ATLAS At Work
Ototoxin Database
DRUG NAME | DRUG TYPE | TRADE NAMES | INDICATIONS | EFFECTS ON HEARING | PERSONAL RISK |
|---|---|---|---|---|---|
Acetazolamide | Rx | Acetazolamide | Glaucoma, edema, epilepsy, altitude sickness | SIDE EFFECTS: Hearing disturbances, tinnitus | Avoid taking with high-dose of aspirin |
Alprazolam | Rx Controlled Substance | Xanax | Anxiety, panic disorder | SIDE EFFECTS: Hallucination, tinnitus as part of withdrawal reaction | Avoid taking with strong cytochrome P450 3A (CYP3A) inhibitors (e.g., ketoconazole, itraconazole). Caution: If you are breastfeeding |
Amikacin | Rx | Arikayce | Serious bacterial infections | WARNING: Ototoxicity (vestibular & auditory): Deafness, dizziness, presyncope, tinnitus, vertigo. | Caution if you have kidney problems |
Amitriptyline | Rx | Amitriptyline | Depression, neuropathic pain, migraine | SIDE EFFECT: Tinnitus | Can cause serious heart conditions - check with your doctor |
Artemether | Rx | Lumefantrine & Coartem with Lumefantrine | Malaria | SIDE EFFECT: Tinnitus | Avoid taking with CYP2D6 inhibitors (e.g., Lumefantrine) |
Aspirin | OTC & Rx | Bayer
Excedrin | Pain, fever, inflammation, CV prophylaxis | SIDE EFFECTS: Tinnitus, hearing loss. | Linked to Reye's syndrome that causes severe and sudden brain swelling |
Avanafil | Rx | Stendra | Erectile dysfunction | WARNING: Sudden hearing loss, tinnitus or dizziness. | Avoid taking with strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir, erythromycin). |
Azithromycin | Rx | Zithromax | Bacterial infections | SIDE EFFECTS: Hearing loss, deafness and/or tinnitus | Caution when taking with digoxin, colchicine, phenytoin, nelfinavir, warfarin |
Bismuth Subsalicylate | OTC | Pepto-Bismol
| Heartburn, indigestion, diarrhea, nausea | SIDE EFFECTS: Tinnitus, hearing loss | Linked to Reye's syndrome that causes severe and sudden brain swelling |
Bortezomib | Rx | Velcade | Cancer | SIDE EFFECTS: Hearing impaired, vertigo | Caution when taking with strong CYP3A4 inhibitor (ketoconazole) or Co-administration with (strong CYP3A4 inducer) decreases exposure Lower dose depending on kidney function |
Bumetanide | Rx | Bumex | Edema | WARNING: Ototoxicity Hearing loss | Kidney problems worsen effects Avoid taking with antihypertensives Caution if pregnant/ breast feeding |
Bupropion | Rx | Wellbutrin, Forfivo
| Depression, smoking cessation | SIDE EFFECT: Tinnitus | CYP2B6 inducers (e.g., lopinavir) decreases exposure |
Carbamazepine | Rx | Tegretol, Equetro, Epitol, Teril | Epilepsy, neuralgia | SIDE EFFECTS: Tinnitus, hyperacusis. | Avoid taking with several medicines - check with your doctor. Can cause some hormonal contraceptives to be less effective. |
Carboplatin | Rx (IV, hospital) | Kyxata | Cancer | SIDE EFFECT: Hearing loss | Avoid taking with aminoglycosides (e.g. Gentamicin) |
Celecoxib | Rx | Celebrex, Elyxyb, Vyscoxa | Osteoarthritis, RA, pain, ankylosing spondylitis | SIDE EFFECTS: Deafness, tinnitus. | Avoid taking with warfarin, NSAID (e.g. ibuprofen, naproxen), aspirin, cyclosporine, and CYP2C9 substrate (e.g., fluconazole), digoxin, lithium. Avoid taking if you have liver problems and if you are pregnant. |
