The problem occurs because you are not sitting in his office as you should. You are ignorant and intimidated because you don’t know medicine, and you have not realized that the sign above his door says practicing medicine. Practicing is just guessing on how others have reacted before you; mistakes can happen.

When you receive an antibiotic like Floxin, be careful. It can cause death. Or if you live through the treatment, it can still cause Ototoxic Hearing Loss, Ototoxic Tinnitus, or heaven forbid as I experienced, both.

My recommendation is to follow my lead.

Go to the doctors with your Google app open and ready to go. Doctors don’t usually like this as you challenge their authority.

I recently did this at the dentist, and when he went to describe a simple pain management medication, I Googled it and found the side effects and told him that I could not live with this risk, what other drugs are available, and he prescribed Tramadol. I went from the most addictive opioid with massive side effects to the least addictive painkiller and learned the precautions and limits with a reduced chance of addiction.

Here is a pamphlet that I found on the side effects. It’s about medications that cause hearing loss and Tinnitus and how to avoid them at all costs.

1.2 The Pamphlet

This pamphlet indicates which most commonly used medications could potentially cause damage to your hearing or aggravate an already existing problem. It is vital that you, the patient, take responsibility for knowing which drugs you should try to avoid.

Usually, any hearing problem will only be caused by exceeding the recommended dosage of the medications. Often these problems are reversible upon discontinuation of the drug. Occasionally there are times when this change in hearing can be permanent. If you are experiencing a hearing problem, or if there is a hearing disorder in your family, ensure that your treating physician and pharmacist know.

If you’re prescribed one of the medications found on this list, you should immediately speak to your physician to see if another, potentially less toxic drug, could be used in its place. (This is why you need to have Google ready to search).

If the drug is over-the-counter, you should ask the pharmacist for a recommendation of a less toxic drug.

In the lists that follow, the generic name of the drug is given first. The trade name, if available, follows capitalized and in parentheses.

Many times a particular generic drug is manufactured under several trade names.

This list was compiled by:

Orin S. Kaufman, D.O.

Here is a list of Medications that cause hearing loss and Tinnitus, ototoxic hearing loss, Drug Hearing Loss, and is not an exhaustive list.

1.3 Medications that cause hearing loss

1.3.1 Salicylates

• aspirin and aspirin-containing products

• salicylates and methyl- salicylates (linaments)

(Toxic effects appear to be dose-related and are almost always reversible once medications are discontinued.)

1.3.2 Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

(Most NSAIDS have the potential for causing hearing loss and Tinnitus. Because new drugs are frequently approved for use, you must check with your doctor or pharmacist to determine if the medication you were prescribed can cause a problem.)

• diclofenac (Voltaren)

• etodolac (Lodine)

• fenoprofen (Nalfon)

• ibuprofen (Motrin, Advil, Nuprin, etc.)

• indomethacin (Indocin)

• naproxen (Naprosyn, Anaprox, Aleve)

• piroxicam (Feldene)

• sulindac (Clinoril)

(Toxic effects are dose-related and are

almost always reversible once medications are discontinued.)

1.3.3 Antibiotics

• aminoglycosides

– amikacin (Amakin)

– gentamycin (Garamycin)

– kanamycin (Kantrex)

– neomycin (Found in many over-the-counter antibiotic ointments.)

– netilmicin (Netromycin)

– streptomycin

– tobramycin (Nebcin)

(Of particular interest: topical ear drop medications containing gentamycin or neomycin do not appear to be ototoxic in humans unless the tympanic membrane (eardrum) is perforated. When a solution of an aminoglycoside antibiotic is used on the skin and used together with an aminoglycoside antibiotic, there is a risk of an increase of the ototoxic effect. It is also the case if used intravenously; there is a risk of a rise in ototoxic effects, primarily if the solution used on a wound that is open or raw or if the patient has underlying kidney damage.

