7 Medications That Can Cause Hearing Loss

Hearing loss is something many people will experience as part of getting older. It can have a big impact on your life, and it usually happens due to natural causes. But, in some cases, medications can also contribute to hearing loss.

Certain antibiotics, over-the-counter (OTC) pain relievers, chemotherapy medications, and more are known to raise the risk of hearing loss. In fact, over 100 types of medications can cause hearing loss. And many medications that can cause hearing loss may also cause tinnitus, or ringing in the ears. Older adults and infants seem to be most at risk. 

Since hearing loss from medications is rare, the benefit of taking a medication often outweighs the risk of hearing loss. Still, it’s good to know if this side effect is possible with a medication you’re taking. Let’s discuss seven types of medications that may cause hearing loss.

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1. Antibiotics like azithromycin

Several antibiotics have been linked to hearing loss. This includes macrolide antibiotics, aminoglycosides, and vancomycin. These antibiotics may cause hearing loss by directly damaging structures in your ear, but the exact reason isn’t fully clear.

In clinical studies, varying degrees of hearing loss have been reported with macrolides like azithromycin (Zithromax), erythromycin, and clarithromycin. This ranges from reversible, mild hearing loss to complete deafness. Hearing loss tends to be more likely if you take high doses of azithromycin over time.

Aminoglycoside antibiotics like gentamicin and tobramycin are effective at killing bacteria, but intravenous (IV) and topical forms of them can increase the risk of hearing loss. Aminoglycosides are a particularly common cause of hearing loss in children.

Vancomycin (Vancocin, Firvanq) is an antibiotic that comes in oral and injectable forms. Both forms have been associated with hearing loss, but most cases are linked to IV vancomycin.

Preventing hearing loss from antibiotics usually involves receiving short courses of medication and prioritizing antibiotics that have a lower risk of hearing-related side effects. But, sometimes a specific antibiotic is necessary to treat an infection. Be sure to check with your healthcare provider if you experience hearing loss after starting an antibiotic.

2. Water pills like Lasix

Water pills like Lasix (furosemide) — also known as loop diuretics — can cause hearing loss. Loop diuretics are thought to cause changes in an ear structure known as the cochlea. The cochlea senses sound vibrations and turns them into electrical signals sent to the brain. Cochlear changes may result in hearing loss. 

Hearing loss caused by loop diuretics is usually temporary and reversible. But permanent deafness can happen on rare occasions. The risk is higher when loop diuretics are combined with other ear-harming medications or given to people with kidney damage.

If you notice hearing loss while taking a diuretic, let your healthcare provider know. They may suggest changing medications.

3. OTC pain relievers

OTC pain relievers include medications like aspirin, acetaminophen (Tylenol), and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin). Routine use of these medications have been associated with hearing loss, but the overall risk is low.

One large review evaluated the effects of acetaminophen and NSAIDs on hearing. Overall, available data reports mixed results on how likely hearing loss is from these medications.

However, very high doses of aspirin (6 to 8 grams in 24 hours) are known to cause hearing loss. Mild damage from aspirin causes temporary hearing loss. But permanent damage to the inner ear is possible. For reference, typical aspirin doses range from 81 mg to 650 mg up to 6 times daily. 

Be sure to let your healthcare provider know if you’re taking OTC pain relievers routinely. Since you don’t need a prescription for these medications, they may not be aware that you’re taking them.

4. Opioids

Opioids like oxycodone (OxyContin) treat moderate to severe pain. While they’re effective, their use tends to be restricted to more severe cases of pain because of the risk of dependence.

What’s more, there have been more reports of hearing loss from opioids in recent years — primarily in cases of opioid overdose. To lower the risk of hearing loss from opioids, it’s important to take them exactly as instructed by your healthcare provider.

5. Erectile dysfunction medications like Viagra

Erectile dysfunction medications like Viagra (sildenafil) are known as phosphodiesterase-5 (PDE5) inhibitors. Other medications in this class include Cialis (tadalafil), vardenafil, and avanafil (Stendra).

One study found a significant link between PDE5 inhibitors and hearing loss. In this study, the risk was mainly connected to Viagra. But there are also limited case reports of hearing loss from Cialis, vardenafil, and avanafil.

In general, the overall risk of hearing loss with PDE5 inhibitors is low. But if you experience any hearing changes after taking one of these medications, let your healthcare provider know.

6. Chemotherapy medications like cisplatin

Many medications used to treat cancer are referred to as chemotherapy. Of these, “platinum-based” chemotherapy medications like cisplatin, carboplatin, and oxaliplatin (Eloxatin) can cause hearing loss.

Hearing loss from these chemotherapy medications is considered dose-related. This means that higher doses are more likely to cause hearing loss. Your cancer specialist will consider your dose carefully if they intend to include platinum-based chemotherapy in your treatment plan.

Researchers are still working on figuring out the best ways to prevent hearing loss from platinum-based chemotherapy.

7. Medications that treat malaria

Chloroquine and hydroxychloroquine (Plaquenil) are used to treat malaria worldwide. Hydroxychloroquine can also treat some types of arthritis and lupus. 

However, both medications have been associated with hearing loss. They can directly damage the cochlea. They can also cause varying degrees of hearing loss, ranging from mild to severe. Many of these changes are reversible, but some reported cases have been permanent.

Check with your healthcare provider if you have hearing changes while taking chloroquine or hydroxychloroquine. They may suggest stopping the medication or switching to a different treatment altogether.

What should I do if my hearing changes after starting a new medication?

If you have hearing changes after starting a new medication, let your healthcare provider know right away. They can help you determine whether it’s related to the medication or something else. They also may suggest getting your hearing tested by an audiologist (an ear specialist). 

If your hearing changes are thought to be caused by a medication, you’ll likely be told to stop taking it. Stopping a medication that’s causing hearing loss as soon as possible is your best chance of reversing any damage. But don’t stop taking any medications without talking to your provider first.

Can hearing loss from medication be reversed?

In many cases, yes. Hearing loss caused by medication can be reversed. 

However, it depends on how severe the damage is. Permanent damage may be more likely to happen if you’re taking more than one medication that causes hearing loss. This is also the case if you’re taking a higher dose of an offending medication, taking it for a long time, or have kidney damage.

Still, everybody is different. Depending on your situation, your healthcare provider can tell you if your hearing changes are reversible.

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Written by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Sanjai Sinha, MD

Sanjai Sinha, MD, is a board-certified physician with over 20 years of experience. He specializes in internal medicine.

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