Ototoxicity and Hearing Loss

You Might Get Better, But You Might Lose Hearing

Japanese woman listening with hand near ear
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Ototoxicity and hearing loss can go hand in hand.

What is Otoxicity?

Certain medications can damage the ear, resulting in hearing loss, ringing in the ear, or balance disorders. These drugs are considered ototoxic. There are more than 200 known ototoxic medications (prescription and over-the-counter) on the market today. These include medicines used to treat serious infections, cancer, and heart disease.

Ototoxic Drugs and Hearing Loss

An ototoxic hearing loss happens when someone takes or is given a drug that causes hearing loss as one of its side effects. Sometimes the drugs are needed to save lives, and hearing loss is the price paid for being able to live.

Sometimes the drug-induced hearing loss is temporary and can be reversed or stopped. Other times it is permanent. People with hearing loss need to be especially aware of the potential for ototoxic effects, as an ototoxic drug can make an existing hearing loss worse.

Some over-the-counter drugs are known to be ototoxic. Just a few:

  • Some antibiotics
  • Some chemotherapy drugs
  • Some anti-inflammatory drugs

Books on Ototoxicity

Few books have been published on ototoxicity. One book is Ototoxic Drugs Exposed: Prescription Drugs and Other Chemicals That Can (and Do) Damage Our Ears. This book is the result of four years of research by Neil Bauman into approximately 1,000 ototoxic drugs.

Another is Ototoxicity by Peter S. Roland and John A. Rutka.

Fact Sheets On Ototoxicity

For a quick overview and lists of known or suspected ototoxic medications, a handful of fact sheets and articles are available online.

  • Fact Sheet from IFHOH - "What You Should Know About Ototoxic Medications." - Gives symptoms of ototoxicity, has a short, but detailed list of common ototoxic medications.
  • The Center for Hearing and Communication has a detailed PDF brochure, "Ototoxic Medications: Drugs That Can Cause Hearing Loss and Tinnitus" on its website. This brochure has a lengthy list of ototixic medications, organized by category.
  • Ototoxicity - The Hidden Menace is a long general article about ototoxicity by Neil Bauman. It bolds the names of ototoxic drugs and gives examples of what people who used ototoxic drugs experienced.

Visitor's Ototoxic Experience

A visitor described his experience with losing his hearing to an ototoxic medication, Tobradex (Tobramycin):

"I became totally deaf on my left side by using Tobradex eye drops in that ear, which were prescribed by my otolaryngologist with his assurances that they were perfectly safe to use. I am still constantly dizzy and cursed with constant tinnitus, in addition to being deaf. What is most upsetting about my experience is the fact that Tobradex is not even FDA approved for use in the ear."

The U.S. Food and Drug Administration has an Index to Drug-Specific Information.

More information can also be found through Drugs@FDA, where the approved label for Tobradex can be downloaded. The section on adverse reactions does not mention any potential for ear damage.

However, it's important to note that no data showing harm to human ears exists because Tobradex was never intended by its manufacturers to be used in the human ear. Therefore, no clinical studies were ever performed to determine its safety in the human ear.

Related blog posts on ototoxicity:

Brush Teeth, Lose Hearing?
You Made My Daughter Deaf. Now Pay for Cochlear Implants


American Speech-Language-Hearing Association. Ototoxic Medications. http://www.asha.org/public/hearing/Ototoxic-Medications/

Haynes, DS. "Topical antibiotics: strategies for avoiding ototoxicity." Ear Nose Throat J. 2004 Jan;83 (1 Suppl):12-4.

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