Medications That Can Damage Your Hearing and What to Ask Your Doctor

Most people know that loud noise can damage hearing over time. Fewer people realize that certain medications can do the same — sometimes gradually, sometimes quickly. This type of hearing damage is called ototoxicity, and it's more common than many patients expect.

Over 200 medications are known to carry ototoxic potential. That includes some drugs people take every day, not just treatments for serious illnesses. Understanding which medications are involved, and what steps you can take, puts you in a better position to protect your hearing.

What Does "Ototoxic" Mean?

The term ototoxic refers to medications or substances that are toxic to the inner ear — specifically the cochlea, which handles hearing, and the vestibular system, which handles balance. Damage to either of these structures can result in hearing loss, tinnitus (ringing in the ears), or balance problems.

In some cases, ototoxic damage is temporary and resolves after stopping the medication. In others, the damage is permanent.

Common Medications Associated With Hearing Loss

Certain antibiotics — Aminoglycoside antibiotics, including gentamicin and tobramycin, are among the most well-documented causes of ototoxic hearing loss. These are typically used in hospital settings for serious infections. The risk is higher with prolonged use or when kidney function is reduced.

Chemotherapy drugs — Cisplatin and carboplatin, both used to treat various cancers, carry significant risk of permanent hearing loss. Cisplatin in particular is known for causing high-frequency hearing loss that can progress even after treatment ends. This is one of the strongest arguments for baseline hearing testing before chemotherapy begins.

Loop diuretics — Furosemide (Lasix) and other loop diuretics, prescribed for heart failure and high blood pressure, can cause temporary hearing loss at high doses. The risk increases when these drugs are combined with other ototoxic medications.

High-dose aspirin and NSAIDs — At very high doses, aspirin and some non-steroidal anti-inflammatory drugs have been linked to temporary tinnitus and hearing changes. For most people taking standard doses, the risk is low, but it's worth being aware of — particularly for those on long-term pain management regimens.

Quinine — Used to treat malaria and sometimes leg cramps, quinine has been associated with tinnitus and hearing changes.

The risk for any given patient depends on several factors, including the specific drug, dose, duration of use, age, kidney function, and whether multiple ototoxic medications are taken together.

Questions Worth Asking Your Doctor or Pharmacist

If you have been prescribed any of the medications above — or are starting a new course of treatment and want to understand the risks — here are some questions worth raising:

• Does this medication have any known effects on hearing?
• Is there an alternative that carries less risk for my ears?
• Should I have a baseline hearing test before starting treatment?
• What signs of hearing change should I watch for?
• Will my hearing be monitored during treatment?

These are straightforward, reasonable questions. Most physicians appreciate patients who are engaged in their care, and having a baseline audiogram on file gives your medical team something concrete to compare if changes occur.

The Value of a Baseline Hearing Test

One of the most practical things you can do before starting a medication with known ototoxic risk is get your hearing tested. A baseline audiogram gives your care team a reference point. If your hearing changes during or after treatment, that comparison can help identify whether medication is a contributing factor and how significant the change has been.

We see this most often with patients beginning chemotherapy, but it applies to anyone starting long-term treatment with a known ototoxic drug.

Tinnitus as an Early Warning Sign

New or worsening tinnitus during a course of medication is worth paying attention to. For some patients, ringing or buzzing in the ears is the first sign that a drug is affecting the inner ear. If you notice this while taking a new medication, let your prescribing physician know. Early awareness can sometimes lead to a dosage adjustment or a switch to an alternative before permanent damage occurs.

Schedule a Hearing Evaluation at Family Audiology and Hearing Centers

If you are currently taking or about to begin a medication with ototoxic potential, a hearing evaluation is a sensible next step. Our audiologists can establish a baseline, monitor for changes, and work alongside your medical team to help protect your hearing through treatment. With several locations across Ohio and Wisconsin, we make it straightforward to fit an appointment into your schedule. Contact us to book a hearing evaluation at the location nearest you.