Many people notice a ringing, buzzing, or hissing in their ears and immediately worry it’s something serious. But sometimes, the culprit isn’t aging, loud noise, or stress-it’s a medication you’re already taking. Medication-induced tinnitus is more common than most realize, and it’s often reversible-if you catch it early.
What Exactly Is Medication-Induced Tinnitus?
Tinnitus isn’t a disease. It’s a symptom: your brain hears sound when no external noise is present. When it’s caused by a drug, it’s called ototoxicity. This means the medication is damaging parts of your inner ear or the nerve that sends sound signals to your brain. The damage can be temporary or permanent, depending on the drug, dose, and how long you’ve been taking it. Over 600 prescription and over-the-counter drugs are known to trigger or worsen tinnitus, according to Sound Relief’s 2025 review. That includes common pills like aspirin, ibuprofen, and even some antidepressants. The good news? Most cases aren’t permanent. About 60% of people see their ringing fade after stopping the drug.Which Medications Are Most Likely to Cause Ringing in the Ears?
Not all drugs carry the same risk. Some are far more likely to cause hearing issues than others. Here’s a breakdown of the most common culprits:- Aminoglycoside antibiotics (like gentamicin and tobramycin): These are powerful drugs used for serious infections. They’re among the most ototoxic. Up to 25% of patients on long-term IV treatment develop permanent hearing loss or tinnitus. Topical forms (eye drops, creams) are much safer.
- Chemotherapy drugs (especially cisplatin): Up to 70% of patients on cisplatin experience some level of hearing damage. It often starts with high-frequency hearing loss-so you might miss birds chirping or alarms beeping before noticing speech becomes unclear.
- Loop diuretics (like furosemide): Used for heart failure or fluid retention. Tinnitus can appear within hours of a high dose. It’s usually temporary but can become permanent with repeated exposure.
- High-dose aspirin and NSAIDs: You need to take a lot-over 4,000 mg of aspirin daily-to trigger ringing. That’s more than 12 regular tablets. Modern headache doses (325-650 mg) rarely cause issues. But some people are unusually sensitive, even at low doses.
- Quinine: Found in some malaria treatments and tonic water. Tinnitus can start within a day or two and usually clears up within weeks after stopping.
- Isotretinoin (Accutane): Used for severe acne. About 5% of users report tinnitus, though the manufacturer says it’s less than 1%. The discrepancy suggests some people are more vulnerable.
What About Antidepressants and Anxiety Meds?
Many people panic when they start an SSRI like sertraline (Zoloft) or fluoxetine (Prozac) and notice new ringing. The truth? Tinnitus from antidepressants is rare-less than 1% of users. But when it happens, it can be confusing because the drug is meant to help mental health, not hurt hearing. Some cases occur when the medication is stopped, not started. Withdrawal from SSRIs has been linked to tinnitus in case reports dating back to 2001. If you’re on an antidepressant and notice ringing, don’t quit cold turkey. Talk to your doctor. They may adjust the dose slowly or switch you to a different class. Benzodiazepines like Xanax or Valium are another gray area. Long-term use (6+ months) is more often tied to tinnitus than short-term use. Again, it’s uncommon-but worth noting if you’ve been on these for years.
Why Do Some Drugs Hurt Your Ears?
The exact mechanism isn’t fully understood. But scientists believe ototoxic drugs interfere with the inner ear’s delicate hair cells or disrupt the electrical signals sent by the eighth cranial nerve. Some drugs build up in the fluid of the inner ear. Others affect blood flow or trigger oxidative stress that damages cells. What’s clear is that risk isn’t random. It depends on:- Dose: Higher doses = higher risk. A single 800 mg ibuprofen for a toothache is unlikely to cause trouble. Taking 800 mg three times a day for a week? That’s a different story.
- Duration: Short-term use is safer. Long-term use increases damage risk.
- Renal function: Your kidneys clear many ototoxic drugs. If they’re not working well, the drug lingers longer and does more harm.
- Genetics: Emerging research shows some people have gene variants that make them far more sensitive to ototoxic drugs. Testing for these isn’t routine yet-but it’s coming.
How Do You Know If Your Tinnitus Is From a Drug?
Timing matters. Most people notice ringing within the first two weeks of starting a new medication. But delayed reactions can happen-up to 90 days with some antibiotics or chemo drugs. Ask yourself:- Did the ringing start shortly after beginning a new drug?
- Did it get worse when you increased the dose?
