Pharmacists should sound the alarm for patients on potential hearing loss associated with some medications.
 
Hearing loss is among the less commonly noted side effects listed on drug labels, but it could be the most distressing one for patients.
 
According to the American Speech-Language-Hearing Association, there are more than 200 ototoxic medications currently on the market. The hearing loss potentially associated with these drugs tends to develop quickly, with the severity ranging from temporary ringing to permanent impairment.  
 
Kathleen Campbell, PhD, an audiologist at the Southern Illinois University School of Medicine, told Pharmacy Times about some modifiable lifestyle factors that pharmacists can counsel patients on to reduce their risk of drug-related hearing loss.
 
“Poor nutrition, smoking, a high fat diet, obesity, and other factors contributing to general poor health can elevate the risk of hearing loss in general—including drug- and noise-induced hearing loss,” she explained.
 
The following are commonly used OTC and prescription drugs that could damage patients’ hearing:
 
1. Aspirin
Aspirin-induced temporary hearing loss is normally associated with large doses, or 8 to 12 pills per day.
 
“Naturally, if a patient self-administers too high of a dose [of aspirin] not advised by their physician, the risk of hearing loss and other side effects increases,” said Dr. Campbell.
 
The effect is typically reversible once the patient reduces the frequency of their aspirin intake or stops taking the drug altogether.
 
2. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs like ibuprofen and naproxen have been linked with hearing issues.
 
Researchers from Brigham and Women’s Hospital studied the relationship between hearing loss and NSAIDs, and found that “NSAID pain relievers like ibuprofen can reduce blood flow to the cochlea [organ in the inner ear that helps hearing], which could impair its function,” said lead study author Sharon G. Curhan, MD, in a press release.
 
 
3. Antibiotics
Patients who take aminoglycosides, the most commonly used class of antibiotics worldwide, risk a 20% to 60% chance of losing their hearing permanently.
 
Researchers are currently testing a modified version of an aminoglycoside that worked in mice without the adverse side effects of deafness or kidney damage.
 
Until somewhat recently, physicians routinely prescribed eardrops that contained aminoglycosides such as neomycin to treat pseudomonas, which are bacteria that cause ear infections.
 
4. Chemotherapy Drugs
Certain chemotherapy drugs such as cisplatin, carboplatin or bleomycin have been associated with hearing loss.
 
Dr. Campbell noted that the case of chemotherapy drugs is an instance where the perceived benefit of an ototoxic drug outweighs the risk of hearing loss.
 
Nonetheless, “Patient[s] should be informed of potential side effects of any prescribed medication,” she said.
 
5. Loop Diuretics
Damage from loop diuretics such as furosemide (Lasix) and bumetanide is caused by changes in the balance of fluids and salts of the inner ear, which can result in tissue swelling and issues with transmission of nerve signals.
 
While loop diuretic-induced hearing loss is normally temporary, the effect is more likely to be permanent when the medication is used in combination with other ototoxic drugs.