Neomycin is the most toxic drug to the structure involved in hearing, the cochlea, so it is recommended for topical use only. But even topical therapy had resulted in hearing loss when large areas were treated, and large amounts of the drug were absorbed into the body. Hearing loss caused by this class of antibiotics is usually permanent.

• erythromycin

– (EES)

– (E-mycin)

– (Ilosone)

– (Eryc)

– (Pediazole)

– (Biaxin)

– (Zithromax)

(Usually ototoxic when given in intravenous doses of 2-4 grams per

24 hours, especially if there is underlying kidney failure.)

• vancomycin (Vancocin) (Similar to aminoglycosides in that it may be ototoxic when used intravenously in life-threatening infections. The fact that aminoglycosides and vancomycin are often used together intravenously when treating life-threatening infections further exaggerates the problem.)

• minocycline (Minocin) (Similar to erythromycin)

• polymixin B & amphotericin B

(Antifungal preparations)

• capreomycin (Capestat) (Anti-tuberculosis medication)

1.4 Drugs that can cause Tinnitus

Diuretics

• bendroflumethiazide (Corzine)

• bumetanide (Bumex)

• chlorthalidone (Tenoretic)

• ethacrynic acid (Edecrin)

• furosemide (Lasix)

(These are usually ototoxic when given intravenously for acute kidney failure, acute hypertensive crisis, or acute pulmonary edema/congestive heart failure. Rare cases of ototoxicity have been found when these medications are taken orally in high doses by people with chronic kidney disease.)

1.4.1 Chemotherapeutic Agents

• bleomycin (Blenoxane)

• bromocriptine (Parlodel)

• carbo platinum (Carboplatin)

• cisplatin (Platinol)

• methotrexate (Rheumatrex)

• nitrogen mustard (Mustargen)

• vinblastin (Velban)

• vincristine (Oncovin)

(The ototoxic effects can be minimized by

carefully monitoring blood levels.)

Quinine

• chloroquine phosphate (Aralen)

• quinacrine hydrochloride

(Atabrine)

• quinine sulfate (Quinam)

(The ototoxic effects are very similar to

those of aspirin.)

Mucosal Protectant

• misoprostol (Cytotec)

Narcotic Analgesics

• hydrocodone (Lorcet, Vicodin)

1.4.2 Vapors, Solvents

• cyclohexane

• dichloromethane

• hexane (gasoline)

• lindane (Kwell)

• methyl-chloride

• methyl-n-butyl-ketone

• perchlor-ethylene

• Styrene

• tetrachlor-ethane

• toluol

• trichloroethylene

1.4.3 Antibiotics

• aminoglycosides (see the previous section)

• amphotericin B

• chloramphenicol (Chloromycetin)

• minocycline (Minocin)

• polymyxin B

• sulfonamides (Septra, Bactrim)

• vancomycin (Vancocin)

1.4.4 Antineoplastics

• bleomycin (Blenoxane)

• cis-platinum (Platinol)

• carbo platinum (Paraplatin)

• methotrexate (Rheumatrex)

• nitrogen mustard (Mustagen)

• vinblastin (Velban)

1.4.5 Diuretics

• acetazolamide (Diamox)

• bumetanide (Bumex)

• bendrofluazide

• clorothalidone (Hygroton, Tenoretic)

• diapamide

• ethacrynic acid (Edecrin)

• furosemide (Lasix)

• hydrochlorthiazide (Hydrodiuril)

• methylchlorthizide (Enduron)

1.4.6 Cardiac Medications

• celiprolol

• flecainide (Tambocar)

• lidocaine

• metoprolol (Lopressor)

• procainamide (Pronestyl)

1.4.7 Nitus

• propranolol (Inderal)

• quinidine (Quinaglute, Quinidex)

• indomethacin (Indocin)

• isoxicam

• ketoprofen (Orudis)

1.4.8 Psychopharmacological Agents

• amitryptiline (Elavil)

• benzodiazepine class

– alprazolam (Xanax)

– clorazepate (Tranxene)

– chlordiazepoxide (Librium)

– diazepam (Valium)

– flurazepam (Dalmane)

