What Medications Cause Tinnitus? A Comprehensive Guide to Ototoxic Drugs

October 5, 2025 •

4 min read

Hundreds of medications, both prescription and over-the-counter, have been identified as potentially causing tinnitus, a condition characterized by a phantom ringing or buzzing in the ears. Understanding what medications cause tinnitus is crucial for patients and healthcare providers to manage symptoms and, in some cases, prevent permanent damage.

Quick Summary

This article explores the link between various drug classes and tinnitus, detailing common ototoxic medications, risk factors, and strategies for managing symptoms. It explains how certain drugs can damage the inner ear, leading to temporary or permanent auditory issues.

Key Points

Diverse Drug Classes: Many different medications, including common painkillers, specific antibiotics, and chemotherapy drugs, can cause tinnitus as a side effect.
Ototoxicity Explained: The inner ear contains delicate hair cells that can be damaged by certain medications, causing the brain to perceive phantom sounds, a condition known as ototoxicity.
Dosage and Duration Matter: For many drugs, tinnitus is a dose-dependent effect, and the risk increases with higher doses and longer periods of use.
Temporary vs. Permanent: While some drug-induced tinnitus is reversible upon discontinuation of the medication, potent drugs like certain chemotherapies can cause irreversible damage.
Consult a Professional: It is crucial to consult a doctor before stopping any prescribed medication if you suspect it is causing tinnitus.
Management is Possible: Tinnitus can be managed through various strategies, including sound therapy, hearing aids, and cognitive behavioral therapy.
High-Risk Groups: Individuals with pre-existing kidney damage, elderly patients, or those taking multiple ototoxic drugs are at a higher risk of developing tinnitus.

What is Ototoxicity?

Ototoxicity refers to damage to the inner ear or auditory nerve caused by certain medications or chemicals. This damage can affect the delicate hair cells in the cochlea, which are responsible for transmitting sound signals to the brain. When these cells are harmed, they can send abnormal signals that the brain interprets as tinnitus. The effects of ototoxicity can be temporary, resolving when the medication is stopped, or in some cases, permanent, leading to lasting tinnitus and hearing loss.

Common Medications Linked to Tinnitus

Many different types of medications have been associated with tinnitus. These include:

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Common NSAIDs like aspirin, ibuprofen, and naproxen can cause temporary tinnitus, particularly at high doses or with frequent use. In some cases, frequent use of even moderate-dose aspirin has been linked to increased risk in younger women.

Antibiotics

Certain antibiotics are known to be ototoxic. Aminoglycosides, such as gentamicin and tobramycin, are highly ototoxic and can cause permanent damage. Macrolides like erythromycin and azithromycin have also been associated with reversible tinnitus.

Cancer Medications (Chemotherapy)

Some chemotherapy drugs are known for their potential to cause ototoxicity. Platinum-based drugs like cisplatin and carboplatin can cause permanent inner ear damage. Taxane drugs, such as paclitaxel, have also been linked to tinnitus and hearing changes.

Loop Diuretics

These medications, used for high blood pressure and fluid retention, can cause tinnitus, especially when given intravenously or at high doses. Examples include furosemide and bumetanide.

Antidepressants and Anti-anxiety Medications

Some antidepressants (SSRIs and TCAs) and anti-anxiety medications (benzodiazepines) have been reported to cause or worsen tinnitus. Tinnitus can also occur as a withdrawal symptom from benzodiazepines.

Antimalarial Drugs

Medications like quinine, chloroquine, and hydroxychloroquine have been known to cause tinnitus and hearing loss, particularly with high doses or prolonged use.

Other Ototoxic Medications

Other drugs potentially linked to tinnitus include certain blood pressure medications (ACE inhibitors, beta-blockers), isotretinoin (for acne), and some anticonvulsants.

Comparison of Ototoxic Drug Classes


Drug Class	Common Examples	Typical Risk Profile	Primary Use
NSAIDs	Aspirin, Ibuprofen, Naproxen	Temporary, dose-dependent	Pain relief, inflammation
Aminoglycoside Antibiotics	Gentamicin, Tobramycin, Neomycin	Permanent damage possible	Severe bacterial infections
Chemotherapy Drugs	Cisplatin, Carboplatin	Permanent damage high risk	Cancer treatment
Loop Diuretics	Furosemide, Bumetanide	Temporary, dose-dependent	High blood pressure, edema
Antidepressants	Sertraline, Amitriptyline	Temporary, variable	Depression, anxiety
Antimalarials	Quinine, Hydroxychloroquine	Variable, high-dose risk	Malaria, autoimmune disease

Risk Factors for Drug-Induced Tinnitus

Several factors can increase the risk of developing ototoxic effects from medication:

Higher dosages.
Longer duration of use.
Intravenous administration for some drugs.
Pre-existing health conditions like kidney dysfunction or dehydration.
Older age and existing hearing issues.

