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

Many people notice a ringing, buzzing, or hissing in their ears after starting a new medication. It’s not just in their head-it’s a real side effect called medication-induced tinnitus. And while it’s often temporary, it can also be a warning sign of lasting damage. The good news? You don’t have to live with it. Knowing which drugs cause it, how to spot it early, and what to do next can protect your hearing.

What Exactly Is Medication-Induced Tinnitus?

Tinnitus isn’t a disease. It’s a symptom: hearing sounds that aren’t there. For some, it’s a quiet ring. For others, it’s a loud buzz that won’t quit. When it starts after taking a new pill, injection, or even an over-the-counter painkiller, it’s likely caused by ototoxicity-meaning the drug is harming your inner ear.

The inner ear has tiny hair cells that turn sound waves into electrical signals your brain understands. Some medications interfere with these cells or the nerves that carry signals to your brain. The result? Your brain gets confused and creates noise where there should be none.

More than 600 prescription and over-the-counter drugs are known to cause or worsen tinnitus, according to Sound Relief’s 2025 review. That includes common meds you might not suspect, like aspirin, ibuprofen, and even some antidepressants.

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

Not all drugs carry the same risk. Some are high-risk, others are rare. Here’s what actually matters:

• Aminoglycoside antibiotics (like gentamicin and tobramycin): These are among the most dangerous. Used for serious infections, they can cause permanent hearing loss in up to 25% of patients on long-term IV treatment. Topical versions (ear drops, creams) are much safer.
• Chemotherapy drugs (especially cisplatin): Between 30% and 70% of patients on cisplatin develop hearing damage. It usually starts with high-pitched sounds you can’t hear anymore-like birds chirping or a phone ringing-before affecting speech.
• Loop diuretics (like furosemide): Often used for heart failure or kidney issues. Tinnitus can appear within hours of a high dose and may last days after stopping.
• High-dose aspirin and NSAIDs: You need to take a lot to trigger it-usually over 4,000 mg of aspirin daily. That’s more than 12 regular tablets. Modern headache doses (325-650 mg) rarely cause issues. But some people are unusually sensitive-even low doses can trigger ringing.
• Quinine: Found in some malaria treatments and tonic water. Can cause tinnitus within 1-3 days. Usually goes away in 1-2 weeks after stopping.
• Isotretinoin (Accutane): Used for severe acne. About 5% of users report tinnitus, though the manufacturer claims less than 1%. Still, it’s listed as a known side effect.
• Antidepressants: Rare, but documented. SSRIs like sertraline (Zoloft) have been linked to tinnitus onset or worsening. Some people report it starting when they stop the drug, not when they start it.
• Benzodiazepines (like Xanax or Valium): Tinnitus is more common after long-term use-usually six months or more.

Is the Ringing Permanent?

It depends on the drug and how long you’ve been taking it.

About 60% of medication-induced tinnitus cases reverse once you stop the drug. That’s the good news. For example:

• Someone on high-dose ibuprofen for back pain notices ringing after 3 days. They stop the pills. The noise fades in a week.
• A patient on furosemide for fluid retention develops tinnitus after two weeks. Their doctor lowers the dose. Symptoms improve.

But some drugs cause irreversible damage:

• Aminoglycosides can permanently destroy inner ear hair cells. Once gone, they don’t grow back.
• Cisplatin often leads to lasting hearing loss, especially in higher doses or with repeated use.

The key is catching it early. If you notice ringing, buzzing, or muffled hearing within the first two weeks of starting a new medication, don’t wait. Talk to your doctor. The sooner you act, the better your chances of saving your hearing.

Why Does This Happen? The Science Behind the Noise

Scientists still don’t fully understand how every drug causes tinnitus. But we know the basics:

- Some drugs build up in the fluid around the inner ear and disrupt the electrical signals from hair cells to the brain.

- Others reduce blood flow to the cochlea, starving the cells of oxygen.

- A few interfere with potassium channels in the inner ear, which are critical for turning sound into nerve signals.

It’s not always about dose. Some people have genetic traits that make them more sensitive. That’s why two people on the same drug can have totally different outcomes.

Research is now looking at genetic testing to identify who’s at higher risk before prescribing ototoxic drugs. Early results show promise-especially in cancer patients who need cisplatin.

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

Do not stop your medication on your own. That can be dangerous. Instead:

1. Write down when the ringing started and how loud it is (scale of 1-10).
2. Check if you’ve taken any new pills, including supplements or OTC painkillers.
3. Call your doctor. Say: “I started [medication name] on [date], and now I have ringing in my ears.”
4. Ask: “Could this be a side effect? Is there a safer alternative?”
5. If your doctor agrees it’s likely the drug, they may reduce your dose, switch you to another medication, or schedule a hearing test.

Your doctor might refer you to an audiologist for a baseline hearing test-especially if you’re on high-risk drugs like cisplatin or gentamicin. These tests check your ability to hear high frequencies first, where ototoxicity shows up earliest.

Can You Manage the Ringing If You Can’t Stop the Drug?

Sometimes, you can’t stop the medication. Maybe it’s saving your life-like chemotherapy or an antibiotic for a severe infection. In those cases, managing the tinnitus becomes the goal.

Two proven approaches help:

• Sound therapy: Using background noise-like a fan, white noise machine, or soft music-to mask the ringing. Studies show it reduces the brain’s focus on the noise in 60-70% of cases.
• Cognitive behavioral therapy (CBT): Helps you change how you react to the sound. Instead of panicking when you hear it, you learn to notice it without distress. CBT has helped 60-70% of patients improve their quality of life.

Neither fixes the cause-but they make the ringing less overwhelming. Many people find they can sleep, work, and live normally again with these tools.

How to Prevent It Before It Starts

Prevention is always better than treatment:

• Ask your doctor: “Is this drug known to affect hearing?” before starting any new prescription.
• Keep a list of all meds you take-including supplements-and share it with every provider.
• Don’t take high-dose NSAIDs for long periods without medical supervision.
• If you’re on a high-risk drug, ask about hearing monitoring. Many hospitals now do baseline and weekly tests for patients on cisplatin or gentamicin.
• Report any hearing changes immediately-even if they seem minor.

The American Academy of Otolaryngology found that only 35% of primary care doctors routinely check for ototoxic risk before prescribing. That means you need to be your own advocate.

What’s Being Done to Fix This?

The problem is growing. Over 50 million Americans have tinnitus, and 5-10% of those cases are linked to medications. That’s millions of people dealing with noise that shouldn’t be there.

Researchers are working on solutions:

• The NIH is funding $12.5 million in research to find “otoprotective” drugs-medications that shield the ear without reducing the effectiveness of the main treatment.
• Hospitals are expanding hearing monitoring programs. In 2018, only 45% of major hospitals did regular checks. Now it’s 68%.
• Pharmaceutical companies are under pressure to label ototoxic risks more clearly. The FDA updated labeling for several antibiotics in 2023 to require hearing monitoring warnings.

The goal? Make it safer to use life-saving drugs without losing your hearing in the process.

Final Thoughts: Don’t Ignore the Ringing

Ringing in the ears isn’t something you should just live with. It’s a signal-sometimes a warning. If it started after a new medication, it’s likely connected. And if you act fast, you might be able to reverse it.

Talk to your doctor. Get your hearing checked. Ask about alternatives. You don’t have to choose between treating your illness and protecting your hearing. With the right info and action, you can do both.