Medications That Cause Tinnitus
If you are experiencing ringing in the ears, a primary care doctor can conduct an exam and order blood tests to identify whether medication could be the cause. He or she may refer you to an ENT for more in-depth testing as well as hearing tests.
Aminoglycoside antibiotics can lead to tinnitus in your ears by damaging hair cells of the inner ear, which play an integral role in hearing by sensing sound and motion, so protecting these hair cells is paramount for maintaining good hearing health. Therefore, it’s advisable to check with your physician after taking medications such as antibiotics if there are any symptoms of tinnitus in the ears; should any damage occur you should consult an audiologist immediately for repair services.
Aminoglycoside antibiotics were among the first clinically utilized after penicillin’s discovery, being some of the earliest medications taken after its discovery. These types of antibiotics work by inhibiting protein synthesis. By binding to RNA within bacteria’s ribosomes and making protein production harder for them to do, aminoglycoside antibiotics kill them off quickly while often producing postantibiotic effects which mean the bacteria won’t return quickly once treatment stops.
Though their use has declined over time with the rise of less toxic broad-spectrum antibiotics, these antibiotics continue to be useful for treating infections caused by Gram-negative bacteria that resist other treatments and often come prescribed alongside cephalosporins and fluoroquinolones.
Aminoglycosides are natural or semisynthetic antibiotics derived from actinomycetes that contain aminocyclitol with various nitrogen-containing sugars, providing basic water-soluble molecules with antibacterial efficacy against Gram-negative bacteria. Streptomycin was the prototype in this class of drugs, derived from Streptomyces griseus; others in its family include: neomycin (1949, Streptomyces fradiae); kanamycin (1949, Streptomyces fradiae); Gentamicin (from Micromonosporum purpurea); Gentamicin (from Micromonosporum purpurea); Tobramycin (S.tenebrarius); all containing its common 2-deoxystreptamine moiety shown.
If you have had cancer, or are currently undergoing chemotherapy treatments, your oncologist may prescribe medications which could lead to hearing changes. These may include certain forms of chemotherapy drugs containing platinum-based chemotherapies; such medications are commonly used for breast, bladder, testicular, ovarian and lung cancer treatments and can cause hearing loss as well as tinnitus symptoms.
Tinnitus may also be caused by radiation therapy or other head and neck cancer treatments, for instance radiotherapy for nasopharyngeal cancer can lead to audiogenic hearing loss (tinnitus in the ears) that usually resolves itself after treatment ends but in rare instances can remain long term.
Other causes of tinnitus may include loud noise exposure, ear infections and head injuries. You can take steps to try to minimize their triggers – like avoiding caffeine, alcohol and tobacco which may make symptoms worse – as well as treatments such as retraining therapy, hearing aids and counseling that could provide some relief.
In the COMP-VA study, subjects were asked to report any changes in their tinnitus due to medication treatment regimen. Tinnitus incidence was then broken down by treatment group; cumulative drug dose and initial onset of tinnitus did not seem related at all. This may be the result of dosage differences across the Cisplatin, Carboplatin and Ototoxic Antibiotic Groups; older participants were more likely to experience tinnitus than those in the Control Group. However, logistic regression analyses did not show significant relationships between cumulative drug dose and tinnitus onset and increased exposure time on an ototoxic drug – as previously reported – and subsequent tinnitus severity. It could be that early treatment onset occurred, meaning increasing exposure time may not pose as great a risk.
Quinine and Chloroquine
Quinine is an antimalaria medication prescribed to treat malaria caused by mosquito bites in areas where malaria is prevalent. When combined with primaquine, it kills off malaria parasites living inside red blood cells and liver tissue to combat infection. Quinine has long been known to cause dose-related, reversible side effects known as cinchonism that include hearing loss, nausea, vomiting, dizziness and vision changes. Furthermore, in rare instances it has even been linked to tinnitus symptoms. Other less commonly experienced adverse reactions of quiine include hypoglycemia (low blood sugar), skin rash, diarrhea, hepatotoxicity and agranulocytosis. An overdose could potentially be fatal and lead to symptoms including delirium, seizures, respiratory depression, coma, hemolysis (including hematological abnormalities and thrombocytopenia ), shock and even death.
