Medications You Didn’t Know Could Be Damaging Your Hearing

When considering the side effects of medications, hearing loss may not come to mind. Yet, many drugs, ranging from everyday painkillers to vital medical treatments, pose risks to hearing. Known as ototoxicity, these effects can vary, including temporary tinnitus or permanent damage. 

People who frequently use certain medications, especially at high doses, should be aware of these risks. Being informed allows you to manage your health conditions effectively while protecting your hearing. In this article, we delve into medications that harm your hearing and offer practical advice to help safeguard your ears from damage.

Aspirin: Common Pain Relief with Unexpected Risks

The Deaf and Hard of Hearing Services Division states that 15% of Americans experience tinnitus, which is especially common among veterans. Notably, around 90% of those with tinnitus also have hearing loss, underscoring a strong connection between the two. 

Aspirin, a widely used pain reliever, may pose unexpected risks to hearing. At high doses, it can cause temporary hearing problems or tinnitus by affecting inner ear cells responsible for sound transmission. While hearing typically recovers after discontinuation, frequent or long-term use can increase the risk. 

For individuals using aspirin to manage chronic conditions like heart disease, it’s essential to monitor any changes in hearing closely. Consulting a doctor about alternative pain relief options may help mitigate potential hearing problems while still addressing pain and supporting cardiovascular health.

How can I manage chronic pain without risking hearing loss?

To avoid hearing risks, choose non-ototoxic pain management strategies like acetaminophen, physical therapy, or alternative treatments like yoga. If potentially ototoxic drugs are necessary, discuss using the lowest effective dose with your doctor. Regular hearing checks and monitoring for early symptoms, such as ringing in the ears, are key steps to safeguard hearing.

Certain Antibiotics: The Risk of Ototoxicity

Some antibiotics, especially aminoglycosides like gentamicin, pose a significant risk of ototoxicity, potentially damaging the inner ear’s hair cells. The risk increases for patients with kidney issues or long-term, high-dose use, potentially leading to hearing loss or tinnitus. 

Frontiers Media states hearing loss occurs in up to 33% of patients on aminoglycosides and 6-7% of those using furosemide. The risk of permanent hearing damage is 50% for those treated with injectable drugs like amikacin and streptomycin for drug-resistant tuberculosis.

Given these risks, doctors carefully weigh the benefits and monitor hearing closely to detect early signs of damage.

Tepezza: A New Drug with Potential Hearing Side Effects

Tepezza (teprotumumab), a treatment for thyroid eye disease, has been effective in reducing symptoms like eye bulging. However, some patients have reported hearing-related side effects, including tinnitus and hearing loss. These issues are believed to arise from the drug’s impact on the auditory pathways.

Tepezza states that in clinical trials, about 10% of patients initially reported hearing issues, increasing to 20% recently. The reported issues included hyperacusis, Eustachian tube dysfunction, and tinnitus. Despite these concerns, only one patient discontinued Tepezza due to hearing problems related to a pre-existing condition.

The rising number of reported hearing issues has led some patients to file lawsuits against the manufacturer, Horizon Therapeutics. 

The Tepezza lawsuit alleges that Horizon Therapeutics did not adequately warn patients about the risks of hearing-related side effects. The legal action seeks compensation for medical expenses and damages related to the lasting harm associated with the drug.

While hearing problems linked to Tepezza are often temporary, some cases persist even after the medication is discontinued, prompting further legal action. 

According to TorHoerman Law, the Judicial Panel on Multidistrict Litigation (JPML) reported 173 active Tepezza lawsuits in September. By October, this number had increased to 178, reflecting the addition of five more cases.

Chemotherapy Drugs: Protecting Your Hearing While Fighting Cancer

Chemotherapy drugs, such as cisplatin and carboplatin, play a crucial role in cancer treatment but come with significant risks to hearing. 

The Division of Cancer Prevention states hearing loss affects around 50% of survivors, with up to 70% in those receiving platinum-based therapies. Tinnitus is also common, impacting about 40% of patients. 

These drugs may harm inner ear structures, particularly at higher or cumulative doses, resulting in auditory issues. Regular hearing tests before, during, and after chemotherapy can detect early impairment, while protective strategies may reduce risks.

Balancing effective cancer treatment with hearing health can greatly improve quality of life and minimize long-term auditory effects.

What steps can I take to protect my hearing during cancer treatment?

Protect your hearing by scheduling regular audiometric tests before, during, and after cancer treatment, particularly with ototoxic chemotherapy. Consider preventive measures like otoprotective agents, if available. Stay alert for early hearing loss signs like tinnitus, and notify your healthcare provider to discuss risk-reducing treatment adjustments.

Loop Diuretics: The Balance Between Fluid and Hearing Health

Loop diuretics like furosemide and bumetanide manage fluid retention in heart failure but may impact hearing, especially at high doses. These medications can cause temporary or permanent hearing loss by disrupting inner ear fluid and electrolyte balance. Symptoms of ototoxicity, which may occur, include tinnitus, muffled sounds, and changes in hearing clarity.

According to NCBI, the risk of reversible hearing loss from loop diuretics is lower than aminoglycosides or platinum-based chemotherapies. Ototoxicity rates for loop diuretics are around seven per 1000 cases, significantly lower than other ototoxic medications. Moreover, salicylates and nonsteroidal anti-inflammatory drugs also contribute to hearing loss, with an incidence of 11 per 1000. 

Loop diuretics may affect the sodium, potassium, and chloride cotransporter in the cochlea, disrupting endolymph potassium levels.

What are the signs of hearing loss associated with loop diuretics?

Hearing loss from loop diuretics may present as ringing in the ears, muffled sounds, or difficulty understanding speech, especially in noisy environments. Symptoms can appear quickly or gradually, depending on dose and duration. If you notice these signs, seek medical evaluation promptly to discuss potential changes in medication or dose to protect your hearing.

Protecting Hearing from Medication Risks

Many commonly used medications carry the risk of hearing damage, making awareness and proactive measures essential. Understanding the potential of ototoxicity from everyday pain relievers to cancer treatments helps individuals balance medical needs with hearing preservation. 

Regular hearing evaluations, early detection of symptoms, and consulting healthcare providers about less ototoxic alternatives can help manage these risks effectively. 

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