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URLhttps://www.verywellhealth.com/medications-that-can-cause-tinnitus-8743066
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Meta Title12 Medications Causing Tinnitus (Ringing in the Ears)
Meta DescriptionMedications that can cause tinnitus include acetaminophen, NSAIDs, some antibiotics, blood pressure medications, and more.
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Key Takeaways Some medications can cause tinnitus, including common painkillers like acetaminophen and NSAIDs. Tinnitus from medications is often temporary and usually stops after discontinuing the medication. Ototoxicity is an adverse effect of some drugs. It is a condition that occurs when the inner ear is damaged by certain medications or chemicals, causing hearing problems or tinnitus (ringing in the ears). The symptoms of tinnitus can vary significantly, depending on whether you hear sounds in one ear, in both ears, or inside the head.  Certain medications cause tinnitus, which can be temporary or rarely permanent and depends on different factors. Common ototoxic drugs (drugs that can have toxic effects on the ears) include antibiotics, analgesics (pain relievers), blood pressure medications, anticonvulsants (anti-seizure drugs) , and others. 1. Acetaminophen Tylenol (acetaminophen) is one of the most commonly used over-the-counter (OTC) painkillers. Prolonged use can cause hearing problems, such as tinnitus. These problems are usually temporary and resolve on their own after stopping the medication. One study from 2023 showed that frequent users of acetaminophen may be at higher risk of persistent tinnitus. The study looked at data from more than 10,000 cases of persistent tinnitus and included only women. More studies that include different populations are needed. 2. Antidepressants Antidepressants are sometimes used to treat tinnitus. However, they have also been reported to cause or worsen tinnitus in people with previous symptoms. Studies have suggested that serotonin may exacerbate tinnitus. This means that selective serotonin reuptake inhibitors (SSRIs) , a type of antidepressant that increases serotonin (a chemical in the brain that regulates various functions such as mood and cognition), could make tinnitus worse. The types of antidepressants used in treating tinnitus‐related symptoms are tricyclic antidepressants and SSRIs. These include: Amitriptyline Lexapro (escitalopram) Pamelor (nortriptyline) Prozac (fluoxetine) Imipramine Zoloft (sertraline hydrochloride) 3. Anti-Seizure Drugs Side effects while taking antiepileptic drugs (AEDs) can occur due to the epilepsy itself or the long-term use of medication. Side effects include tinnitus and sensorineural hearing loss (hearing loss due to nerve damage). Commonly used AEDs that are more likely to cause these side effects are: Depakote (valproate) Dilantin (phenytoin) Lamictal (lamotrigine) Neurontin (gabapentin) Sabril (vigabatrin) Tegretol (carbamazepine) Trileptal (oxcarbazepine) Ototoxicity with AEDs is caused by delayed signal transmission between the neurons (cells that transmit signals throughout the body) and neurotransmitters (chemical messengers that carry messages between nerves). These side effects may be temporary, long-lasting, or irreversible. 4. Antimalarial Drugs Antimalarial drugs can cause ringing in the ears when taken in higher doses for a prolonged time.  In rare cases, these drugs can also cause tinnitus at low doses, but it is temporary and reversible. Common antimalarial drugs that cause tinnitus include quinine, hydroxychloroquine, and chloroquine. 5. Benzodiazepines Benzodiazepines are approved by the Food and Drug Administration (FDA) to treat several conditions, including anxiety disorders, epilepsy, and alcohol withdrawal. Examples include: Ativan (lorazepam) Klonopin (clonazepam) Valium (diazepam) Xanax (alprazolam) Tinnitus can be a rare side effect. It is more commonly associated with benzodiazepine withdrawal and has been reported during the tapering (dose reduction) period. Your healthcare provider will slowly reduce the dose before stopping the medication to reduce the risk of withdrawal-associated side effects. 