Can medication damage your hearing?

Did you know that some over-the-counter medications may cause damage to your hearing? Find out if you're at risk and learn which medications to be weary of!

 Many prescribed or over-the-counter medications can cause hearing loss, tinnitus or both. These are called "ototoxic," meaning toxic to the ear. They may damage the hair cells of the inner ear or interfere with the auditory nerve that transmits hearing signals to the brain. Plus, some drugs distort sounds and interfere with the quality and clarity of hearing, or disturb the delicate mechanisms of the inner ear, causing balance problems and dizziness.

Vapours and solvents, such as cleaning fluids or gasoline, can have similar effects, as can some industrial chemicals and environmental pollutants. Heavy metal poisoning, such as from lead or mercury, can lead to hearing loss or balance problems.

Ototoxic symptoms are frequently temporary and clear up if the medication is stopped quickly enough — so tell your doctor immediately about any symptoms. Aspirin, if taken in high doses, can trigger tinnitus, but this will disappear once you stop taking it.

There are hundreds of drugs that may have ototoxic side effects, but bear in mind that some people are genetically more susceptible to developing it with certain drugs than others. In many instances, especially in the case of anti-cancer drugs, the benefits of taking the medication clearly outweigh the dangers. Other examples pose a risk only when taken in high doses. For example, aspirin is an important drug in the prevention of heart attacks and is not ototoxic when taken at the doses recommended for heart protection.

Among the medications that may be ototoxic, the main culprits are:

• High-dose aspirin.
• High-dose NSAIDs (non-steroidal anti-inflammatory drugs), such as ibuprofen.
• Many antibiotics, especially gentamicin, streptomycin and neomycin, especially when they are injected into the blood or into the ear.
• Anti-malarial drugs containing quinine.
• Diuretics such as furosemide (Lasix) in high doses.
• Heart and blood-pressure medications, such as calcium-channel blockers, though this is rare.
• Hormones, such as oral contraceptives and hormone replacement therapies, in patients with otosclerosis.
• Some anti-cancer (cytotoxic) drugs.

Don't let drugs damage your ears. While ototoxic reactions are relatively rare for most drugs, it is a good idea to minimize the risk of a medication affecting your hearing. Here are some guidelines:

• Before you take any drug, ask your pharmacist or check the label or package insert to see whether ear symptoms are listed among the side effects.
• If your family has a history of ear problems, or you have had a hearing-related reaction to drugs before, tell your doctor.
• Tell your doctor if you've had or have any hearing problems, tinnitus, balance problems or dizziness.
• Avoid very noisy places while you are taking the medication; damage from the noise could add to that of the drug.
• Never take more than the recommended dose.
• While taking any drug, and for a week or two afterwards, watch for any odd symptoms, however slight, and report them to your doctor at once. Early signals of a reaction include dizziness, tinnitus, a fullness or pressure in your ears, worsening of existing hearing loss or tinnitus, and vertigo.

Don't be a pill popper! Aspirin, found in lots of over-the-counter remedies, is a particular culprit when it comes to ear damage. Imagine that you are taking something for arthritis and you develop a cold, so you reach for a cold and flu medication. Later on, you get a headache and, without thinking much about it, take a painkiller. Each of these products could contain aspirin — so you have now had a triple dose without realizing it. Always check packaging for the list of ingredients (aspirin is also called acetylsalicylic acid, or ASA) and try not to take too many pills at once.