What to Do If You Suspect Your Medication is Causing Tinnitus

If you experience tinnitus after starting a new medication, consult your doctor. Do not stop taking prescribed medication without medical advice. Your doctor can help determine if the medication is the cause and discuss options such as adjusting the dose or switching to a different drug. If an ototoxic drug is necessary, your doctor may recommend monitoring your hearing.

Managing Drug-Induced Tinnitus

Various therapies can help manage tinnitus, even if it persists after stopping the medication:

Sound therapy: Using white noise or masking devices.
Tinnitus Retraining Therapy (TRT): Combines sound therapy and counseling to help habituate to the sound.
Hearing Aids: Can help mask tinnitus, especially if hearing loss is present. Many have built-in masking features.
Cognitive Behavioral Therapy (CBT): Helps manage the emotional impact of tinnitus.
Lifestyle changes: Managing stress, exercising, and limiting alcohol and caffeine can also help.

Conclusion

Understanding what medications cause tinnitus is important for managing this condition. Ototoxicity is a known side effect of various drug classes, and the risk often depends on dosage and duration. Always communicate with your healthcare provider about any new or worsening tinnitus symptoms, especially after starting or changing medication. Never discontinue a prescribed medication without consulting your doctor. By working with your doctor and exploring management strategies, you can address medication-related tinnitus and protect your hearing health. For more information on tinnitus, visit the American Tinnitus Association

Keypoints

Diverse Drug Classes: Many different medications, including common painkillers, specific antibiotics, and chemotherapy drugs, can cause tinnitus as a side effect.
Ototoxicity Explained: The inner ear contains delicate hair cells that can be damaged by certain medications, causing the brain to perceive phantom sounds, a condition known as ototoxicity.
Dosage and Duration Matter: For many drugs, tinnitus is a dose-dependent effect, and the risk increases with higher doses and longer periods of use.
Temporary vs. Permanent: While some drug-induced tinnitus is reversible upon discontinuation of the medication, potent drugs like certain chemotherapies can cause irreversible damage.
Consult a Professional: It is crucial to consult a doctor before stopping any prescribed medication if you suspect it is causing tinnitus.
Management is Possible: Tinnitus can be managed through various strategies, including sound therapy, hearing aids, and cognitive behavioral therapy.
High-Risk Groups: Individuals with pre-existing kidney damage, elderly patients, or those taking multiple ototoxic drugs are at a higher risk of developing tinnitus.

Frequently Asked Questions

Yes, some medications, particularly powerful chemotherapy drugs like cisplatin and certain high-dose antibiotics, can cause permanent inner ear damage leading to irreversible tinnitus. However, in many cases, especially with drugs like NSAIDs, the effect is temporary.

The duration varies. For many drugs, tinnitus subsides shortly after the medication is stopped or the dosage is lowered. However, with highly ototoxic medications, it can become a long-lasting or permanent condition.

No. You should never stop a prescribed medication without first consulting a healthcare professional. A doctor can evaluate your symptoms, determine if the drug is the cause, and decide on a safe course of action, which may include dosage adjustment or switching medications.

Yes, common over-the-counter painkillers like aspirin, ibuprofen, and naproxen can cause tinnitus, especially when used frequently or at high doses. The effect is typically temporary and reverses when use is discontinued.

No, not all antibiotics are ototoxic, but certain classes, particularly aminoglycosides (e.g., gentamicin), are known for their potential to damage the inner ear. Factors like high doses and intravenous administration increase the risk.

Yes, the dosage is a major factor. For many ototoxic medications, the risk and severity of tinnitus are dose-dependent, meaning higher doses are more likely to cause or worsen the condition.

Tinnitus can appear or worsen as a withdrawal symptom when stopping certain medications, such as benzodiazepines. A gradual tapering of the dose, supervised by a doctor, is recommended to minimize this risk.