Northern Virginia Resource Center for Deaf and Hard of Hearing Persons 3951 Pender Drive, Suite 130 • Fairfax, VA 22030 703-352-9055 (V) • 703-352-9056 (TTY) • 703-352-9058 (FAX) www.nvrc.org • [email protected] drug isdiscontinued.drug hearing problemsare reversible whenthe causecan permanent damage, some Although there are timeswhen the drugs experienceany changes hearing.in your ofunsure your drug’sorototoxicity if you withyour medical professional areyouif recommendeddosage. Be sureto consult onlycausedbe by exceeding the hearing problem.Usually problemthis will peoplesome or exacerbate an existing knownto cause hearing loss ortinnitus in The followinglists of medications havebeen fully monitoring blood levels.) blood monitoring fully care- by minimized canbe effects ototoxic (The • vincristine • vinblastin • nitrogenmustard • methotrexate • cisplatin • carboplatinum ( • bromocriptine( • Agents Chemotherapeutic discontinued.) are medications once reversible always almost are and related dose be to appear effects (Toxic Salicylates Reproduction in whole or in part is prohibited without written permission. written without prohibited is in part or inwhole Reproduction Persons. Hearing of Hard and Deaf for Center Resource Virginia Northern by 10/2010 Copyright
bleomycine (linaments) salicylagtesand methylsalicylates aspirin andaspirin Drugs That Cause Can
(Platinol) (Velban) Hearing Loss Hearing (Oncovin)
(Blenoxane)
(Rheumatrex) Parlodel Carboplatin Ototoxic Medications (Mustargen)
- containingproducts )
)
intravenously, there is a risk of an increase of the of the ofincrease an is a risk there intravenously, used antibiotic aminoglycoside an with together skin the used on is antibiotic aminoglycoside of an solution a When is perforated. drum) (ear membrane tympanic the unless humans in ototoxic be to not appear do or neomycin gentamycin containing medications ( • Antibiotics medication) • capreomycin (Antifungalpreparations) • polymixin&hotericin B B • problem.) the exaggerates life treating when intravenously together used are often vancomycin and aminoglycosides that fact The infections. life in intravenously used when ototoxic be may it in that aminoglycosides to (Similar failure.) kidney underlying 2 of doses intravenous in given when ototoxic (Usually - - - - permanent.) is usually of antibiotics thisby class caused loss body. Hearing the into absorbed be to drug of the amounts large for allowed which weretreated areas large when loss hearing in resulted has therapy even topical But only. use topical for is recommended it so cochlea, to the toxic is most that drug is the Neomycin damage. kidney underlying has patient or if the or raw, open is that wound a on is used the if solution especially effect, ototoxic Of particular interest is that topical ear drop ear drop topical is that interest particular Of
- aminoglycosides minocycline (Zithromax) (Pediazole) (Ilosone) (EES) 4 grams per 24 hours, especially if there is if there especially hours, per 24 4 grams ------
vancomycin (Vancocin) erythromycin tobramycin kanamycin gentamycin streptomycin netilmicin neomycin amikacin
(Amakin) (Minocin)(Similar erythromycin) to (Netromycin) (Found in many over many (Found in antibiotic ointments) antibiotic
(Capestat)(Anti (Kantrex) - (Nebcin) (Garamycin) threatening infections further further infections threatening
structure involved in hearing, the the hearing, in involved structure
- - -
(Biaxin) (Eryc) (E
- mycin)
-
threatening threatening
-
tuberculosis -
the - counter counter
Non-Steroidal Anti-Inflammatory Drugs Diuretics (NSAIDS) • bendroflumethazide (Corzide) Most NSAIDS have the potential for causing hearing • bumetadine (Bumex) loss and/or tinnitus. Because new drugs are being frequently approved for use, it is • chlor-thalidone (Tenoretic) important that you check with your doctor or pharma- • ethacrynic acid (Edecrin) cist to determine if the drug you were prescribed can • furosemide (Lasix) cause a problem.) (These are usually ototoxic when given intravenously for • dicofenac (Voltaren) acute kidney failure, acute hypertensive crisis, or acute • etocolac (Lodine) pulmonary edema/congestive heart failure. Rare cases of • fenprofen (Nalfon) ototoxicity have been found when these medications are taken orally in high doses by people with chronic kidney • ibuprofen (Motrin, Advil, Nuprin, etc.) disease.) • indomethacin (Indocin) • naproxen (Naprosyn, Anaprox, Aleve) • piroxican (Feldene) Quinine • sulindac (Clinoril) • chloroquine phosphate (Aralen) (Toxic effects are dose related and are almost al- • quinacrine hydrochloride (Atabrine) ways reversible once medications are discontinued.) • quinine sulfate (Quinam) (The ototoxic effects are very similar to those of aspirin.)