Ciprofloxacin | Rx | Cetraxal
Cipro
Ciprofloxacin
| Infections Otitis externa | SIDE EFFECTS: Hearing loss, tinnitus, ear pruritis, fungal ear superinfection | |
Cisplatin | Rx (IV, hospital) | Cisplatin | Cancer | WARNING: Ototoxicity,- hearing loss, tinnitus deafness | Can cause kidney failure Do not take if you are pregnant |
Clonazepam | Rx, Controlled Substance | Klonopin | Seizure disorders, panic disorder | SIDE EFFECTS: Vertigo, otitis, earache, motion sickness | Avoid taking with opioids, phenytoin |
Clorazepate | Rx, Controlled Substance | Tranxene | Anxiety, alcohol withdrawal, adjunct in epilepsy | SIDE EFFECT: Tinnitus | Avoid taking with benzodiazepines, opioids |
Cyclosporine | Rx | Gengraf
Neoral
Sandimmune
| Organ transplantation, rheumatoid arthritis, psoriasis | SIDE EFFECT: Hearing loss | Avoid taking with cyclosporine. |
Deferasirox | Rx | Exjade
Jadenu
| Chronic iron overload | SIDE EFFECTS: High frequency hearing loss, decreased hearing | Avoid taking with CYP2C8 substrates (e.g., repaglinide and paclitaxel), CYP1A2 substrates (e.g., alosetron, caffeine, duloxetine, melatonin, ramelteon, tacrine, theophylline, tizanidine), UGT inducers (e.g., rifampicin, phenytoin, phenobarbital, ritonavir) |
Deferoxamine | Rx | Desferal | Acute iron intoxication, chronic iron overload | SIDE EFFECTS: Tinnitus, high frequency hearing loss | Avoid taking with prochlorperazine Avoid if you have kidney problems, if you are pregnant |
Desipramine | Rx | Norpramin | Depression | SIDE EFFECT: Tinnitus | Lower dose may be needed in elderly |
Diazepam | Rx, Controlled Substance | Valium | Anxiety, alcohol withdrawal, muscle spasm, seizures | SIDE EFFECT: Vertigo | Avoid taking with benzodiazepines, opioids Avoid nursing |
Diclofenac | Rx | Cambia
Cataflam
Zipsor
| Arthritis, ankylosing spondylitis | SIDE EFFECTS: Tinnitus, hearing loss | Avoid taking with aspirin, anticoagulants, NSAIDs (e.g., ibuprofen and naproxen), diuretics, cyclosporine |
Diflunisal | Rx | Diflunisal | Pain, osteoarthritis, rheumatoid arthritis | SIDE EFFECTS: Hearing loss, tinnitus | Avoid taking with NSAIDs (e.g. ibuprofen, naproxen) |
Docetaxel | Rx | Beizray
Docivyx
Taxotere
| Various cancers: Breast, non small cell lung, prostate, gastric, squamous cell | SIDE EFFECTS: Ototoxicity, hearing loss, tinnitus. Not the dominant toxicity but reported. | Avoid taking with drugs that inhibit CYP3A4 (e.g. ketoconazole) |
Doxepin | Rx | Silenor | Insomnia | SIDE EFFECTS: Ear pain, hypoacusis, motion sickness, tinnitus, tympanic membrane | Avoid taking with cimetidine and if you have liver problems. Avoid nursing |
Enalapril | Rx | Epaned
Vasotec
| Hypertension, heart failure, ventricular dysfunction | SIDE EFFECT: Tinnitus, vertigo | Avoid taking with aliskiren and if you have liver problems Avoid taking if you are nursing |
