Merck Manual

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Ear Disorders Caused by Drugs

(Ototoxicity)

By

Mickie Hamiter

, MD, New York Presbyterian Columbia

Reviewed/Revised May 2023
VIEW PROFESSIONAL VERSION

Many drugs, including medications, can damage the ears. These drugs are called ototoxic drugs. They include the antibiotics streptomycin, tobramycin, gentamicin, neomycin, and vancomycin, as well as certain chemotherapy medications (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 the person 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

Treatment of Drug-Related Ear Disorders

When doctors detect ototoxicity, they stop giving the medication (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.

Prevention of Drug-Related Ear Disorders

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

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
Neo-Fradin
FIRVANQ, Vancocin, Vancocin Powder, VANCOSOL
Platinol, Platinol -AQ
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
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