6. Certain Blood Pressure-Lowering Drugs High blood pressure is also a risk factor for tinnitus, especially in older adults. Certain blood pressure medications are associated with hearing loss and tinnitus: Angiotensin converting enzyme (ACE) inhibitors , such as Altace (ramipril) and Vasotec (enalapril) Beta-blockers , such as bisoprolol, Bystolic (nebivolol), and Coreg (carvedilol) Calcium channel blockers, such as Cardizem (diltiazem), Norvasc (amlodipine), and Verelan (verapamil) Loop diuretics, such as Bumex (bumetanide) and Lasix (furosemide) 7. Certain Groups of Antibiotics Antibiotics treat bacterial infections. Aminoglycosides are broad-spectrum antibiotics commonly used in hospital settings. They treat severe infections in people of all ages. Aminoglycoside antibiotics are ototoxic drugs that can cause hearing loss. They affect the inner ear, and some people may develop tinnitus. Healthcare providers will closely monitor people taking these drugs to detect any early hearing loss. The aminoglycoside drugs carrying a high risk of tinnitus include: Amikacin Neomycin Kanamycin Tobramycin 8. Certain Cancer Drugs Certain drugs used to treat cancer are ototoxic and can damage the inner ear. Although these drugs help treat cancer cells, they can cause permanent ear damage. Platinum-based drugs, such as cisplatin and, to a lesser extent, carboplatin and oxaliplatin, are the primary chemotherapeutic drugs that can damage the ear. However, taxane drugs (another class of chemotherapy drug) can also affect hearing. Taxane drugs include Taxol (paclitaxel) and Taxotere (docetaxel) In one study of 273 individuals (mostly women), both platinum-based and taxane-containing drug regimens (used alone and combined) resulted in tinnitus in about 37% to 40% of participants. When receiving treatment, you should get regular hearing exams to identify any damage at an early stage to prevent it from worsening. 9. Isotretinoin Isotretinoin (formerly known by the brand name Accutane) is an oral medication used to treat severe acne. It can cause tinnitus, but it is a rare side effect.  Ask your healthcare provider about alternative options if you have any symptoms. 10. NSAIDs There are several nonsteroidal anti-inflammatory drugs (NSAIDs) that can cause tinnitus. Aspirin is a common NSAID. It is used in large doses for painful inflammatory diseases such as rheumatoid arthritis. In one study, more frequent use (six to seven days per week) of moderate-dose aspirin (greater than 325 milligrams per day) was associated with a higher risk of tinnitus, mainly in women younger than 60. Low-dose aspirin (less than 100 milligrams per day) was not associated with a higher risk of tinnitus. However, these effects are reversible with dose reduction or when you stop taking aspirin. Other NSAIDs, such as Advil (ibuprofen), can cause temporary tinnitus. 11. Proton Pump Inhibitors Proton pump inhibitors (PPIs) are widely used to treat and prevent gastric disorders. They may cause various adverse events, including tinnitus. Several studies have reported that PPIs are related to hearing loss or tinnitus, but the evidence is limited. In different studies, PPI use was associated with an increased risk of hearing loss or tinnitus. 12. Antifungals Some antifungal medications have been reported to cause tinnitus, such as Nizoral (ketoconazole) and Sporanox (itraconazole). Hearing loss has also been reported in a small percentage of people using these drugs. Ways to Treat Tinnitus There are several ways to improve the symptoms of tinnitus. Below are some of the treatments that may help: Exposure to sound therapy can reverse some of these neural changes and help silence tinnitus. Hearing aids can amplify external noises, making the tinnitus less noticeable. Wearable sound generators, tablets, radios, or other small electronic devices that fit in the ear produce soft, pleasant sounds that may relieve tinnitus. Behavioral therapy can improve your well-being by helping you reduce the impact of tinnitus and reduce anxiety. Cognitive behavioral therapy , a type of talk therapy (psychotherapy), can help to reduce negative thinking and depression. These changes reduce the impact of tinnitus. Tinnitus retraining therapy uses counseling and sound therapy to help emotionally and physiologically to help you no longer notice your tinnitus. Sometimes, medications such as antidepressants or antianxiety drugs may help to improve the tinnitus caused by depression or anxiety. 