Erythromycin | Rx | Ery-Tab, Eryc | Bacterial infections | SIDE EFFECT: Hearing loss | Avoid taking if you have heart problems, also taking theophylline, digoxin, verapamil, benzodiazepines, sildenafil. Avoid taking if you are nursing. |
Ethacrynic Acid | Rx | Edecrin | Edema, ascites | SIDE EFFECT: Deafness, tinnitus, vertigo. | Avoid if you have gastrointestinal problems |
Febuxostat | Rx | Uloric
Febuxostat
| Hyperuricemia in gout | SIDE EFFECTS: Deafness, tinnitus, vertigo. | Avoid taking with theophylline |
Fenoprofen | Rx | Fenoprofen | Pain, arthritis | WARNING. Hearing loss potential with prolonged therapy. | Avoid taking with anticoagulants (e.g., warfarin), antiplatelet agents (e.g., aspirin), selective serotonin reuptake inhibitors (SSRIs), and serotonin norepinephrine reuptake inhibitors (SNRIs) and digoxin |
Flecainide | Rx | Flecainide | Paroxysmal supraventricular tachycardia/atrial fibrillation/flutter, ventricular arrhythmias | SIDE EFFECT: Tinnitus | Avoid taking with drugs that inhibit cytochrome P450IID6, such as quinidine |
Flumazenil | Rx, Controlled substance | Flumazenil | Reversal of benzodiazepine sedation | SIDE EFFECTS: Hearing loss, hyperacusis, tinnitus | Avoid taking if sensitive to benzodiazepines |
Fluoxetine | Rx | Prozac
Fluoxetine
| Major depressive disorder, OCD, panic disorder, bulimia nervosa, etc. | Avoid taking with alprazolam | |
Flurazepam | Rx, Controlled Substance | Flurazepam | Insomnia | SIDE EFFECT: Hallucination, tinnitus during withdrawal | Avoid taking with opioids, benzodiazepines |
Furosemide | Rx | Furoscyx
Fursemide
Lasix onyu
| Edema in chronic heart failure | WARNING. Tinnitus, hearing loss, deafness | Avoid taking with gentamicin, amikacin, furosemide, lithium, chloral hydrate Avoid taking during pregnancy/nursing. |
Gabapentin | Rx | Gabapentin
Gabapentin encarbil
Gralise
Horizant
Neurontin | Neuralgia, partial onset seizures | SIDE EFFECT: Ear infection (Otitis media) | Avoid taking with hydrocodone |
Gentamicin | Rx | Gentamycin | Serious bacterial infections | BOXED WARNING. Ototoxicity (vestibular, auditory).Dizziness, vertigo, tinnitus, roaring in the ears hearing loss | Avoid taking if you have kidney problems |
Hydrochlorothiazide | Rx | Hydrochlorothiazide
Inzirqo
Maxzide
Microzide
Esidrix
| Hypertension, edema | SIDE EFFECT: Vertigo | |
Hydrocodone | Rx, Controlled Substance | Hydrocodone
Hysingla
| Severe pain | SIDE EFFECT: Tinnitus | Avoid use with CYP3A4 inhibitors (e.g., Itraconazole, Ketoconazole), CYP3A4 inducers (e.g., Phenytoin, Rifampin (rifampicin), MAOI (e.g., Phenelzine, linezolid), hydrocodone, skeletal muscle relaxants (e.g., Cyclobenzaprine, metaxalone) |
Hydroxychloroquine | Rx | Plaquenil, Sovuna
| Malaria | SIDE EFFECTS: Vertigo, tinnitus, nystagmus, hearing loss | Can worsen existing heart problems Can cause hypoglycemia if taken with insulin and other antidiabetic drugs Avoid taking with methotrexate, cyclosporine, digoxin, cimetidine, rifampin |
Hydroxychloroquine | Rx | Hydroxychloroquine
Plaquenil
Sovuna
| Malaria, rheumatoid arthritis, lupus | SIDE EFFECTS: Vertigo, tinnitus, nystagmus, hearing loss | |
