Medications That Can Affect Your Hearing

When your doctor prescribes a new medication, you probably discuss the most common side effects—stomach upset, drowsiness, or changes in blood pressure. But here's something that might surprise you: many common medications can affect your hearing, sometimes in ways that aren't immediately obvious. If you've noticed changes in your hearing, experienced ringing in your ears, or felt like sounds are muffled, the answer might be sitting in your medicine cabinet.

The medical term for medications that can damage hearing is "ototoxic," which literally means "ear poisoning." Before you panic, it's important to understand that hearing-related side effects are often temporary and reversible, especially when caught early. The key is knowing what to watch for and maintaining open communication with your healthcare providers.

The Hidden Side Effect

Unlike a rash or nausea, hearing changes from medications can be subtle and gradual. You might not notice that you're turning up the TV volume a little more each week, or that you're asking people to repeat themselves more often. This is why hearing-related medication side effects often go unrecognized until they've become significant.

What makes this particularly relevant for older adults is that we often take multiple medications, and the combination can sometimes increase the risk of hearing problems. Additionally, age-related hearing changes can mask or compound medication-related effects, making it challenging to identify the true cause of hearing difficulties.

Common Culprits: Over-the-Counter Medications

Some of the most widely used over-the-counter medications can affect hearing, especially when taken in high doses or for extended periods.

Aspirin and NSAIDs
That daily aspirin for heart health or the ibuprofen you take for arthritis pain can potentially cause hearing problems. High doses of aspirin (typically more than 8-12 tablets per day) can cause tinnitus (ringing in the ears) and temporary hearing loss. The good news is that these effects are usually reversible when the medication is stopped or the dose is reduced.

NSAIDs like ibuprofen (Advil, Motrin) and naproxen (Aleve) can also cause hearing issues, particularly with long-term use. If you're taking these medications regularly for chronic conditions like arthritis, it's worth discussing with your doctor whether the benefits outweigh the potential risks to your hearing.

Acetaminophen (Tylenol)
While generally considered safer than NSAIDs for many people, regular use of acetaminophen, especially in combination with aspirin, has been linked to hearing loss in some studies. This is particularly concerning because acetaminophen is found in many combination medications, so you might be taking more than you realize.

Prescription Medications: The Serious Players

Antibiotics
Certain antibiotics, particularly those in the aminoglycoside family (like gentamicin and streptomycin), can cause significant hearing damage. These are typically used for serious infections and are usually given in hospital settings where hearing can be monitored. However, some topical antibiotic ear drops also contain these medications and can cause problems if used improperly or if you have a perforated eardrum.

Diuretics (Water Pills)
Loop diuretics like furosemide (Lasix) are commonly prescribed for heart failure and high blood pressure. While they're effective at reducing fluid retention, they can also cause hearing problems, particularly when given in high doses or combined with other ototoxic medications.

Chemotherapy Drugs
Cancer treatments, particularly platinum-based chemotherapy drugs like cisplatin, can cause significant hearing loss. This is often permanent and can affect both hearing and balance. If you're undergoing cancer treatment, your medical team should monitor your hearing throughout the process.

Antimalarial Medications
Medications like quinine (sometimes used for leg cramps) and chloroquine can cause hearing problems, particularly with long-term use. These effects are usually reversible, but it's important to be aware of the possibility.

The Aspirin Paradox

Aspirin deserves special attention because it's so commonly used, especially among older adults for cardiovascular protection. The hearing effects of aspirin are dose-dependent and usually temporary, but they can be concerning if you don't know to expect them.

Low-dose aspirin (81mg daily) rarely causes hearing problems. However, higher doses—like those sometimes used for pain relief or anti-inflammatory effects—can cause tinnitus and hearing loss. The symptoms typically appear within days to weeks of starting high-dose aspirin therapy and usually resolve within a few days to weeks after stopping the medication.