Mucosal Protectant Narcotic Analgesics
• misoprostol (Cytotec) • hydrocodone (Lorcet, Vicodin)
Drugs that Can Cause Tinnitus
Antibiotics Vapors, Solvents • aminoglycosides (see previous section) • cyclohexane • amphotericin B • dichloromethane • chloramphenicol (Chloromycetin) • hexane (gasoline) • minocycline (Monocin) • lindane (Kwell) • polymyxine B • methyl-chloride • sulfonamides (Septra, Bactrim) • methyl-n-butyl-ketone • vancomycin (Vancocin) • perchlor-ethylene • Styrene • tetrachlor-ethane Cardiac Medications • toluol • trichloroethylene • celiprolol • flecainide (Tambocar) • lidocaine Anesthetics • metoprolol (Lopressor) • procainamide (Pronestyl) • bupivacain • propranolol (Inderal) • tetracain • quinidine (Quinaglute, Quiniedex) • lidocaine (Novacaine)
Glucocorticosteroids Antimalarials • prednisone (Deltasone) • chloroquine (Aralen) • prednisolone (Prelone) • hydroxychloroquine (Plaquinil) • ACTH (adrenocorticotrophic hormone) (Acthar) 2 Non-Steroidal Anti-inflammatory Drugs Psychopharmacologic Agents (NSAIDS) (Please see notation for NSAIDS under “hearing loss.”) • amitryptiline (Elavil) • benzodiazepine class • aspirin - alprazolam (Xanax) • acematacine - clorazepate (Tranxene) • benorilate - chlordiazepoxide (Librium) • benoxaprofen - diazepam (Valium) • carprofen - flurazepam (Dalmane) • diclofenac (Voltaren) - lorazepam (Ativan) • diflunisal (Dolobid) - midazolam (Versed) • fenoprofen (Nalfon) - oxazepam (Serax) • feprazon - prozepam (Centrax) • ibuprofen (Motrin, Advil, Nuprin) - quazepam (Doral) • indomethacin (Indocin) - temazepam (Restoril) • isoxicam - triazolam (Halcion) • ketoprofen (Orudis) • buptopion (Welbutrin) • methyl salicylates (BenGay) • carbamazepine (Tegretol) • naproxen (Naprosyn, Anaprox, Aleve) • diclofensine •D-Penicilliamin • doxepin (Sinequin) • phenylbutazone (Butazolidine) • desiprimine (Norpramin) • piroxicam (Feldene) • fluoxetin (Prozac) • proglumetacin • imipramine (Tofranil) • proquazon • lithium • rofecoxib (Vioxx) • melitracen • salicylates • molindon (Moban) • sulindac (Clinoril) • paroxetin • tolmetin (Tolectin) • phenelzin (Nardil) • zomepirac • protriptilin (Vivactil) • trazodon (Desyrel) • zimeldin Miscellaneous Toxic Substances
• alcohol Anti-neoplastics • arsenum • caffeine • bleomycin (Blenoxane) • lead • cis-platinum (Platinol) • marijuana • carboplatinum (Paraplatin) • nicotine • methotrexate (Rheumatrex) • mercury • nitrogen mustard (Mustagen) • auronofin (gold, Ridaura) • vinblastin (Velban) (Ironically, several of these drugs found to cause tinnitus, are also used to treat tinnitus; for example: Others amitryptiline, benzodiazepine class, carbamazepine, furosemide, lidocaine, prednisone.) thalidomide (Thalomid)
Adapted from the pamphlet: Diuretics Ototoxic Medications: Drugs that can cause • acetazolamide (Diamox) hearing loss and tinnitus Article by Orin S. Kaufman, D.O. • bumetanide (Bumex) • bendrofluazide League for the Hard of Hearing • clorothalidone (Hygroton, Tenoretic) 50 Broadway, New York, NY 10004 • diapamide www.lhh.org • ethacrynic acid (Edecrin) • furosemide (Lasix) For a more complete list of medications we recommend: • hydrochlorthiazide (Hydrodiuril) Ototoxic Drugs Exposed by Neil G. Bauman. Ph.D. • methylchlorthizide (Enduron) http://www.HearingLossHelp.com 3