

Landier W. (2016). Ototoxicity and cancer therapy. Cancer, 122(11), 1647–1658. https://doi.org/10.1002/cncr.29779

Bagshaw, S. M., Delaney, A., Haase, M., Ghali, W. A., & Bellomo, R. (2007). Loop diuretics in the management of acute renal failure: a systematic review and meta-analysis. Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine, 9(1), 60–68.

About the author 

Doug Morris

Doug is a health researcher who has spent over 30 years as a publisher and consultant in the natural health industry. During his retirement, he spends upwards of 10 hours a day sifting through health journals and reading about new and exciting health breakthroughs - especially those regarding potential tinnitus cures. In his free time, Doug enjoys trying new restaurants and hiking with his Golden Retriever.

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