Medications and hearing: Unmasking the hidden risks of ototoxicity

• Over 200 medications, including antibiotics and NSAIDs, are linked to ototoxicity, causing hearing loss or tinnitus.
• Aspirin is a leading reversible contributor to hearing issues, with higher risks at moderate/high doses.
• Cisplatin and aminoglycosides carry high risks for irreversible hearing loss, especially in cancer patients.
• Ototoxicity occurs due to drug-induced damage to inner ear hair cells or disrupted fluid balance.
• Patients should monitor medications and immediately report hearing changes to doctors.

New research revealing that common medications, including aspirin and over-the-counter painkillers like ibuprofen, may cause irreversible hearing loss and tinnitus has ignited urgent public health concern. This study highlights a previously underreported risk, emphasizing that even a modest 9-10% increase in hearing loss could drastically impact millions globally, given the widespread use of these drugs. While earlier investigations found similar risks in both men and women, current findings underscore a broader threat: over 200 drugs—ranging from everyday analgesics to potent chemotherapy agents—are now recognized as ototoxic, damaging delicate ear structures or neural pathways critical to hearing.

Vulnerable populations, including older adults, kidney disease patients and newborns exposed to antibiotics, face heightened risks, particularly with prolonged or high-dose use. Though reversible in some cases when medication is halted, experts warn of escalating dangers as ototoxic effects can manifest rapidly. These revelations have spurred calls for heightened patient awareness, transparent labeling of drug risks and careful consideration of benefits versus harm, especially as an estimated hundreds of causes of hearing loss, including pharmaceuticals, continue to challenge global health systems.

The hidden threat of ototoxic medications

Ototoxicity, a condition where drugs damage hearing or balance, has long lurked in medication side-effect long lists. A July 2025 study by researchers at Kingston University identified nearly 200 ototoxic substances, but awareness remains low. “These drugs save lives—like antibiotics for sepsis—yet hearing loss can be an invisible consequence,” says study co-author Dipa Kamdar.

The mechanisms vary. Some medications, like aminoglycoside antibiotics (e.g., gentamicin), damage cochlear hair cells—irreparable sensory cells essential for hearing. Others, such as loop diuretics (e.g., furosemide), disrupt inner-ear fluid balance, causing temporary hearing loss. Risk rises with genetic susceptibility, concurrent noise exposure, or combining multiple ototoxic drugs.

Antibiotics and cancer therapies: A tug-of-war between survival and hearing

Aminoglycosides, often life-saving for infections like meningitis or sepsis, pose the steepest hearing risks. “Gentamicin can be a death sentence for hearing,” warns audiologist Dr. Emily Chen. In neonatal ICUs, high intravenous doses can lead to permanent damage, necessitating lifelong hearing aids. Similarly, chemotherapy drugs such as cisplatin spare lives but extract a steep toll: up to 60% of patients experience hearing loss, often irreversible.

Recent studies highlight compounded risks. A 2024 analysis found cisplatin’s toxicity intensifies when paired with radiation, and some patients report symptoms months after treatment ends. Pharmaceutical companies are experimenting with drug-delivery methods to minimize inner-ear permeability, but for now, dosing adjustments and genetic testing remain key safeguards.

Over-the-counter drugs: The aspirin-hearing link

While major causes like antibiotics grab headlines, everyday medications—especially pain relievers—surprise many. A landmark study in The American Journal of Medicine found moderate aspirin use (325 mg six times weekly) increased tinnitus risk by 16% in women under 60. NSAIDs like ibuprofen also carry risks, particularly in younger men, who face a higher likelihood of hearing loss with prolonged use.

Dr. Adrian Turner, an otolaryngologist, notes, “Aspirin is the leading cause of medication-related tinnitus. Reducing doses or switching to acetaminophen often reverses symptoms.” Yet overreliance persists: 19 million U.S. adults regularly take NSAIDs for chronic pain, per CDC data, raising concerns about undiagnosed hearing impacts.

How history and research are shifting the conversation

Ototoxicity has been under the radar for decades. In the 20th century, aminoglycosides emerged as miracle antibiotics without acknowledgment of their hearing risks. By the 1990s, cisplatin’s side effects became notorious in oncology circles, but systemic awareness lagged.

Advocacy groups, including the Academy of Doctors of Audiology, are pushing for label warnings and pediatric hearing screenings after antibiotic use. “We once told patients to suffer through cisplatin’s side effects,” says oncologist Dr. Raj Patel. “Now we track audiograms during chemo to preempt damage.” Regulatory shifts include FDA mandates for ototoxicity data in drug trials, curbing historical secrecy.

Bellwether implications: A call for vigilance

Experts emphasize that ototoxicity isn’t always avoidable—especially in dire treatments—but informed choices matter. Patients should ask doctors for ototoxicity scores of prescribed drugs, monitor symptoms and pursue audiograms post-treatment.

As research expands, stakes grow. GLP-1 diabetes drugs like Ozempic face scrutiny for anecdotal hearing issues, while tinnitus apps like Tinnitrack aim to measure real-time effects. “Your hearing is non-renewable,” says Kamdar. “Treat medications like a scalpel—not a harmless pill—even when they ease pain.”

Preserving sound health

The spotlight on ototoxicity underscores a critical truth: modern medicine’s miracles come with trade-offs. As millions juggle chronic pain, infections and cancer, understanding their medications’ hidden costs could prevent preventable hearing loss. “This isn’t about fear,” says Dr. Turner. “It’s about knowledge—your ears are worth fighting for.” Today’s advancements offer hope, but vigilance demands equal parts science, transparency and patient empowerment.

Sources for this article include:

StudyFinds.org

HealthyHearing.com