Can my medicine affect my hearing?

It is well known that chemicals can affect the human body in various ways. We use the term “side effects” for medications. The intended target of the drug is only a part of the overall affect, as the pill breaks up and courses through your bloodstream. One area of concern with certain drugs is the hearing system. You may notice an effect on your hearing or balance when you take certain medicines. Is this normal? Is it permanent? What can be done?

The ears have three major divisions, outer, middle and inner. The outer ear is the visible part and the canal that leads to the tympanic membrane (ear drum). Behind the drum is the middle ear space with three tiny bones and a passage (eustachian tube) to the throat. The inner ear houses the actual organs of hearing. These organs sit in a fluid with a delicate balance of substances such as sodium, chloride, calcium and potassium ions. Anything that disturbs the chemical makeup of the fluid can affect hearing. Also, since the hearing and balance organs share fluid, balance function may be affected as well.

Since drugs enter the bloodstream, and blood is supplied to the inner ear, drugs can affect the ears. Luckily, we now know the major classes of chemicals that are most toxic to the ears. Aspirin can have a mild affect. Quinine compounds, typically antiviral, can be “ototoxic.” A class of antibiotics called aminoglycosides (typically ending in -mycin) can be very toxic. Certain diuretics (water pills) can affect the ears. Certain chemotherapy drugs, particularly platinum compounds, are very toxic to the ears.

Medications can also interact with one another with unintended consequences. We often use the term “polypharmacy effect.”

Some drugs can have permanent effects; others are temporary. Aspirin is known to be “ototoxic”, but the effects wear off after the drug is out of your system. Cisplatin, aminoglycosides and loop diuretics may have a permanent effect. Of course, if you need the drug for a serious medical condition, you may not have other viable options. It is still a good idea to be aware of the risks involved in any course of treatment. Ask your primary care doctor or pharmacist if you have these concerns or if alternate medications are available. As always, we wish to keep you on a clear path to good hearing and ear health.