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Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Ⓒ 2026 People Inc. — All rights reserved # 12 Medications That Can Cause Tinnitus (Ringing in the Ears) By [Ayesha Gulzar, PharmD](https://www.verywellhealth.com/ayesha-gulzar-5198963) Updated on December 12, 2025 Medically reviewed by [Mary Choy, PharmD](https://www.verywellhealth.com/mary-choy-pharmd-4781312) ![Man holding his hand to his ear](https://www.verywellhealth.com/thmb/FUT5uBTbTw8-hseqiT0bYjwUPmY=/1500x0/filters:no_upscale\(\):max_bytes\(150000\):strip_icc\(\)/VWH-GettyImages-1450981822-25ec4bc8a536460e85bec192f736059d.jpg) ![Man holding his hand to his ear](https://www.verywellhealth.com/thmb/FUT5uBTbTw8-hseqiT0bYjwUPmY=/1500x0/filters:no_upscale\(\):max_bytes\(150000\):strip_icc\(\)/VWH-GettyImages-1450981822-25ec4bc8a536460e85bec192f736059d.jpg) Nes / Getty Images ### Key Takeaways - Some medications can cause tinnitus, including common painkillers like acetaminophen and NSAIDs. - Tinnitus from medications is often temporary and usually stops after discontinuing the medication. Ototoxicity is an adverse effect of some drugs. It is a condition that occurs when the inner ear is damaged by certain medications or chemicals, causing hearing problems or [tinnitus](https://www.verywellhealth.com/ringing-in-ears-symptoms-causes-and-treatment-5323149) (ringing in the ears). The symptoms of tinnitus can vary significantly, depending on whether you hear sounds in one ear, in both ears, or inside the head. Certain medications cause tinnitus, which can be temporary or rarely permanent and depends on different factors. Common ototoxic drugs (drugs that can have toxic effects on the ears) include antibiotics, analgesics (pain relievers), blood pressure medications, [anticonvulsants (anti-seizure drugs)](https://www.verywellhealth.com/anti-epileptic-drugs-4686301), and others. ## 1\. Acetaminophen Tylenol (acetaminophen) is one of the most commonly used over-the-counter (OTC) painkillers. Prolonged use can cause hearing problems, such as tinnitus. These problems are usually temporary and resolve on their own after stopping the medication. One study from 2023 showed that frequent users of acetaminophen may be at higher risk of persistent tinnitus. The study looked at data from more than 10,000 cases of persistent tinnitus and included only women. More studies that include different populations are needed. ## 2\. Antidepressants Antidepressants are sometimes used to treat tinnitus. However, they have also been reported to cause or worsen tinnitus in people with previous symptoms. Studies have suggested that serotonin may exacerbate tinnitus. This means that [selective serotonin reuptake inhibitors (SSRIs)](https://www.verywellhealth.com/selective-serotonin-reuptake-inhibitors-ssris-5223678), a type of antidepressant that increases [serotonin](https://www.verywellhealth.com/serotonin-8682041) (a chemical in the brain that regulates various functions such as mood and cognition), could make tinnitus worse. The types of antidepressants used in treating tinnitus‐related symptoms are [tricyclic antidepressants](https://www.verywellhealth.com/amitriptyline-drug-interactions-296754) and SSRIs. These include: - Amitriptyline - Lexapro (escitalopram) - Pamelor (nortriptyline) - Prozac (fluoxetine) - Imipramine - Zoloft (sertraline hydrochloride) ## 3\. Anti-Seizure Drugs Side effects while taking antiepileptic drugs (AEDs) can occur due to the epilepsy itself or the long-term use of medication. Side effects include tinnitus and sensorineural hearing loss (hearing loss due to nerve damage). Commonly used AEDs that are more likely to cause these side effects are: - Depakote (valproate) - Dilantin (phenytoin) - Lamictal (lamotrigine) - Neurontin (gabapentin) - Sabril (vigabatrin) - Tegretol (carbamazepine) - Trileptal (oxcarbazepine) Ototoxicity with AEDs is caused by delayed signal transmission between the neurons (cells that transmit signals throughout the body) and [neurotransmitters](https://www.verywellhealth.com/neurotransmitters-8706506) (chemical messengers that carry messages between nerves). These