Merck Manual

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Ear Disorders Caused by Drugs

(Ototoxicity)

By

Lawrence R. Lustig

, MD, Columbia University Medical Center and New York Presbyterian Hospital

Full review/revision Jun 2021 | Modified Sep 2022
VIEW PROFESSIONAL VERSION

Many drugs can damage the ears (ototoxic drugs). Some ototoxic drugs include the antibiotics streptomycin, tobramycin, gentamicin, neomycin, and vancomycin, certain chemotherapy drugs (for example, cisplatin), furosemide, and aspirin.

Whether people develop drug ototoxicity depends on many factors, including:

  • How much of the drug the person took (the dose)

  • How long the person took the drug

  • Whether the person has decreased kidney function, making it harder to clear the drug from a person's body

  • Whether the person has a family history of ear disorders caused by drugs

  • Whether the person's genetic make-up makes them more susceptible to the effects of ototoxic drugs

  • Whether the person is taking more than one ototoxic drug at the same time

Symptoms of Drug-Related Ear Disorders

Prevention of Drug-Related Ear Disorders

People should take the lowest effective dosage of ototoxic drugs, and the dosage should be closely monitored (for example, by measuring drug levels in the bloodstream when possible). If possible before beginning treatment with an ototoxic drug, people should have their hearing measured and then monitored during treatment, because symptoms are late warning signs that the drug has caused damage.

To prevent harming the fetus, pregnant women should avoid taking ototoxic antibiotics.

Older people and people with preexisting hearing loss should not be treated with ototoxic drugs if other effective drugs are available.

Treatment of Drug-Related Ear Disorders

When doctors detect ototoxicity they stop giving the drug (unless the disorder being treated is life-threatening and there are no other alternatives). There is no treatment to reverse ototoxicity, but sometimes hearing or loss of balance may partially recover on its own.

Drugs Mentioned In This Article

Generic Name Select Brand Names
No brand name available
AK-Tob, BETHKIS, Kitabis Pak, Nebcin, Tobi, TOBI Podhaler, Tobrasol , Tobrex
Garamycin, Genoptic, Genoptic SOP, Gentacidin, Gentafair, Gentak , Gentasol, Ocu-Mycin
Vancocin, Vancocin Powder, VANCOSOL
Delone , FUROSCIX, Lasix
Anacin Adult Low Strength, Aspergum, Aspir-Low, Aspirtab , Aspir-Trin , Bayer Advanced Aspirin, Bayer Aspirin, Bayer Aspirin Extra Strength, Bayer Aspirin Plus, Bayer Aspirin Regimen, Bayer Children's Aspirin, Bayer Extra Strength, Bayer Extra Strength Plus, Bayer Genuine Aspirin, Bayer Low Dose Aspirin Regimen, Bayer Womens Aspirin , BeneHealth Aspirin, Bufferin, Bufferin Extra Strength, Bufferin Low Dose, DURLAZA, Easprin , Ecotrin, Ecotrin Low Strength, Genacote, Halfprin, MiniPrin, St. Joseph Adult Low Strength, St. Joseph Aspirin, VAZALORE, Zero Order Release Aspirin, ZORprin
NOTE: This is the Consumer Version. DOCTORS: VIEW PROFESSIONAL VERSION
VIEW PROFESSIONAL VERSION
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