Ibuprofen | OTC, Rx | Advil
Caldolor
Motrin
| Analgesic, antipyretic, anti-inflammatory | SIDE EFFECTS: Tinnitus, hearing loss | Avoid during pregnancy |
Imipramine | Rx | Imipramine | Depression | SIDE EFFECT: Tinnitus | |
Indomethacin | Rx | Indocin
Indomethacin
| Arthritis, ankylosing spondylitis, painful shoulder | SIDE EFFECTS: Hearing loss, tinnitus, deafness, vertigo | Avoid taking with anticoagulants (e.g., warfarin) or antiplatelet agents (e.g., aspirin), digoxin, cyclosporine, probenecid. |
Interferon alpha | Rx | Intron A
Pegasys
Pegintron
Sylatron
| Hepatitis, hairy cell leukemia. | SIDE EFFECTS: Hearing loss, tinnitus, vertigo, otitis media | Avoid taking with myelosuppressive agents (such as zidovudine), theophylline |
Isotretinoin | Rx | Absorica, Amnesteem, Claravis, Isotretinoin, Myorisan, Zenatane | Severe acne | WARNING. Hearing loss, tinnitus | Avoid taking with vitamin A. |
Itraconazole | Rx | Itraconazole,
Sporanox,
Tolsura
| Fungal infections | WARNING. Hearing loss, Tinnitus | Avoid taking with alfuzosin, methadone, quinidine, digoxin, clarithromycin, apixaban |
Ketamine | Rx, Controlled Substance | Spravato | Depression | SIDE EFFECTS: Hallucination and tinnitus, vertigo, hyperacusis | Avoid taking with CNS depressants (e.g., benzodiazepines, opioids, alcohol), psychostimulants (e.g., amphetamines, methylphenidate, modafinil, armodafinil), MAOI (e.g., phenelzine, tranylcypromine, isocarboxazid, and selegiline) |
Ketoprofen | Rx | Ketoprofen | Arthritis, dysmenorrhea | SIDE EFFECTS: Hearing loss, tinnitus, visual disturbances, vertigo, | Avoid taking if you have heart problems |
Leuprolide | Rx | Eligard,
Fensolvi,
Leuprolide acetate,
Lupron depot
| Advanced prostate cancer | SIDE EFFECT: Vertigo, tinnitus | Avoid taking if you have heart problems |
Levofloxacin | Rx | Levofloxacin | Infections | SIDE EFFECTS: Hypoacusis tinnitus | |
Lidocaine | Rx | Bondlido,
Glydo,
Lidocaine,
Lidoderm,
Xylocaine,
Zingo,
Ztlido
| Local anesthesia, neuralgia pain | SIDE EFFECT: Tinnitus | Avoid taking with Class I antiarrhythmic drugs (such as tocainide or mexiletine) Avoid taking if you are nursing. |
Lithium | Rx | Lithium carbonate,
Lithium citrate,
Lithobid
| Acute manic and mixed episode | SIDE EFFECTS: Tinnitus.vertigo | Avoid taking with Renin-Angiotensin System Antagonists (e.g., losartan, Olmesartan) |
Lorazepam | Rx, Controlled Substance | Ativan,
Lorazepam,
Lorazepam Intensol,
Loreev XR
| Anxiety disorders | SIDE EFFECTS: Tinnitus, hyperacusis with withdrawal, vertigo | Avoid taking with CNS depressants such as alcohol, barbiturates, antipsychotics, sedative/hypnotics, anxiolytics, antidepressants, narcotic analgesics, sedative antihistamines, anticonvulsants, and anesthetics. Avoid taking if you are nursing |
Mefloquine | Rx | Mefloquine hydrochloride | Malaria | SIDE EFFECTS: Tinnitus, vertigo | Avoid if you have psychiatric disorders, liver problems |
Meropenem | Rx | Meropenem | Antibacterial | SIDE EFFECTS: Hearing loss in children | Avoid taking with probenecid, valproic acid. |
