These Prescriptions May Cause Ringing in the Ears

assortment of medicines
Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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Tinnitus, or ringing in the ears, is a perception of sound in one or both ears in the absence of an external source. It’s often described by patients as buzzing, ringing, or whooshing. While there is often no known cause for tinnitus, there are a handful of medications that may contribute.

Medications that are known to cause tinnitus or hearing loss are considered “ototoxic medications.” Discontinuing these medications can prevent tinnitus and hearing progression, though the ringing may not always go away. Here are some commonly prescribed medications known to cause tinnitus:

  1. Gentamicin and tobramycin are antibiotics used for the treatment of severe bacterial infections and are a well-known cause of tinnitus and vertigo along with hearing loss.
  2. Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen (Aleve) and ibuprofen (Motrin, Advil) are known to cause ringing in the ears. Though tinnitus usually occurs only at high doses, doctors should still discuss this side effect with their patients.
  3. Loop diuretics like furosemide (Lasix) and bumetanide (Bumex) are commonly prescribed for swelling in the legs, heart failure, and to lower blood pressure. They are known to cause ringing in the ears.
  4. Tricyclic antidepressants like amitriptyline and nortriptyline are used for the treatment of depression, chronic pain, and migraine prevention and they may also cause ringing in the ears.
  5. Azithromycin (Zithromax or the “Z-pack”) and clarithromycin are antibiotics prescribed for bacterial infections like community-acquired pneumonia, sinusitis, bronchitis, etc. Both are reported causes of ringing in the ears.
  6. ACE inhibitors are medications used to lower blood pressure that may cause ringing in the ears. These drugs typically end in -il (common examples are lisinopril, enalapril, and ramipril).
  7. Amlodipine (Norvasc) and nicardipine are calcium channel blockers. Amlodipine is commonly prescribed for high blood pressure, and reports of tinnitus follow its use.
  8. Alprazolam (Xanax), diazepam (Valium) and lorazepam (Ativan) are benzodiazepines used for the treatment of anxiety, and may cause tinnitus.
  9. Isotretinoin (Accutane, Claravis, Absorica, and others) is a pill used for severe acne that may lead to tinnitus.
  10. The fluoroquinolone antibiotic ciprofloxacin (Cipro) has been reported to cause tinnitus. However, there is some good news—those reports have not carried over to a similar antibiotic levofloxacin (Levaquin). Cipro is prescribed for bacterial infections like urinary tract infections, acute sinusitis and pneumonia and may lead to tinnitus.
  11. Atorvastatin (Lipitor) specifically has been reported to cause tinnitus. Atorvastatin is used to lower cholesterol.

Dr O.

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