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A study published in the American Journal of Audiology reveals that these drugs alter the ionic composition of endolymph, the fluid in the inner ear, causing imbalances that affect both hearing and balance. Some patients experience ringing in the ears and dizziness shortly after starting treatment.
The combination of diuretics and chemotherapy drugs further increases the risk, posing a challenge in cancer patients who also require fluid management.
Common Anti-Inflammatory Drugs and Analgesics
According to Schacht et al. (2012), aspirin, also known as acetylsalicylic acid, and other salicylates can cause tinnitus and temporary hearing loss. Although in most cases the symptoms disappear upon discontinuation of the medication, at high doses the risk increases considerably.
Accordingly, the study in Cold Spring Harbor Perspectives in Medicine reports that acetaminophen and other non-opioid analgesics have also been linked to an increased risk of hearing problems, especially with prolonged use.
These medications are generally considered safe, but evidence shows that prolonged use, especially in combination with other drugs, increases the likelihood of hearing complications.
Antimalarials and Specific Antibiotics
Medicines such as chloroquine and quinine, historically used against malaria, can cause tinnitus, dizziness, and hearing loss. The exact mechanism is still being investigated, but it appears to be linked to damage to the auditory nerve.
Furthermore, antibiotics such as vancomycin, especially when administered with aminoglycosides, increase the risk of ototoxicity. This combined effect represents a considerable risk in hospital treatment.
Although these drugs have saved millions of lives, their ototoxic potential requires rigorous monitoring in patients at risk.
Phosphodiesterase Inhibitors
The article published in The Anatomical Record describes how popular erectile dysfunction medications, such as sildenafil (Viagra) and tadalafil (Cialis), have received safety warnings due to cases of sudden hearing loss and vertigo.
The mechanism is not entirely clear, but it is believed to affect blood perfusion in the inner ear, reducing the supply of oxygen and nutrients to sensory cells.
Although these effects are rare, the growing popularity of these drugs warrants the warning. Patients who notice ringing in the ears or sudden hearing loss should discontinue use and seek medical advice.
Conclusion
Medications that cause hearing impairment represent a clinical challenge. Aminoglycosides, cisplatin, loop diuretics, anti-inflammatory drugs, antimalarial drugs, and erectile dysfunction drugs have all been shown to cause deafness, dizziness, and tinnitus.
Scientific knowledge allows for a balanced assessment of risks and benefits, but prevention depends on close medical monitoring. Detecting symptoms early can prevent permanent damage and preserve a healthy quality of life.
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