Updated February, 2026
Some medications save lives. Others quietly damage your hearing while doing it. If you take prescription drugs for a chronic condition, understanding what medicines can cause hearing problems could protect one of your most vital senses.
This guide covers every major drug class linked to hearing damage, what symptoms to watch for, and why a baseline hearing test matters more than most patients realize.
How Medications Damage Your Hearing
The medical term for drug-induced ear damage is ototoxicity. Ototoxic medications harm the delicate hair cells inside the cochlea. These hair cells convert sound waves into signals your brain understands. Once destroyed, hair cells never grow back.
Damage can show up as hearing loss, tinnitus (ringing or buzzing), dizziness, or balance problems. Symptoms may appear gradually or suddenly. Some medications cause reversible effects. Others cause permanent damage.
According to ASHA, more than 200 known ototoxic medications are currently available. Many patients take them for years without knowing the risk.
That’s exactly why a baseline hearing test matters. A test before or early in treatment gives your care team a reference point. If your hearing changes, they can respond before damage becomes irreversible. If you haven’t been tested and take any medication in this article, now is a smart time to start.
Quick Reference: Most Common Ototoxic Medications
This table covers the six drug classes most people encounter in everyday healthcare. Each one carries a documented risk to your hearing.
| Drug Class | Common Examples | Hearing Risk | Reversible? |
|---|---|---|---|
| Aspirin / NSAIDs | Aspirin, ibuprofen, naproxen | Hearing loss, tinnitus | Often, at lower doses |
| Loop diuretics | Furosemide (Lasix), bumetanide | Hearing loss, cochlear damage | Sometimes |
| Aminoglycoside antibiotics | Gentamicin, tobramycin, streptomycin | Permanent sensorineural hearing loss | Rarely |
| Platinum chemotherapy | Cisplatin, carboplatin, oxaliplatin | Severe hearing loss | Rarely |
| Heart medications | Metoprolol, enalapril, amlodipine | Tinnitus, hearing changes | Variable |
| Hormone therapy (HRT) | Estrogen, estrogen/progestogen combos | Gradual hearing loss | Unknown |
If you take any of these regularly, talk with your hearing care provider about monitoring.
Complete Ototoxic Drug Reference
The table below covers all major drug classes linked to hearing damage. Use it as a reference when reviewing your own medication list.
| Drug Class | Examples | Primary Effect | Risk Level |
|---|---|---|---|
| Aminoglycoside antibiotics | Gentamicin, tobramycin, streptomycin | Permanent sensorineural hearing loss | High |
| Other antibiotics | Azithromycin, vancomycin, clarithromycin | Tinnitus, hearing changes | Moderate |
| Platinum chemotherapy | Cisplatin, carboplatin, oxaliplatin | Severe cochlear damage | Very high |
| Aspirin (high dose) | Aspirin 6–8g/day | Tinnitus, temporary hearing loss | Moderate |
| NSAIDs | Ibuprofen, naproxen | Hearing loss with long-term use | Moderate |
| Acetaminophen | Tylenol (high/frequent doses) | Hearing loss | Moderate |
| Loop diuretics | Furosemide, bumetanide | Cochlear damage, electrolyte disruption | High |
| Heart medications | Metoprolol, enalapril, amlodipine | Tinnitus, hearing loss | Low–moderate |
| Anti-malarials | Chloroquine, hydroxychloroquine | Cochlear inflammation, hearing loss | Moderate |
| Hormone therapy | Estrogen, combined HRT | Gradual hearing loss | Unknown |
| Antipsychotics | Haloperidol, risperidone | Tinnitus, vertigo | Moderate |
| Antidepressants (SSRIs) | Fluoxetine, sertraline | Tinnitus, balance issues | Moderate |
| Mood stabilizers | Lithium | Tinnitus, hearing loss | Variable |
| ED medications | Sildenafil, tadalafil, vardenafil | Sudden hearing loss (rare) | Sometimes |
| Antifungals | Itraconazole, amphotericin B | Cochlear hair cell damage | Variable |
| Recreational drugs | Cannabis, cocaine, MDMA | Tinnitus, vasoconstriction damage | Variable |
Keep this list handy when reviewing your medications with any healthcare provider.
Antibiotics and Hearing Loss
Antibiotics fight dangerous infections, but some carry real risk to your inner ear. Research in Frontiers in Neurology confirms ototoxic potential across multiple antibiotic classes, not just the aminoglycosides.
Aminoglycosides are the most serious offenders. This class includes gentamicin, tobramycin, amikacin, streptomycin, kanamycin, and neomycin. They can cause permanent sensorineural hearing loss and vestibular damage. Some affect balance first. Others damage cochlear function directly.