side effects may be temporary, long-lasting, or irreversible. ## 4\. Antimalarial Drugs Antimalarial drugs can cause ringing in the ears when taken in higher doses for a prolonged time. In rare cases, these drugs can also cause tinnitus at low doses, but it is temporary and reversible. Common antimalarial drugs that cause tinnitus include quinine, hydroxychloroquine, and chloroquine. ## 5\. Benzodiazepines [Benzodiazepines](https://www.verywellhealth.com/uses-types-and-risks-of-benzodiazepines-8631164) are approved by the Food and Drug Administration (FDA) to treat several conditions, including anxiety disorders, epilepsy, and alcohol withdrawal. Examples include: - Ativan (lorazepam) - Klonopin (clonazepam) - Valium (diazepam) - Xanax (alprazolam) Tinnitus can be a rare side effect. It is more commonly associated with benzodiazepine withdrawal and has been reported during the tapering (dose reduction) period. Your healthcare provider will slowly reduce the dose before stopping the medication to reduce the risk of withdrawal-associated side effects. ## 6\. Certain Blood Pressure-Lowering Drugs High blood pressure is also a risk factor for tinnitus, especially in older adults. Certain blood pressure medications are associated with hearing loss and tinnitus: - [Angiotensin converting enzyme (ACE) inhibitors](https://www.verywellhealth.com/ace-inhibitors-blood-pressure-control-in-diabetes-1087278), such as Altace (ramipril) and Vasotec (enalapril) - [Beta-blockers](https://www.verywellhealth.com/propranolol-vs-metoprolol-11691471), such as bisoprolol, Bystolic (nebivolol), and Coreg (carvedilol) - Calcium channel blockers, such as Cardizem (diltiazem), Norvasc (amlodipine), and Verelan (verapamil) - Loop diuretics, such as Bumex (bumetanide) and Lasix (furosemide) ## 7\. Certain Groups of Antibiotics Antibiotics treat bacterial infections. Aminoglycosides are broad-spectrum antibiotics commonly used in hospital settings. They treat severe infections in people of all ages. Aminoglycoside antibiotics are ototoxic drugs that can cause hearing loss. They affect the inner ear, and some people may develop tinnitus. Healthcare providers will closely monitor people taking these drugs to detect any early hearing loss. The aminoglycoside drugs carrying a high risk of tinnitus include: - Amikacin - Neomycin - Kanamycin - Tobramycin ## 8\. Certain Cancer Drugs Certain drugs used to treat cancer are ototoxic and can damage the inner ear. Although these drugs help treat cancer cells, they can cause permanent ear damage. Platinum-based drugs, such as cisplatin and, to a lesser extent, carboplatin and oxaliplatin, are the primary chemotherapeutic drugs that can damage the ear. However, taxane drugs (another class of chemotherapy drug) can also affect hearing. Taxane drugs include Taxol (paclitaxel) and Taxotere (docetaxel) In one study of 273 individuals (mostly women), both platinum-based and taxane-containing drug regimens (used alone and combined) resulted in tinnitus in about 37% to 40% of participants. When receiving treatment, you should get regular hearing exams to identify any damage at an early stage to prevent it from worsening. ## 9\. Isotretinoin Isotretinoin (formerly known by the brand name Accutane) is an oral medication used to treat severe acne. It can cause tinnitus, but it is a rare side effect. Ask your healthcare provider about alternative options if you have any symptoms. ## 10\. NSAIDs There are several [nonsteroidal anti-inflammatory drugs (NSAIDs)](https://www.verywellhealth.com/best-anti-inflammatory-medication-2548734) that can cause tinnitus. Aspirin is a common NSAID. It is used in large doses for painful inflammatory diseases such as rheumatoid arthritis. In one study, more frequent use (six to seven days per week) of moderate-dose aspirin (greater than 325 milligrams per day) was associated with a higher risk of tinnitus, mainly in women younger than 60. Low-dose aspirin (less than 100 milligrams per day) was not associated with a higher risk of tinnitus. However, these effects are reversible with dose reduction or when you stop taking aspirin. Other NSAIDs, such as Advil (ibuprofen), can cause temporary tinnitus. ## 11\. Proton Pump Inhibitors [Proton pump inhibitors (PPIs)](https://www.verywellhealth.com/proton-pump-inhibitors-what-they-do-and-how-they-work-8727585) are widely used to treat and prevent gastric disorders. They may cause various adverse events, including tinnitus. Several studies have reported that PPIs are related to hearing loss or tinnitus, but the evidence is limited. In different studies, PPI use was associated with an increased risk of hearing loss or tinnitus. ## 12\. Antifungals Some [antifungal medications](https://www.verywellhealth.com/antifungal-cream-5222895) have been reported to cause tinnitus, such as Nizoral (ketoconazole) and Sporanox (itraconazole). Hearing loss has also been reported in a small percentage of people using these drugs. ## Ways to Treat Tinnitus There are several ways to improve the symptoms of tinnitus. Below are some of the treatments that may help: - Exposure to sound therapy can reverse some of these neural changes and help silence tinnitus. - Hearing aids can amplify external noises, making the tinnitus less noticeable. - Wearable sound generators, tablets, radios, or other small electronic devices that fit in the ear produce soft, pleasant sounds that may relieve tinnitus. - Behavioral therapy can improve your well-being by helping you reduce the impact of tinnitus and reduce anxiety. - [Cognitive behavioral therapy](https://www.verywellhealth.com/dialectical-behavior-therapy-5212359), a type of talk therapy (psychotherapy), can help to reduce negative thinking and depression. These changes reduce the impact of tinnitus. - Tinnitus retraining therapy uses counseling and sound therapy to help emotionally and physiologically to help you no longer notice your tinnitus. - Sometimes, medications such as antidepressants or antianxiety drugs may help to improve the tinnitus caused by depression or anxiety. Read more: - [Health A-Z](https://www.verywellhealth.com/health-a-z-4014770) - [Ear, Nose & Throat](https://www.verywellhealth.com/ear-nose-throat-4014732) 22 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our [editorial process](https://www.verywellhealth.com/verywell-editorial-process-4777042) to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. 1. Curhan SG, Glicksman J, Wang M, et al. [Longitudinal study of analgesic use and risk of incident persistent tinnitus.](https://doi.org/10.1007/s11606-021-07349-5) *J Gen Intern Med*. 2022;37(14):3653-3662. doi:10.1007/s11606-021-07349-5 2. Miller CW. [Development of tinnitus at a low dose of sertraline: clinical course and proposed mechanisms](https://doi.org/10.1155/2016/1790692). *Case Rep Psychiatry*. 2016;2016:1790692. doi:10.1155/2016/1790692 3. Mendis D, Johnston M. [An unusual case of prolonged tinnitus following low-dose amitriptyline](https://pubmed.ncbi.nlm.nih.gov/18308819/). *J Psychopharmacol*. 2008;22(5):574-575. doi: 10.1177/0269881107082126 4. Tang ZQ, Trussell LO. [Serotonergic modulation of sensory representation in a central multisensory circuit is pathway specific](https://www.cell.com/cell-reports/fulltext/S2211-1247%2817%2931098-7). *Cell Rep*. 2017;20(8):1844-1854. doi:10.1016/j.celrep.2017.07.079 5. Han BI, Lee HW, Ryu S, Kim JS. [Tinnitus update](https://doi.org/10.3988/jcn.2021.17.1.1). *J Clin Neurol*. 2021;17(1):1-10. doi:10.3988/jcn.2021.17.1.1 6. Kim SH, Kim D, Lee JM, et al. [Review of pharmacotherapy for tinnitus](https://doi.org/10.3390/healthcare9060779). *Healthcare (Basel)*. 2021 ;9(6):779. doi: 10.3390/healthcare9060779 7. Tanaka M, Hasegawa S, Nakao S, et al. [Analysis of drug-induced hearing loss by using a spontaneous reporting system database](https://doi.org/10.1371/journal.pone.0217951). *PLoS One*. 2019;14(10):e0217951. doi:10.1371/journal.pone.0217951 8. Hamed SA. [The auditory and vestibular toxicities induced by antiepileptic drugs](https://doi.org/10.1080/14740338.2017.1372420). *Expert Opin Drug Saf.* 2017;16(11):1281-1294. doi: 10.1080/14740338.2017.1372420 9. Hamed SA. [The auditory and vestibular toxicities induced by antiepileptic drugs.](https://doi.org/10.1080/14740338.2017.1372420) *Expert Opin Drug Saf*. 2017;16(11):1281-1294. doi: 10.1080/14740338.2017.1372420 10. Jozefowicz-Korczynska M, Pajor A, Grzelczyk WL. [The ototoxicity of antimalarial drugs—a state of the art review](https://doi.org/10.3389/fneur.2021.661740). *Frontiers in Neurology.