Methotrexate | Rx | Jylamvo
Methotrexate
Rasuvo
Trexall
| Certain cancers, rheumatoid arthritis, severe psoriasis | SIDE EFFECT: Tinnitus | Avoid taking with certain drugs (e.g.. Penicillin or sulfonamide antibiotics, phenytoin, salicylates, sulfonamides), folic acid, theophylline Avoid taking if you are pregnant |
Metoprolol | Rx | Kapspargo
Lopressor
Metoprolol
Toprol
| Hypertension Angina pectoris Myocardial infarction | SIDE EFFECTS: Tinnitus, vertigo | Avoid taking with catecholamine depleting drugs (e.g., reserpine), strong inhibitors of CYP2D6 (e.g. quinidine, fluoxetine, paroxetine), verapamil, diltiazem |
Midazolam | Rx, Controlled Substance | Midazolam
Nayzilam
| Seizures | WITHDRAWAL EFFECTS: Hearing things not there, tinnitus, hyperacusis SIDE EFFECTS: Vertigo | Avoid taking with CYP3A4 inhibitors (e.g., ketoconazole, itraconazole), opioids, barbiturates, alcohol, or other CNS depressants Avoid taking if you are nursing Avoid if you have kidney problems |
Minocycline | Rx | Emrosi
Minosin
| Rosacea | SIDE EFFECTS: Hearing loss, vertigo, | Avoid taking with antacids containing aluminum, calcium or magnesium and iron-containing preparations |
Naproxen | Rx, OTC | Aleve
Anaprox
Naprelan
Naprosyn
Naproxen
| Pain, fever | SIDE EFFECTS: Tinnitus, hearing disturbances, vertigo | Avoid taking with anticoagulants such as warfarin, analgesic doses of aspirin, diuretice, digoxin, lithium, methotrexate, antacids such as magnesium oxide or aluminum hydroxide Avoid use if you are pregnant |
Neomycin | Rx | Neomycin | |||
Nicotine | Rx | Nicotrol Spray | WITHDRAWAL SYMPTOMS: Hearing disturbances, tinnitus OVERDOSE SYMPTOMS: Hearing difficulties SIDE EFFECTS: Ear pain | Avoid taking if you are pregnant | |
Nilotinib | Rx | Danziten
Nilotinib
Tasigna
| Cancer | SIDE EFFECTS: Vertigo, hearing loss, ear pain, tinnitus | |
Paroxetin | Rx | Brisdelle
Paroxetine
Paxil
| Depression and other related disorders Menopause symptoms | SIDE EFFECTS: Hearing things no there (hallucinations), tinnitus, vertigo, ear pain, otitis media, hyperacusis, | |
Penicillamine | Rx | Cuprimine, Depen | Wilson's disease, cystinuria, severe rheumatoid arthritis | SIDE EFFECTS: Tinnitus, peripheral sensory neuropathy. | Avoid if you have kidney problems Avoid if you are pregnant/nursing |
Piroxicam | Rx | Feldene
Piroxicam
| Arthritis | SIDE EFFECTS: Hearing loss, tinnitus, vertigo | |
Plazomicin | Rx | Zemdri | Urinary tract infections | BOXED WARNING: Ototoxicity, hearing loss, deafness, tinnitus, hypoacusis | |
Pramipexole | Rx | Mirapex
Pramipexole
| Parkinson’s disease | SIDE EFFECTS: Deafness,hearing loss, ear pain, hypoacusis,otitis externa, otitis media | |
Procainamide | Rx | Procainamide | Ventricular arrhythmia | SIDE EFFECTS: Hearing things not there (hallucinations) | |
Propranolol | Rx | Inderal
Innopran
Propranolol
| Hypertension, Angina pectoris, Migraine, Stenosis | SIDE EFFECT: Hearing things not there (hallucinations) | |
Protriptyline | Rx | Protriptyline | Depression | SIDE EFFECT: Tinnitus | |
