Can some drugs be toxic to our hearing health?
Taking medications generally aims to benefit a person’s health, but can also involve the appearance of undesirable effects. There are several medications which pose a risk to the hearing or balance system.
They are said to have “ototoxic potential”, that is to say they can damage the structures of the ear by causing hearing loss, tinnitus and dizziness, temporarily or permanently.
What medications cause a risk of ototoxicity?
Hundreds of prescriptions and over-the-counter medications can pose a risk of ototoxicity. Here are some examples:
- Antibiotics: Amikacin, Gentamicin, Neomycin, Streptomycin, Tobramycin, Azithromycin, Clarithromycin, Erythromycin, Doxycycline, Minocycline, Tetracycline and Vancomycin.
- Analgesics and anti-inflammatories: salicylates (Aspirin), Ibuprofen, Naproxen, etc.
- Antineoplastic drugs (chemotherapy or treatments for cancer):
- Higher risk: Cisplatin and Carboplatin
- Others: Oxaplatin, Vinblastine, Vincristine, Doxorubicin, Cyclophosphamide, Methotrexate, Ifosfamide, Dactinomycin, Bleomycin, Vinorelbine and Etoposide.
- Others: certain diuretics (e.g.: Furosemide, etc.), certain antimalarials (e.g.: Chloroquine, Quinine, etc.), certain chelators (e.g.: Deferoxamine), etc.
What is the risk of developing ototoxicity when taking one of these medications?
Medications with ototoxic potential present a risk of hearing toxicity, but do not necessarily imply the appearance of this “side effect”. The risk will depend on several other factors.
Factors related to the person taking the medication:
- Already being diagnosed with hearing loss, especially linked to sound exposure.
- Having a specific medical condition (e.g.: impaired kidney function, genetics, anemia).
- Advanced age of the patient.
Drug-related factors:
- Dosage.
- Method of administration (intravenous, oral, etc.).
- Treatment duration.
- Interaction with other medications with ototoxic potential.
Can I prevent hearing damage when taking medications with ototoxic potential?
- Before taking any medication, do not hesitate to mention to the health professionals you’re consulting (doctors, pharmacists) that you have hearing loss or tinnitus, if it’s the case. They will be able to ensure that the prescribed medication will meet your needs while considering the potential for hearing toxicity.
- Use hearing protection when exposed to loud noises to protect your hearing.
- For over-the-counter medications, be sure to read the information on the box and consult your pharmacist if necessary (ototoxic risk, interaction with other medications).
If you notice the appearance or worsening of symptoms related to your hearing after taking medications, consult your audiologist to update your hearing evaluation and have the necessary follow-ups for your condition!
BY Charlène Ricard, Audiologist at Polyclinique de l’Oreille