* 2021;12:661740. doi:10.3389/fneur.2021.661740 11. Laskey C, Opitz B. [Tinnitus associated with benzodiazepine withdrawal syndrome: a case report and literature review.](https://doi.org/10.9740/mhc.2020.05.100) *The Mental Health Clinician.* 2020;10(3):100. doi:10.9740/mhc.2020.05.100 12. Figueiredo RR, Azevedo AA, Penido NDO. [Positive association between tinnitus and arterial hypertension](https://doi.org/10.3389/fneur.2016.00171). *Frontiers in Neurology.* 2016;7:171. doi:10.3389/fneur.2016.00171 13. Ellison DH. [Clinical pharmacology in diuretic use](https://journals.lww.com/cjasn/fulltext/2019/08000/clinical_pharmacology_in_diuretic_use.21.aspx). *Clin J Am Soc Nephrol*. 2019;14(8):1248-1257. doi:10.2215/CJN.09630818. 2019 Apr 1. Erratum in: *Clin J Am Soc Nephrol*. 2019;14(11):1653-1654. doi:10.2215/CJN.09840819 14. Rivetti S, Romano A, Mastrangelo S, et al. [Aminoglycosides-related ototoxicity: mechanisms, risk factors, and prevention in pediatric patients](https://doi.org/10.3390/ph16101353). *Pharmaceuticals*. 2023;16(10):1353. doi:10.3390/ph16101353 15. Chattaraj A, Syed MP, Low CA, Owonikoko TK. [Cisplatin-induced ototoxicity: a concise review of the burden, prevention, and interception strategies](https://doi.org/10.1200/OP.22.00710). *JCO Oncol Pract*. 2023;19(5):278-283. doi:10.1200/OP.22.00710. 16. Cheung S, Henderson-Sabes J, Mastick J, et al. [Cancer survivors and neurotoxic chemotherapy: hearing loss and tinnitus](https://doi.org/10.1136/spcare-2022-003684). *BMJ Support Palliat Care*. 2023;13(3):345-353. doi:10.1136/spcare-2022-003684. 17. Rosende L, Verea-Hernando MM, Andrés A de, et al. [Hypoacusia in a patient treated by isotretinoin.](https://doi.org/10.1155/2011/789143) *Case Reports in Medicine.* 2011;2011:789143. doi:10.1155/2011/789143 18. Sheppard A, Hayes S, Chen GD, Ralli M, Salvi R. [Review of salicylate-induced hearing loss, neurotoxicity, tinnitus and neuropathophysiology.](https://pmc.ncbi.nlm.nih.gov/articles/PMC4025186/) *Acta Otorhinolaryngologica Italica*. 2014;34(2):79. 19. Yee J, Han HW, Gwak HS. [Proton pump inhibitor use and hearing loss in patients with type 2 diabetes: evidence from a hospital-based case-control study and a population-based cohort study](https://doi.org/10.1111/bcp.15210). *Br J Clin Pharmacol*. 2022;88(6):2738-2746. doi:10.1111/bcp.15210. 20. Kim SY, Lee CH, Min C, et al. [Association between proton pump inhibitors and hearing impairment: a nested case-control study](https://doi.org/10.3390/cimb43010012). *Curr Issues Mol Biol*. 2021;43(1):142-152. doi:10.3390/cimb43010012 21. National Institutes of Health. [Tinnitus](https://www.nidcd.nih.gov/health/tinnitus). 22. Reynard P, Thai-Van H. [Drug-induced hearing loss: Listening to the latest advances](https://doi.org/10.1016/j.therap.2023.10.011). *Therapie*. 2024;79(2):283-295. doi:10.1016/j.therap.2023.10.011 ![Ayesha]() ![Ayesha](https://www.verywellhealth.com/thmb/qzxyuCJXeivhzBuv6cVSjUMWDJ8=/144x144/filters:no_upscale\(\):max_bytes\(150000\):strip_icc\(\)/20210814_171303-4947aeb853b7494ba9f67537baae0cc2.jpg) By [Ayesha Gulzar, PharmD](https://www.verywellhealth.com/ayesha-gulzar-5198963) Ayesha Gulzar is a clinical pharmacist interested in medical research, pharmacy practice, and medication therapy management. Dr. Gulzar has been working in medical communications, writing medical and clinical research for patients and health professionals in the United Kingdom. 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### Key Takeaways - Some medications can cause tinnitus, including common painkillers like acetaminophen and NSAIDs. - Tinnitus from medications is often temporary and usually stops after discontinuing the medication. Ototoxicity is an adverse effect of some drugs. It is a condition that occurs when the inner ear is damaged by certain medications or chemicals, causing hearing problems or [tinnitus](https://www.verywellhealth.com/ringing-in-ears-symptoms-causes-and-treatment-5323149) (ringing in the ears). The symptoms of tinnitus can vary significantly, depending on whether you hear sounds in one ear, in both ears, or inside the head. Certain medications cause tinnitus, which can be temporary or rarely permanent and depends on different factors. Common ototoxic drugs (drugs that can have toxic effects on the