What Are Ototoxic Medications?

Ototoxic medications are drugs that can affect the ears—especially the cochlea (hearing) and
vestibular system (balance). In some people, they may cause:

• Tinnitus (ringing, buzzing, hissing, or roaring in the ears)
• New or worsened hearing loss
• Balance problems or dizziness

Not everyone who takes these medications develops tinnitus, and in many situations the benefits of the drug
clearly outweigh the risks. The goal is not to scare you, but to help you:

• Recognize tinnitus as a potential side effect
• Know when to reach out to your prescribing doctor
• Protect your ears as much as possible during treatment

For a broader overview of tinnitus itself, start with
What Is Tinnitus? and
Tinnitus Causes & Triggers.

How Medications Can Cause or Worsen Tinnitus

Medications can influence tinnitus in different ways:

• Direct effects on inner ear cells: Some drugs can stress or damage the tiny hair cells in the
  inner ear that help you hear.
• Changes in blood flow to the ear: Certain medications affect circulation, which can change how
  the ear and auditory nerve function.
• Chemical changes in the nervous system: Medications that act on the brain or nerves can also
  alter how sound signals are processed.
• Interactions with existing hearing loss: If you already have
  hearing changes, some medications may make underlying tinnitus
  more noticeable.

Tinnitus from medications may:

• Start soon after beginning a new drug or changing the dose
• Become louder during treatment and then settle once the drug is stopped
• Fluctuate with things like caffeine, alcohol, and stress
  (see Does Caffeine Affect Tinnitus? and
  Could Drinking Alcohol Affect Your Hearing?)

Common Types of Medications Linked to Tinnitus

Many different medications have been associated with tinnitus. Here are broad categories that are often discussed
in the tinnitus and audiology literature. This is not a complete list, and individual risk varies.

If you’re curious about non-medication triggers as well, visit
Lifestyle & Diet Tips for Tinnitus and
Simple Steps to Protect and Preserve Your Hearing.

Temporary vs. Permanent Drug-Related Tinnitus

One of the biggest questions patients ask in our San Mateo and San Carlos clinics is:
“Will this tinnitus go away once I stop the medication?”

The answer depends on several factors, including:

• The specific medication and dosage
• How long you’ve been taking it
• Other risk factors (age, noise exposure, kidney function, cardiovascular health)
• Whether you had tinnitus or hearing loss before starting the drug

In some cases, tinnitus:

• Improves or disappears after the medication is stopped or the dose is adjusted
• Remains but becomes less noticeable over time as the brain adapts
• Persists, especially if inner ear damage or existing hearing loss is present

For a broader look at recovery and prognosis, see
Can Tinnitus Go Away on Its Own? and
Is My Tinnitus Permanent?.

When to Call Your Doctor About Medication & Tinnitus

Contact your prescribing clinician promptly if you notice:

• New tinnitus that starts soon after a medication change
• Sudden or rapidly worsening tinnitus in one or both ears
• Tinnitus plus new hearing loss, dizziness, or balance changes
• Significant impact on sleep, mood, or ability to function

These symptoms don’t automatically mean the medication must be stopped, but they do warrant a
conversation. Your doctor may:

• Review whether tinnitus is a known side effect
• Consider dose adjustments or alternative medications
• Order additional tests if needed
• Recommend a hearing and tinnitus evaluation with an audiologist

For help deciding how urgent your situation might be, see
When to See a Doctor About Tinnitus and
Sudden Tinnitus: Should I Go to the ER?.

Why You Shouldn’t Stop Medications on Your Own

The safest approach is to:

• Take note of your tinnitus symptoms and when they occur
• Contact your prescribing physician or specialist
• Ask whether tinnitus is a known side effect and what options exist
• Consider a baseline or follow-up hearing test to monitor any changes

How Audiologists Help with Medication-Related Tinnitus

At California Hearing Center, we frequently see Bay Area patients who are:

• Starting or currently taking potentially ototoxic medications
• Undergoing cancer treatment or complex medical care
• Noticing new tinnitus after a medication change

Self-Care Tips While You Sort Things Out

While you’re talking with your doctor and audiologist, these steps can help support your ears and nervous system:

• Protect your hearing from loud sounds—especially if you’re on a medication with known ototoxic
  potential. See
  Simple Steps to Protect and Preserve Your Hearing
  .
• Use gentle background sound at night or in quiet spaces to reduce contrast with tinnitus.
  Learn more in Managing Tinnitus at Night and
  Best Tinnitus Relief Apps.
• Support your body with sleep, hydration, and movement. These won’t “cure” tinnitus but can
  lower overall sensitivity.
• Practice relaxation techniques to reduce the stress response that amplifies tinnitus. Try ideas
  from
  Best Relaxation Techniques for Tinnitus Relief
  .
• Notice how caffeine and alcohol affect you personally, using guidance from
  
  Does Caffeine Affect Tinnitus?
  and
  Could Drinking Alcohol Affect Your Hearing?.

Medication & Tinnitus in Bay Area Patients

In the San Francisco Bay Area, many of our patients:

• Receive care at regional cancer centers, cardiology practices, and major hospital systems
• Juggle demanding careers in tech, healthcare, finance, and education
• Are taking multiple medications at once while also managing stress and sleep challenges

If you live in San Mateo,
San Carlos, or surrounding communities, you don’t have to navigate
medication-related tinnitus alone. We regularly see patients from across the Peninsula, San Francisco, the East
Bay, and the South Bay who want both medical and audiology perspectives on their symptoms.

You may also find value in our local tinnitus pages:
Peninsula Tinnitus Treatment,
San Francisco Tinnitus Treatment,
East Bay – Oakland & Berkeley, and
South Bay & San Jose.

Next Steps with California Hearing Center

If you’re worried that a medication might be affecting your ears, we can help you:

• Document your tinnitus and hearing changes clearly
• Obtain baseline and follow-up hearing tests
• Share results with your medical team to inform decisions
• Explore tinnitus management tools while treatment decisions are made

Many patients feel more confident once they have objective data and a clear plan. You may want to review these
pages before your visit:

• What to Expect at Your Tinnitus Appointment
• Tinnitus Severity Assessment
• Comprehensive Tinnitus Treatment Options
• Coping with Tinnitus Anxiety
• Tinnitus Patient Success Stories