Do you ever have a ringing sound in your ears?
Well, a pharmacist has revealed 11 of the most common medications that can cause the uncomfortable feeling known as tinnitus.
The condition, which affects more than 50 million people in the US, is a symptom of several medical conditions such as ear injury, earwax blockage or age-related hearing loss.
Sometimes the noise is present in one or both ears and is usually described as a ringing tone, but it can also present itself as a range of sounds including buzzing, roaring and whistling.
Although there is no cure, pharmacist Ayesha Gulzar says there are things you can do to reduce its impact, starting with checking what medications you’re taking.
She explains: ‘Certain medications cause tinnitus, which can be temporary or rarely permanent and depends on several factors.
“Common ototoxic medications (drugs that can have toxic effects on the ears) include antibiotics, analgesics (pain relievers), blood pressure medications, anticonvulsants (anti-seizure drugs), and others.”
First on Ms. Gulzar’s list of tinnitus-induced medications is Tylennol (acetaminophen), which is usually used to treat minor aches and pains.
Pharmacist Ayesha Gulza has revealed eleven medications that can cause the uncomfortable feeling known as tinnitus. The condition affects more than 50 million people in the US
She warns that long-term use of the painkiller can cause hearing problems.
Research has shown that the drug can even cause hearing loss in some cases, especially when used in high doses and in younger individuals.
This is because it can deplete a protective antioxidant in the inner ear called glutathione, making the ear more sensitive to damage from noise and other factors.
NSAIDs fall into the same category, and Ms. Gulzar says aspirin and ibuprofen are the worst offenders for causing temporary tinnitus when used in high doses.
Your browser does not support iframes.
Ms Gulzar then discusses antidepressants. Although they are sometimes used to treat tinnitus, she says they have “also been reported to cause or worsen tinnitus in people with previous symptoms.”
She explains why this happens: ‘Studies have suggested that serotonin can make tinnitus worse.
‘This means that selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant that increases serotonin (a chemical in the brain that regulates various functions such as mood and cognition), can make tinnitus worse.’
Some of the most common tricyclic antidepressants and SSRIs used to treat tinnitus-related symptoms include Zoloft, Lexapro, and Prozac.
Antiepileptic drugs can have a similar effect on hearing, as they can have a direct toxic impact on the inner ear, a phenomenon called ‘ototoxicity’ which damages the delicate hair cells responsible for hearing.
This can manifest as tinnitus, reduced hearing and balance problems, depending on the severity of the damage.
Ototoxicity with use of antiepileptic drugs (AEDs), says Ms. Gulzar, is “caused by delayed signal transmission between neurons (cells that carry signals throughout the body) and neurotransmitters (chemical messengers that carry messages between nerves).
‘These side effects can be temporary, long-lasting or irreversible.’
Moving on to her next medication to watch out for, Ms. Gulzar points out that anti-malarial medications have a greater chance of causing tinnitus if taken in high doses for a longer period of time.
Short-term use rarely causes tinnitus, but it can occur. The antimalarials most commonly associated with tinnitus are quinine, hydroxychloroquine (Plaquenil) and chloroquine.
Although benzodiazepines such as Xanax and Valium are used to treat various health conditions, including anxiety and panic disorders, they can cause tinnitus if stopped abruptly.
This is because the drugs can disrupt the normal neural pathways involved in hearing perception, leading to the perception of ringing sounds in the ears.
This withdrawal phenomenon is most common in people who have been taking the medication for a long time.
To avoid this side effect, Ms. Gulzar says a healthcare provider can help you taper your dose over weeks or months.
Although benzodiazepines such as Xanax and Valium are used to treat a variety of health conditions, they can cause tinnitus if stopped abruptly
A fair amount of blood pressure medications have also been found to cause temporary or permanent hearing loss and tinnitus.
Ms Gulzar says this mainly occurs in older adults and a healthcare provider should be alerted if symptoms develop.
Certain groups of antibiotics also fall into this category, with aminoglycosides – used to treat serious infections in people of all ages – being one of the culprits.
The health expert notes: ‘Aminoglycoside antibiotics are ototoxic drugs that can cause hearing loss.
‘They affect the inner ear and some people can develop tinnitus. Healthcare providers will closely monitor people taking these medications to detect any early hearing loss.”
The aminoglycoside drugs that carry a high risk of tinnitus include Amikacin, Neomycin, Kanamycin, and Tobramycin.
Although necessary for cancer treatment, studies have shown that common chemotherapy drugs appear to increase hearing loss in some adults and can lead to permanent damage.
Ms Gulzar explains: ‘Platinum-based drugs, such as cisplatin and, to a lesser extent, carboplatin and oxaliplatin, are the main chemotherapeutic drugs that can damage the ear.
However, taxane drugs (another class of chemotherapy drugs) can also affect hearing. Taxane drugs include Taxol (paclitaxel) and Taxotere (docetaxel).”
She highlights a study of 273 individuals who took both platinum-based and taxane-containing medications, and 37 to 40 percent of participants went on to develop tinnitus.
The last two medications Ms. Gulzar highlights are isotretinoin (formerly known by the brand name Accutane), an oral medication used to treat severe acne, and proton pump inhibitors (PPIs), which are used to treat and prevent stomach conditions.
She says both groups of medications can cause tinnitus in rare cases.
“Ask your healthcare provider about alternative options if you have complaints,” she concludes.