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    Old 04-26-2005, 03:17 AM   #1
    Cuilc's Avatar
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    Tinnitus and hearing loss - drugs that can cause it

    Found this on the internet which may be of use to some people. I was prescribed temazepam last week to help me sleep as I'm suffering from severe tinnitus after an ear infection. It's on the list!

    Ototoxic Medications:
    Drugs That Can Cause Hearing Loss and Tinnitus

    Orin S. Kaufman, D.O.
    Physician, a volunteer at the League for the Hard of Hearing, and a late-deafened adult.

    The importance of compiling and publishing a list of fairly commonly used medications and compounds that can cause either tinnitus and/or hearing loss is self-evident. Usually, these problems are reversible; that is, the hearing change is corrected when the medication is discontinued. But there are still infrequent times when this change can be permanent. If someone is experiencing a hearing problem or if there is a hearing disorder in the family, it is imperative the treating physician be aware of this fact. If a person is prescribed one of the medications found on this list, (s)he should speak to the physician to see if another, potentially less toxic drug could be used in its place.

    This information is very important to a physician. Armed with it, (s)he may then be able to prescribe a drug that would have a potentially less toxic effect on hearing. The likelihood of having a problem with hearing from the use of one of these medications is usually extremely small. The drugs with the greatest potential to cause a hearing loss are usually used only in life-threatening situations.

    Remember, the physician is the person best qualified to determine which medication is best for you. It is important that (s)he be aware of not only any real or potential problems concerning hearing, but also of any other conditions which may be present that would influence the selection of medication.

    In the lists that follow, the generic name of the drug is given first, with the trade name, if available, following in parentheses and capitalized. Also, many times a particular generic drug is produced by different manufacturers with different trade names. The trade names mentioned in this article were selected by the author over other trade names purely by coincidence. The inclusion of a particular trade name and the exclusion of another should not be interpreted as prejudicial either for one nor against the other.

    Drugs That Can Cause Hearing Loss

    A. Salicylates

    1. aspirin and aspirin-containing products
    2. salicylates & methyl-salicylates (linaments)

    (Toxic effects appear to be dose related and are almost always reversible once medications are discontinued).

    B. Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)

    1. diclofenac (Voltaren)
    2. etocolac (Lodine)
    3. fenprofen (Nalfon)
    4. ibuprofen (Motrin, Advil, Nuprin, etc.)
    5. indomethacin (Indocin)
    6. naproxen (Naprosyn, Anaprox, Alleve)
    7. piroxicam (Feldene)
    8. sulindac (Clinoril)

    (Toxic effects are dose related and are almost always reversible once medications are discontinued).

    C. Antibiotics

    1. aminoglycosides
    a. amikacin (Amakin)
    b. gentamycin (Garamycin)
    c. kanamycin (Kantrex)
    d. neomycin (Found in many over-the-counter antibiotic ointments)
    e. netilmicin (Netromycin)
    f. streptomycin
    g. tobramycin (Nebcin)

    (Of particular interest is that topical ear drop medications containing gentamycin or neomycin do not appear to be ototoxic in humans unless the tympanic membrane (ear drum) is perforated. When a solution of an aminoglycoside antibiotic is used on the skin together with an aminoglycoside antibiotic used intravenously, there is a risk of an increase of the ototoxic effect, especially if the solution is used on a wound that is open or raw, or if the patient has underlying kidney damage.

    Neomycin is the drug that is most toxic to the structure involved in hearing, the cochlea, so it is recommended for topical use only. But even topical therapy has resulted in hearing loss when large areas were treated which allowed for large amounts of the drug to be absorbed into the body. Hearing loss caused by this class of antibiotics is usually permanent).

    2. erythromycin

    a. EES
    b. E-mycin
    c. Ilosone
    d. Eryc
    e. Pediazole
    f. Biaxin
    g. Zithromax

    (Usually ototoxic when given in intravenous doses of 2-4 grams per 24 hours, especially if there is underlying kidney failure).