- Did it improve after stopping the drug?
What Should You Do If You Suspect a Medication Is Causing Tinnitus?
Never stop a prescribed medication on your own. Even if you think it’s the cause, stopping suddenly can be dangerous. For example, quitting an antibiotic early can lead to resistant infections. Stopping an antidepressant too fast can cause withdrawal symptoms. Instead:- Document your symptoms. Note the date, timing, and severity.
- Make a list of all medications you’re taking-prescription, OTC, supplements, and even herbal remedies.
- Schedule a visit with your prescribing doctor. Bring your symptom log.
- Ask: “Could this drug be causing my tinnitus? Are there alternatives?”
- Lower your dose
- Switch you to a non-ototoxic alternative
- Order an audiogram to check your hearing baseline
- Refer you to an audiologist for monitoring
Can You Prevent Medication-Induced Tinnitus?
Yes, in many cases. Prevention starts with awareness.- If you’re about to start a high-risk drug (like cisplatin or gentamicin), ask for a baseline hearing test before treatment begins.
- For long-term medications, ask if periodic hearing checks are recommended.
- Let your doctor know if you already have tinnitus or hearing loss. That changes their risk assessment.
- Don’t self-medicate with high doses of NSAIDs or aspirin. Stick to the label.
- Stay hydrated and avoid alcohol while on ototoxic drugs-they can worsen the effect.
What If the Tinnitus Doesn’t Go Away After Stopping the Drug?
About 40% of cases become permanent, especially with aminoglycosides or cisplatin. But that doesn’t mean you’re stuck with it. Sound therapy and cognitive behavioral therapy (CBT) help 60-70% of people manage the annoyance and reduce the emotional toll. These don’t cure the ringing-but they make it easier to ignore. Hearing aids can also help, especially if you have underlying hearing loss. New research is exploring otoprotective agents-drugs that shield the ear from damage without affecting the main treatment. NIH funded $12.5 million for this in 2024, and early trials are promising.Bottom Line: Don’t Panic, But Don’t Ignore It
Ringing in the ears from medication is real, common, and often treatable. You don’t need to memorize a list of 600 ototoxic drugs. But you should know:- High-dose aspirin and NSAIDs can cause it-but standard doses usually don’t.
- Antibiotics and chemo drugs carry the highest risk.
- Antidepressants rarely cause it, but withdrawal can.
- Always talk to your doctor before changing or stopping any medication.
- Early action gives you the best chance of recovery.
Can aspirin cause ringing in the ears?
Yes, but only at very high doses-typically above 4,000 mg per day. That’s more than 12 regular aspirin tablets. Most people take 325-650 mg for headaches or heart health, and at those levels, tinnitus is extremely unlikely. A small number of individuals are unusually sensitive and may notice ringing even at low doses, but this is rare.
Do antidepressants cause tinnitus?
Tinnitus is a rare side effect of antidepressants, affecting less than 1% of users. It’s more commonly reported when the drug is stopped, not started. Some SSRIs like sertraline have been linked to withdrawal-related tinnitus in case studies. If you notice ringing after starting or stopping an antidepressant, talk to your doctor before making any changes.
Is tinnitus from medication permanent?
In about 60% of cases, tinnitus improves or disappears after stopping the drug. But for some medications-especially aminoglycoside antibiotics and chemotherapy drugs like cisplatin-damage can be permanent. The sooner you identify the cause and stop the drug, the better your chances of recovery.
What should I do if I think a medication is causing my tinnitus?
Don’t stop taking the medication on your own. Keep a log of when the ringing started, how loud it is, and whether it changed with dose. Make a list of all your medications and schedule a visit with your doctor. They can assess whether the drug is likely the cause and suggest alternatives or adjustments.
Can hearing tests detect medication-induced tinnitus?
Hearing tests won’t detect tinnitus directly-it’s a subjective sound you hear. But they can show if there’s hearing loss, especially in high frequencies, which often accompanies ototoxic damage. A baseline test before starting high-risk drugs and follow-up tests during treatment help doctors spot early signs and adjust treatment before damage becomes permanent.
Are there any drugs that are safe for people with tinnitus?
Many common medications are safe. Most blood pressure pills, thyroid meds, and diabetes drugs don’t affect hearing. When possible, doctors will choose non-ototoxic alternatives-for example, switching from furosemide to spironolactone for fluid retention. Always ask your doctor if your medication carries ototoxic risk, especially if you already have tinnitus.