Multiple Medications: The Compound Effect

If you're taking several medications, the risk of hearing problems can increase. This is particularly true if you're taking more than one potentially ototoxic medication. For example, taking a diuretic along with high-dose aspirin might increase your risk of hearing problems more than taking either medication alone.

This is why it's so important to keep all your healthcare providers informed about every medication you're taking, including over-the-counter drugs, supplements, and herbal remedies. What might seem like a harmless combination to you could be potentially problematic for your hearing.

Recognizing the Warning Signs

The early signs of medication-related hearing problems can be subtle:

• Gradually increasing the volume on your TV or radio
• Difficulty understanding conversations, especially in noisy environments
• Ringing, buzzing, or other sounds in your ears (tinnitus)
• Feeling like your ears are "full" or "plugged"
• Dizziness or balance problems
• Sounds seeming muffled or distant

If you notice any of these symptoms after starting a new medication or increasing a dose, don't ignore them. Contact your healthcare provider promptly. In many cases, catching medication-related hearing problems early can prevent permanent damage.

The Importance of Timing

The timing of hearing symptoms in relation to medication changes can provide important clues. If you start a new medication and notice hearing changes within days or weeks, there's a good chance the medication is the culprit. However, some medications can cause hearing problems even after you've been taking them for months or years.

Keep a simple log of when you start new medications and any changes in your hearing. This information can be invaluable to your healthcare providers in determining whether a medication might be affecting your hearing.

Communication with Your Healthcare Team

When discussing medications with your doctor or pharmacist, don't hesitate to ask about potential effects on hearing. Questions you might consider include:

• Are there any alternatives to this medication that might be less likely to affect my hearing?
• What should I watch for in terms of hearing changes?
• How quickly should I contact you if I notice hearing problems?
• Are there any other medications I'm taking that might increase my risk?

Remember, your healthcare providers want to help you maintain your quality of life, and that includes preserving your hearing. They may be able to adjust doses, switch medications, or provide additional monitoring to minimize risks.

The Risk-Benefit Balance

It's important to understand that having hearing-related side effects doesn't automatically mean you should stop taking a medication. Many of these medications treat serious conditions, and the benefits may far outweigh the risks. For example, if you're taking a life-saving cancer treatment or a medication that prevents heart attacks, the hearing risks might be acceptable.

The key is making informed decisions in partnership with your healthcare providers. They can help you weigh the risks and benefits based on your specific situation and health needs.

Monitoring and Prevention

If you're taking medications that can affect hearing, regular hearing evaluations can help detect problems early. Some healthcare providers recommend baseline hearing tests before starting certain medications, followed by periodic monitoring.

You can also do some self-monitoring at home. Pay attention to how clearly you're hearing everyday sounds, and don't hesitate to mention any changes to your healthcare providers, even if they seem minor.

The Supplement Question

Don't forget that over-the-counter supplements and herbal remedies can also affect hearing. Some supplements, particularly those containing high doses of aspirin-like compounds, can cause hearing problems. Always inform your healthcare providers about any supplements you're taking.

When Permanent Damage Occurs

While many medication-related hearing problems are temporary, some can cause permanent damage. This is particularly true for certain antibiotics and chemotherapy drugs. If you've experienced permanent hearing loss from medications, don't despair. Modern hearing aids are more effective than ever, and there are many strategies for managing hearing loss and maintaining your quality of life.

The Bottom Line

Medications can be life-saving and life-enhancing, but they can also sometimes affect your hearing. Being aware of this possibility and maintaining open communication with your healthcare providers is your best defense. Most medication-related hearing problems are preventable or reversible when caught early.

Don't let fear of hearing side effects prevent you from taking medications you need. Instead, be an informed patient who knows what to watch for and when to seek help. Your hearing is precious, but so is your overall health. With proper awareness and communication, you can protect both.

Remember, you're not just a passive recipient of medical care—you're an active participant in your health. By staying informed about your medications and their potential effects on your hearing, you're taking an important step toward maintaining your quality of life and staying connected to the world around you.