Additional antibiotics linked to hearing problems include azithromycin (Zithromax), clarithromycin (Biaxin), vancomycin (Vancocin), minocycline (Minocin), and ritonavir (Norvir).
Ask your doctor whether a hearing evaluation before and after treatment makes sense for your situation. Catching changes early keeps your options open.
Chemotherapy Drugs and Hearing Loss
Platinum-based chemotherapy agents rank among the most aggressively ototoxic substances in medicine. A systematic review and meta-analysis documents the global scale of hearing loss tied to these treatments.
Cisplatin causes significant hearing loss in up to 50 percent of patients. Carboplatin and oxaliplatin carry lower but real risk, particularly at higher cumulative doses. These drugs destroy cochlear hair cells in ways your body cannot repair.
Regular audiological monitoring during treatment is essential. If you or a family member is undergoing platinum-based chemotherapy, request hearing evaluations as part of the care plan. Early detection of high-frequency changes helps oncology teams and hearing care providers coordinate care before damage spreads into speech frequencies.
Pain Relievers and Hearing Loss
Over-the-counter pain relievers feel routine, but daily or high-dose use can affect your hearing in ways that build slowly.
Aspirin at doses of 6 to 8 grams per day can cause tinnitus and temporary or permanent hearing loss. NSAIDs like ibuprofen and naproxen link to hearing problems with extended use. High or frequent doses of acetaminophen also damage hearing over time. Read more about acetaminophen and hearing loss and what the research shows.
Use pain relievers as directed and work with your doctor to address the root cause of any ongoing pain. If you rely on these medications daily, a periodic hearing check is a simple and worthwhile precaution.
Diuretics and Hearing Loss
Loop diuretics like furosemide (Lasix) and bumetanide (Bumex) are prescribed for high blood pressure and fluid retention. They work by altering electrolyte levels throughout the body, and those same changes can disrupt the delicate fluid environment inside the cochlea.
Specifically, loop diuretics can deplete the potassium and sodium balance that cochlear hair cells depend on. They can also reduce blood flow to the inner ear, depriving it of oxygen and nutrients. The result can be temporary or permanent hearing loss, depending on dose and duration.
If you notice any hearing changes while taking a diuretic, let your doctor know promptly. A hearing evaluation can confirm whether your medication is contributing.
Heart Medications and Hearing Loss
Cardiovascular drugs are a significant but underappreciated source of ototoxic risk. Hypertension itself is linked to tinnitus, and several medications used to treat it can add to the problem.
The following heart medications carry documented hearing risks:
- Beta-blockers like metoprolol (Lopressor) and atenolol (Tenormin) have been associated with tinnitus and hearing changes in some patients.
- ACE inhibitors like enalapril (Vasotec) and lisinopril (Zestril) occasionally cause hearing problems, though the risk is lower than other classes.
- Calcium channel blockers like amlodipine (Norvasc) and diltiazem (Cardizem) have been linked to tinnitus and hearing loss.
- Aspirin at preventive doses is lower risk, but long-term use still warrants monitoring.
If you manage a chronic heart condition, hearing monitoring deserves a place in your overall health routine alongside your other regular checks.
Anti-Malarial Drugs and Hearing Loss
Chloroquine and hydroxychloroquine treat malaria, lupus, and rheumatoid arthritis. Both are ototoxic. They can damage cochlear tissue directly and cause inner ear inflammation that compounds hearing loss over time. Effects range from mild to significant and can become permanent with prolonged use.
Quinine, historically used for malaria, is known to cause temporary hearing loss and tinnitus. If you take any of these medications on an ongoing basis, ask your hearing care provider about establishing a monitoring schedule.
Hormone Therapy and Hearing Loss
Hormone replacement therapy helps many women manage menopause symptoms effectively. But long-term use carries a hearing risk that most patients are never told about.
A large study following nearly 81,000 postmenopausal women over more than 20 years found that women on hormone therapy for five to ten years had a 15 percent higher risk of hearing loss. Those using it for more than ten years saw that risk increase to 21 percent.
Researchers believe HRT may reduce blood flow to the cochlea or disrupt the hormonal balance the inner ear depends on. Because the effect builds slowly, it is often missed until it becomes significant. If you have been on hormone therapy for several years and haven’t had a recent hearing evaluation, scheduling one now is a straightforward protective step.
Psychotropic Medications and Hearing Loss
Mental health medications are an overlooked category when it comes to hearing risk.