ears) include antibiotics, analgesics (pain relievers), blood pressure medications, [anticonvulsants (anti-seizure drugs)](https://www.verywellhealth.com/anti-epileptic-drugs-4686301), and others. ## 1\. Acetaminophen Tylenol (acetaminophen) is one of the most commonly used over-the-counter (OTC) painkillers. Prolonged use can cause hearing problems, such as tinnitus. These problems are usually temporary and resolve on their own after stopping the medication. One study from 2023 showed that frequent users of acetaminophen may be at higher risk of persistent tinnitus. The study looked at data from more than 10,000 cases of persistent tinnitus and included only women. More studies that include different populations are needed. ## 2\. Antidepressants Antidepressants are sometimes used to treat tinnitus. However, they have also been reported to cause or worsen tinnitus in people with previous symptoms. Studies have suggested that serotonin may exacerbate tinnitus. This means that [selective serotonin reuptake inhibitors (SSRIs)](https://www.verywellhealth.com/selective-serotonin-reuptake-inhibitors-ssris-5223678), a type of antidepressant that increases [serotonin](https://www.verywellhealth.com/serotonin-8682041) (a chemical in the brain that regulates various functions such as mood and cognition), could make tinnitus worse. The types of antidepressants used in treating tinnitus‐related symptoms are [tricyclic antidepressants](https://www.verywellhealth.com/amitriptyline-drug-interactions-296754) and SSRIs. These include: - Amitriptyline - Lexapro (escitalopram) - Pamelor (nortriptyline) - Prozac (fluoxetine) - Imipramine - Zoloft (sertraline hydrochloride) ## 3\. Anti-Seizure Drugs Side effects while taking antiepileptic drugs (AEDs) can occur due to the epilepsy itself or the long-term use of medication. Side effects include tinnitus and sensorineural hearing loss (hearing loss due to nerve damage). Commonly used AEDs that are more likely to cause these side effects are: - Depakote (valproate) - Dilantin (phenytoin) - Lamictal (lamotrigine) - Neurontin (gabapentin) - Sabril (vigabatrin) - Tegretol (carbamazepine) - Trileptal (oxcarbazepine) Ototoxicity with AEDs is caused by delayed signal transmission between the neurons (cells that transmit signals throughout the body) and [neurotransmitters](https://www.verywellhealth.com/neurotransmitters-8706506) (chemical messengers that carry messages between nerves). These side effects may be temporary, long-lasting, or irreversible. ## 4\. Antimalarial Drugs Antimalarial drugs can cause ringing in the ears when taken in higher doses for a prolonged time. In rare cases, these drugs can also cause tinnitus at low doses, but it is temporary and reversible. Common antimalarial drugs that cause tinnitus include quinine, hydroxychloroquine, and chloroquine. ## 5\. Benzodiazepines [Benzodiazepines](https://www.verywellhealth.com/uses-types-and-risks-of-benzodiazepines-8631164) are approved by the Food and Drug Administration (FDA) to treat several conditions, including anxiety disorders, epilepsy, and alcohol withdrawal. Examples include: - Ativan (lorazepam) - Klonopin (clonazepam) - Valium (diazepam) - Xanax (alprazolam) Tinnitus can be a rare side effect. It is more commonly associated with benzodiazepine withdrawal and has been reported during the tapering (dose reduction) period. Your healthcare provider will slowly reduce the dose before stopping the medication to reduce the risk of withdrawal-associated side effects. ## 6\. Certain Blood Pressure-Lowering Drugs High blood pressure is also a risk factor for tinnitus, especially in older adults. Certain blood pressure medications are associated with hearing loss and tinnitus: - [Angiotensin converting enzyme (ACE) inhibitors](https://www.verywellhealth.com/ace-inhibitors-blood-pressure-control-in-diabetes-1087278), such as Altace (ramipril) and Vasotec (enalapril) - [Beta-blockers](https://www.verywellhealth.com/propranolol-vs-metoprolol-11691471), such as bisoprolol, Bystolic (nebivolol), and Coreg (carvedilol) - Calcium channel blockers, such as Cardizem (diltiazem), Norvasc (amlodipine), and Verelan (verapamil) - Loop diuretics, such as Bumex (bumetanide) and Lasix (furosemide) ## 7\. Certain Groups of Antibiotics Antibiotics