Chloroquine and hydroxychloroquine, two antimalarial medications, may also lead to tinnitus. These drugs have been known to damage cochlear outer hair cells as well as interfere with post synaptic sodium channel function in inner cochlear hair cells of the cochlea. Although this form of hearing loss cannot typically be detected with brainstem audiograms alone, pure tone audiometry and evoked potential testing can detect its symptoms more readily. Chloroquine-induced tinnitus usually reverses itself upon discontinuing medication use – less likely when patients take it with food intake.
Imatinib and sorafenib, two protein kinase inhibitors used to treat breast, lung and kidney cancer respectively can also produce tinnitus as side effects; loop diuretics like furosemide or torsemide may produce it temporarily before disappearing once patients stop taking these medications; such tinnitus manifests as changes in sound input to auditory system that manifest as ringing or buzzing sound sensations.
Each year, millions of people take antidepressants, with one of the most frequently reported side effects being tinnitus. Though often associated with depression or other mental health conditions, studies suggest some antidepressants may actually contribute to or exacerbate existing tinnitus issues.
There are various medications that may cause tinnitus, including tricyclic antidepressants, benzodiazepines and herbal products. If this side effect arises while taking these drugs for your condition, discuss it with your physician to see whether there may be another approach without this drawback.
TCAs were originally prescribed to treat depression; however, they are now being widely used off-label for nerve pain from diabetes or shingles, migraine prevention, anxiety relief or feelings of unrest in panic disorder and even as an antidote for drug withdrawal syndrome. They can cause tinnitus if taken for extended periods or in high dosage; the most widely prescribed TCAs include Amitriptyline, Nortriptyline and Imipramine – among many others.
Benzodiazepines like Lorazepam or Diazepam are sedatives that can help alleviate anxiety and decrease seizures for certain individuals. Unfortunately, however, these drugs may also cause tinnitus as a side effect and it is wise to gradually withdraw yourself from them over several weeks to months in order to minimize this symptom.
Studies have revealed that taking certain antidepressant drugs – specifically selective serotonin reuptake inhibitors (SSRIs), like mirtazapine and citalopram – may help relieve tinnitus symptoms by balancing chemicals that play an integral part of mood regulation in the brain, as well as helping with other relief strategies such as cognitive behavior therapy, music therapy, relaxation therapies or hypnosis.
Tinnitus (pronounced: tih-NITE-us) is any sound in your head without an external cause, typically heard ringing in either or both ears, buzzing, hissing, chirping, roaring or even shrieking from inside your head without externally-produced sources. These sounds may also include buzzing, hissing, hissing pulsatile (reaching with every heartbeat), intermittent (in the form of constant or intermittent sounds) or even pulsatile (in which case you may hear sounds pitched higher or lower than normal); hearing loss can often come alongside this condition.
Tinnitus can be caused by numerous factors, from exposure to loud noise to medications that damage the ears (ototoxic drugs). Other potential triggers for Tinnitus include impacted earwax build-up or middle ear infections; natural aging processes; Meniere’s disease or TMD disorders that impair hearing; as well as Meniere’s syndrome itself.
As soon as you experience new tinnitus symptoms, contact your physician immediately. They will discuss your medical history and conduct a physical exam that includes checking for impacted earwax or fluid build-up; ordering tests such as blood work or an MRI of your brain/head to identify its source; possibly referring you to an Otolaryngologist, an expert specialized in ears, noses and throat (also referred to as an ENT).
Treatment options for tinnitus depend on its source. If it’s caused by an underlying medical condition, treating that should lead to its resolution; otherwise, such treatments could include changing or discontinuing medications prescribed to you by your physician.
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