Antipsychotics like haloperidol (Haldol) and risperidone (Risperdal) have been linked to tinnitus, vertigo, and hearing loss. SSRIs like fluoxetine (Prozac) and sertraline (Zoloft) are associated with tinnitus and balance difficulties. Lithium, used for bipolar disorder, can cause tinnitus and hearing changes, particularly at higher serum levels.
If you take any of these medications and notice new ringing in your ears, muffled hearing, or balance issues, report it to your prescribing provider. A hearing test can help clarify whether the medication is playing a role.
Erectile Dysfunction Medications and Hearing Loss
PDE5 inhibitors including sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) have been linked to sudden sensorineural hearing loss in rare cases. Tinnitus and vertigo are also reported. Learn more about Viagra and hearing loss and what the evidence shows.
Sudden hearing loss after taking one of these medications is a medical emergency. Seek care immediately. Prompt treatment can sometimes reverse the damage.
Antifungal Medications and Hearing Loss
Antifungal drugs are essential for serious infections but carry ototoxic risk at high doses or with extended use. Azoles like itraconazole (Sporanox) and ketoconazole (Nizoral) have been associated with hearing damage. Amphotericin B, used for systemic fungal infections, is among the more aggressively ototoxic antifungals available.
If you are on a prolonged antifungal course, ask your doctor whether audiological monitoring should be part of your care plan.
Recreational Drugs and Hearing Loss
The hearing risks of recreational drugs rarely get the attention they deserve. Stimulants like cocaine and amphetamines cause vasoconstriction that reduces blood flow to the inner ear and can permanently damage cochlear hair cells. MDMA raises blood pressure and heart rate in ways that stress inner ear blood vessels. Cannabis has been associated with tinnitus and temporary hearing changes.
When recreational drug use occurs alongside ototoxic prescription medications, the combined risk compounds significantly.
When Multiple Medications Stack Up
Taking several medications at once creates cumulative risk that even some providers underestimate. A nationwide cohort study in Scientific Reports identified previously unknown ototoxic drug interactions using large-scale patient records. The findings confirm what hearing care providers see regularly: drug combinations can amplify hearing damage beyond what any single medication causes alone.
The classic high-risk combination is loop diuretics paired with aminoglycoside antibiotics. But any combination of drugs with moderate ototoxic potential can accelerate damage when taken together.
Managing polypharmacy risk takes coordination. Review all medications including supplements with your doctor regularly. Keep a complete medication list at every appointment. If you take three or more medications with any ototoxic potential, a baseline hearing evaluation is not just recommended. It is essential.
The connection between hearing loss and broader health is real. Untreated hearing loss is strongly linked to cognitive decline. Identifying and addressing hearing changes early is one of the most meaningful investments you can make in your long-term health.
Hear Better. Start with a Test.
At American Hearing + Audiology, we work with patients managing ototoxic medications every day. Our hearing care providers are experienced in baseline testing, monitoring medication-related changes, and recommending next steps when hearing is affected.
We are locally owned and operated with 19 locations across the country and remote care available when you need it. Also, we are in-network with all major insurance carriers including Blue Cross Blue Shield, Aetna, and UnitedHealthcare. We verify your benefits and handle billing directly so you never have to figure it out alone. Most hearing evaluations are covered at no cost to you.
If you take any medication discussed in this article, a baseline hearing test is one of the most proactive steps you can take today. Find a clinic near you and schedule yours.
What Medicines Can Cause Hearing Problems: Your Questions Answered
How do I know if my medication is ototoxic? Ask your prescribing doctor or pharmacist directly. Over 200 medications carry ototoxic potential. If you take any drug covered in this article, request an audiological evaluation to establish a baseline.
Is drug-induced hearing loss always permanent? Not always. Some effects reverse when a medication is stopped. Aminoglycosides and platinum-based chemotherapy tend to cause permanent damage. Aspirin and quinine at high doses are more likely to be temporary. The sooner changes are detected, the more options you have.
What symptoms should prompt an immediate call to my doctor? Sudden hearing loss in one or both ears, new tinnitus, significant new dizziness, or any noticeable hearing change while starting a new medication all warrant prompt contact. Sudden sensorineural hearing loss is a medical emergency.
Can I still take ototoxic medications if I need them? In most cases, yes. Your doctor weighs the treatment benefit against the risk and may use the lowest effective dose, schedule regular monitoring, or consider alternatives. Never stop a prescribed medication without consulting your provider first.
Does American Hearing + Audiology provide monitoring for patients on ototoxic medications? Yes. Our hearing care providers support patients managing medication-related hearing changes at every stage. We offer comprehensive evaluations, real ear measurement, and ongoing follow-up care. Find a clinic near you to get started.
