Tinnitus and Ringing in the Ears from Medications: What to Know

Have you started a new medication and suddenly noticed a ringing, buzzing, or hissing in your ears? You’re not alone. Tinnitus - that persistent sound with no external source - can be triggered or worsened by many common drugs. It’s not just a minor annoyance. For some, it becomes a constant companion that disrupts sleep, focus, and even mental health. The good news? In many cases, it’s reversible. The key is knowing which medications to watch for, how to spot the signs early, and what to do next.

What Exactly Is Medication-Induced Tinnitus?

Tinnitus isn’t a disease. It’s a symptom. And when it’s caused by a drug, it’s called ototoxicity. That means the medication is damaging parts of your inner ear or the nerve that sends sound signals to your brain. This damage can cause ringing, roaring, clicking, or even a high-pitched whistle - usually in both ears. It might show up within hours of taking a new pill, or it could creep in slowly over weeks.

Over 600 prescription and over-the-counter drugs are known to cause or worsen tinnitus, according to recent clinical reviews. That includes everything from painkillers and antibiotics to antidepressants and cancer drugs. The scary part? Many people don’t realize their tinnitus is drug-related. They assume it’s just aging, stress, or noise exposure. But if the ringing started after you began a new medication, that’s a red flag.

Which Medications Are Most Likely to Cause Ringing in the Ears?

Not all drugs carry the same risk. Some are far more dangerous than others. Here’s a breakdown of the most common culprits, ranked by risk level:

• High-risk drugs: These can cause permanent hearing damage. Includes aminoglycoside antibiotics like gentamicin and tobramycin (especially when given IV), platinum-based chemotherapy like cisplatin (up to 70% of patients develop hearing issues), and loop diuretics like furosemide (Lasix) used for heart failure or kidney problems.
• Moderate-risk drugs: Often reversible if caught early. Includes aspirin - but only at very high doses (4,000 mg or more daily). Modern headache doses (325-650 mg) rarely cause issues. Also includes isotretinoin (Accutane) for acne, which affects about 5% of users.
• Low-risk drugs: Tinnitus is rare. Includes most antidepressants like sertraline (Zoloft) or fluoxetine (Prozac), affecting less than 1% of users. Also includes beta blockers - but only some, like carvedilol. Aténolol doesn’t seem to cause it.

One surprising fact: NSAIDs like ibuprofen and naproxen can trigger tinnitus, especially at high doses. One Reddit user reported ringing within 48 hours of taking 800 mg of ibuprofen three times a day for a toothache. The sound faded within a week after stopping. That’s a classic case of temporary ototoxicity.

Why Do Some Drugs Hurt Your Ears?

The exact science isn’t fully understood, but researchers believe ototoxic drugs interfere with the tiny hair cells in your cochlea - the part of your inner ear that turns sound waves into electrical signals. These cells don’t regenerate. Once they’re damaged, the signal to your brain gets distorted, and you hear phantom sounds.

Some drugs also affect blood flow to the inner ear or disrupt the balance of electrolytes like potassium and sodium, which are critical for nerve function. That’s why kidney function matters. If your kidneys can’t clear the drug properly, it builds up and increases your risk. That’s why doctors monitor blood levels of drugs like gentamicin - to keep doses safe.

Is It Permanent? How Long Does It Last?

This is the biggest question for most people. The answer: it depends.

• Reversible: About 60% of cases clear up within days to weeks after stopping the drug. This includes tinnitus from NSAIDs, high-dose aspirin, quinine (used for malaria), and even some antidepressants.
• Potentially permanent: Aminoglycosides and cisplatin can cause irreversible damage. Even after you stop the drug, the ringing may stick around. That’s why doctors test hearing before and during treatment for these drugs.
• Delayed onset: Some people don’t notice tinnitus until weeks or even months after starting a drug. This is common with antidepressants and benzodiazepines. It’s not always the drug itself - sometimes it’s the withdrawal. Stopping sertraline suddenly, for example, has been linked to new-onset tinnitus in case reports.