    3. vancomycin (Vancocin) (Similar to aminoglycosides in that it may be ototoxic when used intravenously in life- threatening infections. To further exaggerate the problem is the fact that aminoglycosides and vancomycin are often used together intravenously when treating life-threatening infections).
    4. minocycline (Minocin) (Similar to erythromycin).
    5. polymixin B & amphotericin B (Antifungal preparations).
    6. capreomycin (Capestat) (Anti-tuberculosis medication).

    D. Diuretics

    1. bendroflumethazide (Corzide)
    2. bumetadine (Bumex)
    3. chlor-thalidone (Tenoretic)
    4. ethacrynic acid (Edecrin)
    5. furosemide (Lasix)

    (These are usually ototoxic when given intravenously for acute kidney failure, acute hypertensive crisis, or acute pulmonary edema/congestive heart failure. Rare cases of ototoxicity have been found when these medications are taken orally in high doses by people with chronic kidney disease).

    E. Chemotherapeutic Agents

    1. bleomycine (Blenoxane)
    2. bromocriptine (Parlodel)
    3. carboplatinum (Carboplatin)
    4. cisplatin (Platinol)
    5. methotrexate (Rheumatrex)
    6. nitrogen mustard (Mustargen)
    7. vinblastin (Velban)
    8. vincristine (Oncovin)

    (The ototoxic effects can be minimized by carefully monitoring blood levels).

    F. Quinine

    1. chloroquine phosphate (Aralen)
    2. quinacrine hydrochloride (Atabrine)
    3. quinine sulfate (Quinam)

    (The ototoxic effects are very similar to those of aspirin).

    G. Mucosal Protectant

    1. misoprostol (Cytotec)

    Drugs That Can Cause Tinnitus

    This list of drugs is very similar to the list of ototoxic drugs that can cause hearing loss. There are some notable additions to the previous list.

    A. Vapors, Solvents

    1. cychohexane
    2. dichloromethane
    3. hexane (gasoline)
    4. lindane (Kwell)
    5. methyl-chloride
    6. methyl-n-butyl-ketone
    7. perchlor-ethylene
    8. styrene
    9. tetrachlor-ethane
    10. toluol
    11. trichloroethylene

    B. Antibiotics

    1. aminoglycosides (see previous section)
    2. amphotericin B
    3. chloramphenicol (Chloromycetin)
    4. minocycline (Minocin)
    5. polymyxine B
    6. sulfonamides (Septra, Bactrim)
    7. vancomycin (Vancocin)

    C. Anti-Neoplastics

    1. bleomycin (Blenoxane)
    2. cis-platinum (platinol)
    3. carboplatinum (Paraplatin)
    4. methotrexate (Rheumatrex)
    5. nitrogen mustard (Mustagen)
    6. vinblastin (Velban)

    D. Diuretics

    1. acetazolamide (diamox)
    2. bumetanide (Bumex)
    3. bendrofluazide
    4. clorothalidone (Hygroton, Tenoretic)
    5. diapamide
    6. ethacrynic acid (Edecrin)
    7. furosemide (Lasix)
    8. hydrochlorthiazide (Hydrodiuvil)
    9. methylchlorthizide (Enduron)

    E. Cardiac Medications

    1. celiprolol
    2. flecainide (Tambocar)
    3. lidocaine
    4. metoprolol (Lopressor)
    5. procainamide (Pronestyl)
    6. propranolol (Inderal)
    7. quinidine (Quinaglute, Quinidex)

