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Ear Disorders Caused by Drugs

(Ototoxicity)

By

Lawrence R. Lustig

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

Last full review/revision Jun 2020| Content last modified Jun 2020

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

In addition to being responsible for hearing, the inner ear is also responsible for balance (see also Overview of the Inner Ear).

Symptoms

When people have ear disorders caused by drugs, their symptoms include one or more of the following:

  • Hearing loss
  • Tinnitus (noise or ringing in the ears)
  • Problems with walking and balance

Vertigo (a false sensation of moving or spinning) may develop temporarily. Other symptoms can be temporary, but are sometimes permanent.

Prevention

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

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
streptomycin No US brand name
vancomycin VANCOCIN
tobramycin TOBI, TOBREX
gentamicin GENOPTIC
furosemide LASIX
cisplatin PLATINOL
neomycin NEO-FRADIN

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