treat bacterial infections. Aminoglycosides are broad-spectrum antibiotics commonly used in hospital settings. They treat severe infections in people of all ages. Aminoglycoside antibiotics are ototoxic drugs that can cause hearing loss. They affect the inner ear, and some people may develop tinnitus. Healthcare providers will closely monitor people taking these drugs to detect any early hearing loss. The aminoglycoside drugs carrying a high risk of tinnitus include: - Amikacin - Neomycin - Kanamycin - Tobramycin ## 8\. Certain Cancer Drugs Certain drugs used to treat cancer are ototoxic and can damage the inner ear. Although these drugs help treat cancer cells, they can cause permanent ear damage. Platinum-based drugs, such as cisplatin and, to a lesser extent, carboplatin and oxaliplatin, are the primary chemotherapeutic drugs that can damage the ear. However, taxane drugs (another class of chemotherapy drug) can also affect hearing. Taxane drugs include Taxol (paclitaxel) and Taxotere (docetaxel) In one study of 273 individuals (mostly women), both platinum-based and taxane-containing drug regimens (used alone and combined) resulted in tinnitus in about 37% to 40% of participants. When receiving treatment, you should get regular hearing exams to identify any damage at an early stage to prevent it from worsening. ## 9\. Isotretinoin Isotretinoin (formerly known by the brand name Accutane) is an oral medication used to treat severe acne. It can cause tinnitus, but it is a rare side effect. Ask your healthcare provider about alternative options if you have any symptoms. ## 10\. NSAIDs There are several [nonsteroidal anti-inflammatory drugs (NSAIDs)](https://www.verywellhealth.com/best-anti-inflammatory-medication-2548734) that can cause tinnitus. Aspirin is a common NSAID. It is used in large doses for painful inflammatory diseases such as rheumatoid arthritis. In one study, more frequent use (six to seven days per week) of moderate-dose aspirin (greater than 325 milligrams per day) was associated with a higher risk of tinnitus, mainly in women younger than 60. Low-dose aspirin (less than 100 milligrams per day) was not associated with a higher risk of tinnitus. However, these effects are reversible with dose reduction or when you stop taking aspirin. Other NSAIDs, such as Advil (ibuprofen), can cause temporary tinnitus. ## 11\. Proton Pump Inhibitors [Proton pump inhibitors (PPIs)](https://www.verywellhealth.com/proton-pump-inhibitors-what-they-do-and-how-they-work-8727585) are widely used to treat and prevent gastric disorders. They may cause various adverse events, including tinnitus. Several studies have reported that PPIs are related to hearing loss or tinnitus, but the evidence is limited. In different studies, PPI use was associated with an increased risk of hearing loss or tinnitus. ## 12\. Antifungals Some [antifungal medications](https://www.verywellhealth.com/antifungal-cream-5222895) have been reported to cause tinnitus, such as Nizoral (ketoconazole) and Sporanox (itraconazole). Hearing loss has also been reported in a small percentage of people using these drugs. ## Ways to Treat Tinnitus There are several ways to improve the symptoms of tinnitus. Below are some of the treatments that may help: - Exposure to sound therapy can reverse some of these neural changes and help silence tinnitus. - Hearing aids can amplify external noises, making the tinnitus less noticeable. - Wearable sound generators, tablets, radios, or other small electronic devices that fit in the ear produce soft, pleasant sounds that may relieve tinnitus. - Behavioral therapy can improve your well-being by helping you reduce the impact of tinnitus and reduce anxiety. - [Cognitive behavioral therapy](https://www.verywellhealth.com/dialectical-behavior-therapy-5212359), a type of talk therapy (psychotherapy), can help to reduce negative thinking and depression. These changes reduce the impact of tinnitus. - Tinnitus retraining therapy uses counseling and sound therapy to help emotionally and physiologically to help you no longer notice your tinnitus. - Sometimes, medications such as antidepressants or antianxiety drugs may help to improve the tinnitus caused by depression or anxiety.
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