We usually take medications like pain relievers and antibiotics to treat health problems, such as headache pain, arthritis, or in the case of antibiotics, an infection.
And while it’s true that these medications may treat one health problem, in the process they might cause another, namely hearing loss, tinnitus or vestibular disorders.
In fact, drugs that can impact hearing, whether over-the-counter or prescription, are called ototoxic.
Pain Relievers
Let’s take aspirin for example. Aspirin is commonly taken for all sorts of health problems, from the occasional headache to joint pain. It’s well-documented that high doses of aspirin are commonly associated with reversible tinnitus or ringing in the ears. But now researchers at Brigham and Women’s Hospital have determined more typical doses of aspirin and other over-the-counter pain relievers are associated with the risk of persistent tinnitus.
This research was conducted by the Conservation of Hearing Study (CHEARS) which examined risk factors for hearing loss and tinnitus among participants in several large ongoing prospective cohort studies. The data source for this study was the Nurses’ Health Study II, established in 1989 with the enrollment of 116,430 female registered nurses aged 25 to 42. In this longitudinal cohort study, participants completed questionnaires every two years about demographic, health, and lifestyle factors, including medication use.
Information on tinnitus was collected in 2009, 2013, and 2017 by questionnaire, and tinnitus was defined as persistent if it occurred several days a week or more.
- The associations of low-dose (less than 100 mg.) and moderate-dose (more than 325 mg.) aspirin differed by age.
- Among women over age 60, frequent use of low-dose aspirin (six to seven days a week) was associated with a modestly lower risk of persistent tinnitus.
- Among women under 60, frequent use of moderate-dose aspirin was associated with a 16% higher risk of persistent tinnitus.
More frequent use of nonsteroidal anti-inflammatory drugs (NSAIDs) was independently and significantly associated with higher risk of persistent tinnitus, and the level of the risk tended to be greater when the NSAID was used more often.
Among frequent users of NSAIDs, the adjusted relative risk for persistent tinnitus was up to 17% higher, compared with women who used NSAIDs less than one day a week. The association between NSAID use and tinnitus did not vary significantly by age.
More frequent use of acetaminophen was also independently and significantly associated with a higher risk of persistent tinnitus, and the level of the risk tended to be greater with increasing frequency of use.
Compared with women who used acetaminophen less than one day a week, the adjusted relative risk was 8% higher for use four to five days a week and 18% higher for use six to seven days a week.
Antibiotics
Antibiotics, which treat bacterial infections, can be important life-saving medications. But just like any medication, they carry the risk of side effects.
Powerful antibiotics often delivered in the hospital to treat meningitis, sepsis, serious respiratory infections and other life-threatening infections, are known to cause hearing loss. One powerful class of antibiotics, known as aminoglycosides, carries the potential side effects of hearing loss, tinnitus and balance problems.
Some common aminoglycosides that are capable of damaging hearing are:
- Streptomycin
- Neomycin
- Amikacin (Amikin)
- Gentamicin (Garamycin)
- Kanamycin (Kantrex)
- Paromomycin (Humatin)
- Tobramycin (Tobi)
- Vancomycin (not technically an aminoglycoside, but still linked to temporary mild hearing loss)
Anywhere from 20 to 60 percent of adults who are given aminoglycosides experience some degree of hearing loss, from mild to profound. It usually causes high-frequency hearing loss. At higher doses given over longer period of times, it may affect other ranges of hearing, such as low frequencies, and eventually it can cause complete deafness.
Currently, hearing loss and balance problems are considered unavoidable potential side effects when prescribed these life-saving antibiotics.
Bottom line, if you regularly take over-the-counter pain relievers or have recently taken an antibiotic that’s considered ototoxic, talk with your primary care provider about the potential impact on your hearing or see a doctoral-level audiologist for a comprehensive hearing evaluation. Obviously, you should never discontinue a prescription medication without discussing it with your physician first.
Even if the evaluation determines your hearing is normal, it serves as a baseline and can help determine future hearing loss.
