Tinnitus and Ringing in the Ears from Medications: What to Know

Many people notice a new ringing, buzzing, or hissing in their ears after starting a new medication. It’s not just in their head - it’s a real side effect called medication-induced tinnitus. And it’s more common than most doctors tell you. Over 600 prescription and over-the-counter drugs can trigger or worsen this sound, even if they have nothing to do with your ears on paper. The good news? In most cases, it stops when you stop the drug. The bad news? Some drugs can cause permanent damage - and you might not know you’re at risk until it’s too late.

How Medications Damage Your Ears

Your inner ear is full of tiny hair cells that turn sound waves into electrical signals your brain understands. Some medications interfere with these cells or the nerve that carries sound to your brain. This is called ototoxicity. It doesn’t always mean you’ll lose hearing - but you’ll likely hear ringing, roaring, or clicking when there’s no sound around.

The exact mechanism isn’t fully understood, but experts believe these drugs cause chemical changes inside the ear. They might block blood flow, overload cells with toxins, or mess with the electrical signals. The result? Your brain starts hearing phantom noise.

Not all ototoxic drugs are created equal. Some cause temporary ringing that fades within days. Others, like certain antibiotics or chemotherapy drugs, can destroy inner ear cells permanently. The difference often comes down to dosage, how long you take it, and your body’s sensitivity.

Drugs That Commonly Cause Tinnitus

Here are the main categories of medications linked to ringing in the ears, ranked by risk level:

• Aminoglycoside antibiotics - Gentamicin, tobramycin. Used for serious infections. Risk of permanent hearing loss is high, especially with IV use or long courses. Topical versions (eye drops, creams) are much safer.
• Chemotherapy drugs - Cisplatin and carboplatin. Up to 70% of patients on cisplatin develop hearing problems. Tinnitus often starts with high-pitched tones you can’t even hear normally - then spreads to speech frequencies.
• Loop diuretics - Furosemide (Lasix), bumetanide. Used for heart failure and swelling. Tinnitus can hit fast - sometimes within hours. Usually reversible if caught early.
• High-dose aspirin and NSAIDs - Taking more than 4,000 mg of aspirin daily can cause ringing in about 15% of people. But here’s the catch: most people take 325-650 mg for headaches. At those doses, tinnitus is extremely rare. Same goes for ibuprofen - 800 mg three times a day might trigger it, but 200 mg once in a while won’t.
• Antimalarials - Quinine. Used for leg cramps or malaria. Ringing often starts within 1-3 days and fades within weeks after stopping.
• Isotretinoin (Accutane) - Used for severe acne. About 5% of users report tinnitus. Some cases resolve after stopping; others stick around.
• Antidepressants - SSRIs like sertraline (Zoloft) and fluoxetine (Prozac). Tinnitus is rare - less than 1% of users. But some people report it starting or worsening when they begin or stop the drug.
• Benzodiazepines - Xanax, Valium. Long-term use (6+ months) is linked to tinnitus in some users. Not common, but documented.

Some drugs have mixed reports. Beta blockers like carvedilol (Coreg) have been tied to tinnitus, but atenolol hasn’t. The difference? It’s not just the class - it’s the specific molecule. That’s why blanket warnings like “all antidepressants cause tinnitus” are misleading.

Is Your Tinnitus Reversible?

About 60% of medication-induced tinnitus cases go away after stopping the drug. But not all.

If you’re on cisplatin or gentamicin, permanent damage is possible - even if you feel fine at first. That’s why doctors monitor hearing during treatment. Baseline hearing tests before starting, then follow-ups every 1-2 weeks, are standard for high-risk drugs.

For NSAIDs or aspirin, symptoms usually vanish within a week of quitting. One Reddit user reported ringing after taking 800 mg ibuprofen every 8 hours for a toothache. It started after 2 days. He stopped the pills. The noise was gone in 5 days.

The problem? Many people don’t connect the dots. They think the ringing is stress, aging, or just “normal.” They keep taking the drug - and the damage becomes permanent.

What to Do If You Notice Ringing

Don’t panic. Don’t quit your meds cold turkey. Do this:

1. Check your meds. Look up your pills on GoodRx, Healthline, or the FDA’s drug label. Search for “tinnitus” or “ototoxic.”
2. Track timing. Did the ringing start within 1-14 days of beginning the drug? That’s a strong clue. Delayed onset (up to 90 days) happens with chemo and some antibiotics.
3. Call your doctor. Say: “I started [drug name] and now I have constant ringing in my ears. Could this be related?”
4. Don’t stop abruptly. Stopping antidepressants or blood pressure meds suddenly can be dangerous. Your doctor might switch you to a safer alternative or lower the dose.
5. Ask for a hearing test. An audiologist can check if your hearing has changed - especially in high frequencies. Early detection saves hearing.

Some people are more sensitive. A tiny number react to low-dose aspirin. If you’ve had tinnitus from a small dose before, avoid that drug forever. Tell every doctor you see.

What Your Doctor Should Be Doing

Most primary care doctors don’t screen for ototoxicity. A 2022 survey found only 35% routinely ask about hearing changes before prescribing high-risk drugs.

You deserve better. Ask your doctor:

• “Is this drug known to affect hearing?”
• “Do I need a baseline hearing test before starting?”
• “Are there safer alternatives?”
• “Should I get my hearing checked during treatment?”

For high-risk drugs like cisplatin or gentamicin, hospitals are starting to use therapeutic drug monitoring - checking blood levels to avoid overdose. It’s not everywhere yet, but it’s growing. Ask if your hospital does it.

Living With Medication-Induced Tinnitus

If the drug must continue - like chemo for cancer - you can’t just stop. But you can manage the ringing.

Sound therapy helps. White noise machines, fans, or soft music can mask the sound. Cognitive behavioral therapy (CBT) teaches your brain to stop reacting to the noise. Studies show 60-70% of people feel better with CBT, even if the sound doesn’t vanish.

Avoid caffeine, alcohol, and nicotine. They can make tinnitus louder. Stress makes it worse too. Sleep and exercise matter.

There’s no pill to cure it - yet. But the NIH is funding $12.5 million in research for otoprotective agents - drugs that shield your ears from damage without lowering the treatment’s effectiveness. Early trials are promising.

Bottom Line: Know Your Meds, Protect Your Hearing

You don’t need to memorize a list of 600 ototoxic drugs. But you do need to know the big ones: antibiotics like gentamicin, chemo drugs like cisplatin, high-dose NSAIDs, and diuretics like Lasix.

If you’re on one of these, pay attention. Ringing in your ears isn’t just annoying - it’s a warning sign. Talk to your doctor. Get your hearing checked. Don’t wait until the sound won’t go away.

Most cases are reversible. But only if you act fast.

Next Steps

If you’re on a medication that lists tinnitus as a side effect:

• Write down the name of the drug and when you started it.
• Rate your tinnitus: 1 (barely noticeable) to 10 (unbearable).
• Call your doctor and say: “I’m hearing ringing since I started [drug name]. Can we review this?”
• Ask for a referral to an audiologist if you haven’t had a hearing test in the last year.

If you’ve already stopped the drug and the ringing is gone - great. But if it’s still there after 4 weeks, see an audiologist. Persistent tinnitus isn’t normal, even if the drug is out of your system. There are effective management strategies - you just need to take the first step.