Quazepam | Rx, Controlled Substance | Doral | Insomnia | WITHDRAWAL EFFECTS: Hearing things others don’t hear, tinnitus, hyperacusis | |
Quinidine | Rx | Quinidine | Atrial fibrillation/flutter Ventricular arrhythmias | SIDE EFFECTS: Tinnitus, hearing loss, vertigo, deafness | |
Quinine | Rx | Quinine | Malaria | SIDE EFFECTS: Tinnitus, hearing loss, vertigo, deafness | |
Ropinirole | Rx | Parkinson’s | WARNING: Hallucination- hearing things not there. | ||
Ropivacaine | Rx | Naropin
Ropivacaine
| Anesthesia | WARNING: Tinnitus SIDE EFFECTS: Tinnitus, hearing abnormalities, vertigo | |
Sildenafil | Rx | Revatio
Sildenafil
Viagra
Vybrique
| Pulmonary arterial hypertension Erectile dysfunction | WARNING: Hearing loss, tinnitus, dizziness SIDE EFFECTS: Hearing loss | |
Streptomycin | Rx | Streptomycin | Severe infections | BOXED WARNING: Disturbances of vestibular and cochlear functions WARNING: Ototoxicity, hearing loss | |
Sulfamethoxazole | Rx | Bactrim
Sulfatrim
Sulfamethoxazole and trimethoprim
| Bacterial infections | SIDE EFFECTS: Tinnitus, vertigo | |
Sulindac | Rx | Sulindac | Arthritis | SIDE EFFECTS: Tinnitus, decreased hearing | |
Tacrolimus | Rx | Astagraf
Envarsus
Prograf
Protopic
Tacrolimus
| Transplant | SIDE EFFECTS: Hearing loss, tinnitus, dizziness | |
Tadalafil | Rx | Adcirca
Alyo
Cialis
Opsynvi
Tadliq
Tadalafil
| Erectile dysfunction Benign prostatic hyperplasia | WARNING: Hearing loss | |
Temazepam | Rx, Controlled Substance | Restoil
Temazepam
| Insomnia | WITHDRAWAL SYMPTOMS: Hearing things that others do not see or hear, tinnitus, hyperacusis | |
Teprotumumab | Rx | Tepezza | Thyroid eye disease | WARNING: Hearing loss SIDE EFFECTS: Deafness, eustachian tube dysfunction, hyperacusis, hypoacusis, autophony, tinnitus | |
Terbinafine | Rx | Terbinafine | Fungal infection | SIDE EFFECTS: Hearing loss, vertigo, tinnitus | |
Thalidomide | Rx | Thalomid
Thalidomide
| Cancer | SIDE EFFECTS: Deafness, tinnitus | |
Tobramycin | Rx | Tobramycin | Bacterial infection | WARNING: Dizziness, vertigo, tinnitus, roaring in the ears and hearing loss SIDE EFFECTS: Tinnitus, hearing loss, vertigo | |
Tolmetin | Rx | Tolmetin | Arthritis | SIDE EFFECTS: Tinnitus | |
Topiramate | Rx | Eprontia
Qudexy
Topamax
Topiramate
Trokendi
| Epilepsy Migraine | SIDE EFFECTS: Otitis media | |
Trazodon | Rx | Raldesy
Trazodon
| Depression | DISCONTINUATION SYMPTOMS: Tinnitus SIDE EFFECTS: Vertigo | |
Triazolam | Rx, Controlled Substance | Halcion
Triazolam
| Insomnia | WITHDRAWAL SYMPTOMS: Hearing things that others do not see or hear, SIDE EFFECTS: Vertigo | |
Valproate sodium | Rx | Valproate | Epilepsy | SIDE EFFECTS: Tinnitus | |
Valproic acid | Rx | Valproic acid | Seizures | SIDE EFFECTS: Tinnitus | |
Vancomycin | Rx | Firvanq kit
Tyzavan
Vancocin
Vancomycin
| Bacterial infections | OTOTOXICITY: Hearing loss, vertigo, tinnitus | |
Vardenafil | Rx | Vardenafil | Erectile dysfunction | WARNING: Sudden hearing loss, tinnitus and dizziness, | |
Verteporfin | Rx | Visudyne | Macular degeneration | SIDE EFFECTS: Hearing loss, vertigo, |