– lorazepam (Ativan)

– midazolam (Versed)

– oxazepam (Serax)

– prozepam (Centrax)

– quazepam (Doral)

– temazepam (Restoril)

– triazolam (Halcion)

• bupropion (Welbutrin)

• carbamzepine (Tegretol)

• diclofensine

• doxepin (Sinequin)

• desiprimine (Norpramin)

• fluoxetin (Prozac)

• imipramine (Tofranil)

• lithium

• melitracen

• molindon (Moban)

• paroxetin

• phenelzin (Nardil)

• protriptilin (Vivactil)

• trazodon (Desyrel)

• zimeldin

1.5 Non-Steroidal Anti-inflammatory Drugs (NSAIDs)

(Please see notation for NSAIDS under “hearing loss.”)

• aspirin

• acematacine

• benorilate

• benoxaprofen

• carprofen

• diclofenac (Voltaren)

• diflunisal (Dolobid)

• fenoprofen (Nalfon)

• feprazon

• ibuprofen (Motrin, Advil, Nuprin)

• methyl salicylates (BenGay)

• naproxen (Naprosyn, Anaprox, Aleve)

• D-Penicilliamin

• phenylbutazone (Butazolidine)

• piroxicam (Feldene)

• proglumetacin

• proquazon

• rofecoxib (Vioxx)

• salicylates

• sulindac (Clinoril)

• tolmetin (Tolectin)

• zomepirac

1.5.1 Glucocorticosteroids

• prednisolone (Prednisone)

• ACTH (adrenocorticotrophic hormone) (Acthar)

1.5.2 Anesthetics

• bupivacain

• tetracain

• lidocaine (Novacaine)

1.5.3 Antimalarials

• chloroquine (Aralen)

• hydroxychloroquine (Plaquenil)

1.5.4 Others

• thalidomide (Thalomid)

1.5.5 Miscellaneous Toxic Substances

• alcohol

• arsenum

• caffeine

• lead

• marijuana

• nicotine

• mercury

• auronofin (gold, Ridaura)

(Ironically, several of these drugs found to cause Tinnitus, are also used to treat

tinnitus (e.g., amitryptiline, benzodiazepine class, carbamazepine, furosemide, lidocaine, prednisone).)

This is a list of Medications that cause hearing loss and Tinnitus, ototoxic hearing loss, Drug Hearing Loss, and is not an exhaustive list.

1.6 About the League

A pioneer in hearing rehabilitation, human services, and hearing conservation. The League for the Hard of Hearing, founded in 1910, is a private, not-for-profit rehabilitation agency for infants, children, and adults who are hard of hearing, deaf, and deaf-blind.

The mission of the League for the Hard of Hearing is to improve the quality of life for people with all degrees of hearing loss. This is accomplished by providing hearing rehabilitation and human service programs for people who are hard of hearing and deaf, and their families, regardless of age or mode of communication.
We strive to empower consumers and professionals to achieve their potential and to provide leadership to, and be the model for, disciplines that relate to hearing rehabilitation.
We promote hearing conservation and provide public education about hearing.

1.7 Ototoxic Drugs: Bibliography

Claussen, C.F, (1996). Chemically induced or drug-induced Tinnitus. International Tinnitus Journal, 2, l-2.
Drug Facts & Comparisons. (1995) St. Louis, MO. J.B. Lippincott.
Epstein, S. (1996) What you should know about ototoxic medications. Journal of Self Help for Hard of Hearing People, 16, 29-30.
PDR Drug Interactions and Side Effects. (50th ed.). (1996). Montvale, N.J: Medical Economics Co.
Physicians Desk Reference (50th ed.). (1996). Montvale, NJ: Medical Economics Co. Suss, E. When the Hearing Gets Hard. (pp. 167-216). New York, NY: Bantam Books.
USP is dispensing Information. (1997). In Drug Information for the Health Care Professional. Vol. 1. Rockville, MD: The United States Pharmacopeial Convention, Inc.

Original Copy