Drugs That Cause Tinnitus: What Can Be Done About Them?

There are many probable factors that can cause tinnitus. The most notable ones among them are constantly hearing loud sounds, obstructions caused by ear wax, and senility brought about by old age. In addition to them, certain medicines can also be held responsible for tinnitus, as a result of which the affected person has to bear the noises, day after day. In 1944, when Streptomycin hit the markets, and was widely prescribed to tackle tuberculosis, this was confirmed. Not only did Streptomycin have the customary side effects usually found with antibiotics, but it also caused tribulations in the vestibule as well as the internal parts of the ear (Cochlear). This meant that, those who were treated with this drug, experienced vertigo and problems in hearing as well.

The above idea was provided all the more support by the characteristics of the aminoglycoside group antibiotics, which were put into application later. The ill-effects of these medicines were termed ototoxicity, and it was found common in the effects of loop diuretics, quinine drugs, cancer treatments (platinum-based chemotherapy), and even in the medications used to treat common fever. The cochleo-vestibulat structure of the human body is adversely affected by the high count of toxicity in these drugs. In other words, the harmful ototoxic effects can rob a person of his/her balance in the vestibular or the inner ear (Cochlear). The result can be manifested as tinnitus, reductions in the power to listen, vertigo, a state of non-equilibrium, and other health hazards.

It would be a mistake to assume that the modus operandi of the drugs with ototoxicity is the same in all cases. In fact, the effects vary from one type of medicine to another. For example, the antibiotics of the Aminoglycoside group tend to bring the glutamate receptors of the cochlea into action, as a result of which, both the neurons of the inner ear (cochlear) as well as the hair cells may get adversely affected. The ill-effects tend to spill over to the available free radicals as well. That, in turn, brings about further mutilation of the hair cells. The neurons of the inner ear are not spared either.

The damage to the hair cells occurs in stages. At first, the ones in the inner rows (the outer hair cells) are affected. Next, the hair cells in the outer rows (the inner hair cells) feel the impact. In this manner, the damages spread across the hair cells. The indicators of these problems become apparent within a short period (or immediately after) of withdrawal of the medicine. At the first stage, the affected person has problem in listening sounds at high frequency (due to ototoxic nature of the drugs). This can lead to tinnitus. Over time, patients start having difficulties in sounds of lower frequencies, and recognizing voices becomes tough as well.

Medical practitioners generally like to prescribe antioxidants before recommending any type of drugs with ototoxic effects. This is because the effects caused by ototoxicity cannot generally be reversed. The antioxidants ensure that the free radicals do not get mutilated. As a result, auditory problems as well as risks of losing the internal balance of the vestibule get reduced considerably. Hence, it is indeed a wise decision to prescribe antioxidants.

So that there can remain no scope of confusion regarding this, a list of the six types of medicines that were believed to have ototoxic effects was published in the September 1996 issue of the Tinnitus Today magazine. Prepared by a renowned Doctor of Medicine, the list is exhaustive. Here, we would look into this list as it was published. This would do away with any chances of wrong interpretation.

i) Salicylate drugs that cause tinnitus (like Aspirin or similar other medicines):

Ototoxicity becomes evident if 6 to 8 pills per day are taken. The problems caused can however be rectified once these medicines are stopped,

ii) Anti inflammatory drugs that cause tinnitus (classified under the Non-Steroidal (NSAIDS) Group):

Similar to the above case, a daily dosage of 6 to 8 tablets can result in ototoxic effects. Once patients stop taking them, the problems can be effectively treated. Some of the medicines that fall under this category are Clinoril, Aleve, Anaprox, Advil, Poradol, Lodine, Aleve, Indocin, Naprosyn, Nalfon, Feldene and Nuprine.

iii) Antibiotic drugs that cause tinnitus (like Aminoglycoside group, Erythromycin group or Vancomycin group):

• Aminoglycoside group  When medicines belonging to this group are applied to patients intravenously, ototoxic effects may be seen. This ototoxicity can be effectively tackled if the blood pressure level is monitored on a regular basis. Some of such drugs under this group are Tobramycin, Kanamycin, Gantamycin, Amikacin, Streptomycin, Neomycin and Netilmycin. However, ear drops or topical medications that use Gantamycin or Neomycin as ingredients are not ototoxic in nature,

• Erythromycin group  When the newer derivatives of this group of antibiotics are administered in an intravenous method (at dosages of 2 to 4 grams at intervals of 24 hours), ototoxic effects can be detected. There can be a number of resultant health hazards, with renal failures being the chief among them. However, if these drugs are taken orally at reduced dosages (less than one gram at intervals of 24 hours), ototoxicity does not occur. Some of the notable medications that fall under this class are EES, Pediazol, Eryc, E-mycin, Biaxine, Llosone and Zithromax.

• Vancomycin group  This group of antibiotics resembles those in the aminoglycoside group, both in its beneficial features as well as ototoxicity. When given to patients intravenously in a life-crisis situation, these drugs can show apparent ototoxic effects. The ototoxicity receives a boost due to the fact that they are prescribed together with aminoglycosides in most cases. The most notable drug in this group is Vincocin.

iv)Loop diuretic drugs that cause tinnitus (like Bumex, Lasix and Endecrin):

When administered to patients suffering from hypertensions or acute kidney related problems intravenously, these loop diuretics can display ototoxic properties. On the other hand, even if patients are given high doses, no ototoxicity is observed, only if the medium of administration is oral. Thus, those who have serious problems with their kidneys should be given oral doses rather than intravenous injecting methods,

v)Cancer treating Chemotherapy drugs that cause tinnitus (like Cisplatin, Vincristine and Nitrogen Mustard):

Drugs of these types are widely used for treating cancer, and come with ototoxic properties as well. The problems created may become irreversible if these drugs are taken simultaneously along with aminoglycosides or loop diuretics, since the level of ototoxicity may move beyond controllable levels. Otherwise, a regular practice of serial audiograms, along with constant monitoring of the blood pressure can solve the problems

vi)Anti-malarial drugs that cause tinnitus (like Quinine), and other medicines that are used to prevent night cramps (like Atabrine, Legatrin, Aralen, and Q-Vel Muscle relaxants):

The ototoxic effects associated with quinine are somewhat similar to the ones that come with the usage of aspirin. As and when the medicines are withdrawn, the problems also make an exit. This list also notes the major indicators of ototoxicity-related problems, according to their frequency levels. These symptoms can be listed as under:

• If patients experience in either, or both of their ears,
• A new source of noise, complicating existing tinnitus problems,
• Due to the tinnitus infection, the ears feeling heavy or full, and
• Either starting to have problems in hearing, or experiencing added auditory problems for people who are already hard of hearing.

It is evident that tinnitus can be caused by many medications. In addition, we need to consider that the conventional medications treat only the symptoms of tinnitus, and do not deal with the actual underlying reasons of the ailment. Hence, hoping for a permanent cure is rather futile. Nor can remedial products prepared at home, or medicines with herbal ingredients work well on a consistent basis. The best bet is holistic remedies that detect the main causes of the disease. Once done, these factors can be effectively resolved, thereby bringing about a complete cure.