    F. Psychopharmacologic Agents

    1. amitryptiline (Elavil)
    2. benzodiazepine class
    a. alprazolam (Xanax)
    b. clorazepate (Tranxene)
    c. chlordiazepoxide (Librium)
    d. diazepam (Valium)
    e. flurazepam (Dalmane)
    f. lorazepam (Ativan)
    g. midazolam (Versed)
    h. oxazepam (Serax)
    i. prozepam (Centrax)
    j. quazepam (Doral)
    k. temazepam (Restoril)
    l. triazolam (Halcion)
    3. bupropion (Welbutrin)
    4. carbamzepine (Tegretol)
    5. diclofensine
    6. doexpin (Sinequin)
    7. desiprimine (Norpramin)
    8. fluoxetin (Prozac)
    9. imipramine (Tofranil)
    10. lithium
    11. melitracen
    12. molindon (Moban)
    13. paroxetin
    14. phenelzin (Nardil)
    15. protriptilin (Vivactil)
    16. trazodon (Desyrel)
    17. zimeldin

    G. Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)

    1. asprin
    2. acematacine
    3. benorilate
    4. benoxaprofen
    5. carprofen
    6. diclofenac (Voltaren)
    7. diflunisal (Dolobid)
    8. fenoprofen (Nalfon)
    9. feprazon
    10. ibuprofen (Motrin, Advil, Nuprin)
    11. indomethacin (Indocin)
    12. isoxicam
    13. ketoprofen (Orudis)
    14. methyl salicylates (BenGay)
    15. naproxen (Naprosyn, Anaprox, Alleve)
    16. D-Penicilliamin
    17. phenylbutazone (Butazolidine)
    18. piroxicam (Feldene)
    19. proglumetacin
    20. proquazon
    21. salicylates
    22. sulindac (Clinoril)
    23. tolmetin (Tolectin)
    24. zomepirac

    H. Glucocorticosteroids

    1. prednisolone (Prednisone)
    2. ACTH (adrenocorticotrophic hormone) (Acthar)

    I. Anesthetics

    1. bupivacain
    2. tetracain
    3. lidocaine (Novacaine)

    J. Antimalarials

    1. chloroquine (Aralen)
    2. hydroxychloroquine (Plaquinil)

    K. Miscellaneous Toxic Substances

    1. alcohol
    2. arsenum
    3. caffeine
    4. lead
    5. marijuana
    6. nicotine
    7. mercury
    8. auronofin (gold), (Ridaura)

    Ironically, several of these drugs found to cause tinnitus are also used to treat tinntus (e.g. amitryptiline, benzodiazepine class, carbamzazpine, furosemide, lidocaine, prednisone).

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    Old 04-29-2005, 10:15 PM   #2
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    Re: Tinnitus and hearing loss - drugs that can cause it

    That is very interesting to hear b/c ive been taking Restoril for about 10 yrs,,i am addicted so what am i to do? i have gone as far as cutting the dosage inhalf(its a capsule, so it takes alot of time & patience to divide it.~
    Im sure it will take years to get off this med,,in the meantime I have to live with the tennitus. IF the meds are indeed the reson behind it?

    I have taken valium for the ringing & it has Always helped,,,weird huh? maybe b/c i take 2 mg sparingly~

    Old 05-01-2005, 01:08 PM   #3
    lori j
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    Re: Tinnitus and hearing loss - drugs that can cause it

    Yes, very interesting. I was on naproxen for back pain all winter & am off it 7 weeks & still have ringing in my ears. It all started when taking naproxen & also I have the heart beating sound in my left ear only. I have the fullness feeling in my ears & some vertigo. Anyone know what the residual effects are of these meds?

    Old 05-20-2006, 02:30 PM   #4
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    Thumbs down Re: Tinnitus and hearing loss - drugs that can cause it

    I was given Zithromax tablets-Z-pak for three days and developed tinnitus and loss of hearing just after that. I went to about five doctors and all but one said they had never heard of this.Somehow i don't believe the. I went into a depression and had to take anti-depressants for relief. It really affected my like.I would lkie to hear from anyone else with this problem.

    Old 07-26-2007, 06:42 PM   #5
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    Re: Tinnitus and hearing loss - drugs that can cause it

    Hi did your symptoms get better. How's your hearing now? I was on zithromax last week and i think i might be experiencing the same side effects.

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