Most people who develop drug-induced tinnitus notice it within the first two weeks. If you’ve been on a medication for six months and suddenly hear ringing, it’s less likely to be the drug - but still possible.

What Should You Do If You Notice Ringing After Starting a New Drug?

DO NOT stop your medication on your own. That’s dangerous. Some drugs - like blood pressure meds or antidepressants - need to be tapered slowly. Stopping abruptly can cause serious side effects.

Instead, do this:

1. Write it down. Note when the ringing started, what it sounds like, and whether it’s constant or comes and goes.
2. Check your meds. Look up the drug’s side effects on a trusted site like the FDA’s database or your pharmacy’s info sheet. Many list tinnitus as a possible side effect.
3. Call your doctor. Don’t wait. Say: “I started [drug name] two weeks ago, and now I have constant ringing in my ears. Could this be related?”

Your doctor might:

• Switch you to a different drug with lower ototoxic risk
• Lower your dose
• Order a hearing test to check for damage
• Monitor your kidney function if you’re on a high-risk drug

Many people are surprised to learn their doctor can often find an equally effective alternative. For example, if you’re on a high-dose NSAID for arthritis, switching to a COX-2 inhibitor or a non-NSAID pain reliever might solve the problem.

Can You Prevent Medication-Induced Tinnitus?

Yes - but it takes awareness and action.

• Ask before you start. When a new medication is prescribed, ask: “Can this cause ringing in the ears or hearing loss?”
• Get baseline hearing tested. If you’re starting cisplatin, gentamicin, or another high-risk drug, ask for an audiogram before treatment begins. That way, doctors can track changes.
• Don’t mix high-risk drugs. Taking multiple ototoxic drugs at once (like aspirin + furosemide) increases risk dramatically.
• Monitor kidney health. Poor kidney function means drugs stay in your system longer. Stay hydrated and get regular blood tests if you’re on long-term ototoxic meds.
• Know your sensitivity. A small number of people are unusually sensitive to aspirin - they get tinnitus even at low doses. If you’ve had this happen before, avoid aspirin and tell your doctor.

What If the Tinnitus Won’t Go Away?

If the ringing sticks around after you’ve stopped the drug, it’s not your fault. You did everything right. Now it’s about managing it.

Studies show that sound therapy (using white noise machines or soft background music) and cognitive behavioral therapy (CBT) help 60-70% of people cope better. These don’t cure tinnitus, but they help your brain stop noticing it as much. Many people report sleeping better and feeling less anxious within weeks.

There’s no magic pill to make it vanish - yet. But research is moving fast. The NIH is funding $12.5 million in studies to find drugs that protect the ear from ototoxic damage without reducing the medicine’s effectiveness. Genetic tests are also being developed to identify people at higher risk before they even start treatment.

Bottom Line: Don’t Panic - But Don’t Ignore It

Medication-induced tinnitus is more common than most people think. But it’s also one of the most treatable forms of tinnitus. The key is catching it early. If you notice new or worsening ringing after starting a new drug, talk to your doctor. Don’t wait. Don’t assume it’s harmless. And never stop your meds without professional advice.

Many people go years thinking their tinnitus is just part of life - until they realize it started after a prescription they forgot about. You have the power to change that. Know your meds. Listen to your ears. And speak up.

What’s Next?

If you’re currently on a medication and experiencing tinnitus, schedule a call with your doctor this week. Bring your list of all meds - including supplements and OTC painkillers. Ask about alternatives and whether a hearing test is recommended.

If you’ve already had tinnitus from a drug and it’s resolved, great. But remember: if you ever need that same drug again, you’re at higher risk. Tell every new provider about your history.

And if you’re starting a new treatment - especially for cancer, infection, or chronic pain - ask the big question: “Could this affect my hearing?” That simple step could save you from months of ringing in your ears.