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

Many people notice a ringing, buzzing, or hissing sound in their ears and assume it’s just stress or aging. But sometimes, the culprit isn’t your ears at all-it’s something you’re taking to feel better. Tinnitus caused by medications is more common than most realize, and it can happen fast, even with drugs you’ve used for years without issue.

What Exactly Is Medication-Induced Tinnitus?

Tinnitus isn’t a disease. It’s a symptom: your brain hears sound when there’s none outside your head. When it’s triggered by a drug, it’s called ototoxicity. That means the medication is damaging parts of your inner ear or the nerve that carries sound signals to your brain. It’s not rare. Over 600 prescription and over-the-counter drugs are known to cause or worsen tinnitus, according to Dr. Julie Prutsman, Au.D., in her 2025 clinical review.

The damage doesn’t always show up right away. Some people notice ringing within hours of starting a new pill. Others don’t hear it until weeks or even months later. The good news? About 60% of these cases go away once you stop the drug. The bad news? Some drugs can cause permanent hearing damage-even after you’ve stopped taking them.

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

Not all drugs carry the same risk. Some are high-risk, some are low, and some only cause trouble at very high doses. Here’s what the evidence shows:

• Aminoglycoside antibiotics (like gentamicin and tobramycin): These are used for serious infections. When given intravenously, they carry a high risk of permanent hearing loss and tinnitus. Up to 25% of patients on long-term IV therapy experience lasting damage. Topical versions (like ear drops or skin creams) are much safer.
• Chemotherapy drugs (especially cisplatin): Between 30% and 70% of patients on cisplatin develop hearing problems. The damage often starts with high-pitched sounds you can’t hear anyway-like birds chirping or alarms-before it affects speech. Once it’s gone, it usually doesn’t come back.
• Loop diuretics (like furosemide): Used for heart failure or fluid retention. These can cause temporary tinnitus, especially at high doses. It often clears up after stopping the drug.
• High-dose aspirin and NSAIDs: You need to take a lot-over 4,000 mg of aspirin daily-to trigger ringing. That’s far more than the 325-650 mg used for headaches. Still, a few people are unusually sensitive and report tinnitus even at low doses.
• Isotretinoin (Accutane): Used for severe acne. About 5% of users report tinnitus, though the manufacturer says it’s less than 1%. The discrepancy suggests some people are more vulnerable than others.
• Antidepressants (especially SSRIs like sertraline): Tinnitus is rare here, affecting less than 1% of users. But some report ringing when they start or stop the drug. It’s often temporary, but case studies show it can stick around.
• Benzodiazepines (like Xanax or Valium): Long-term use (6+ months) is linked to tinnitus in some users. Stopping these can also trigger ringing, making it hard to tell if the drug caused it or just masked it.

What’s surprising? Beta blockers aren’t all the same. Carvedilol has been tied to tinnitus, but atenolol hasn’t. Quinine (used for malaria or leg cramps) can cause ringing within a day or two-and it usually fades in 1-2 weeks after stopping.

Why Does This Happen? The Science Behind the Noise

No one fully understands how drugs damage the inner ear. But we know it’s not just about killing bacteria or reducing pain. Ototoxic drugs interfere with the delicate electrical signals in your cochlea-the snail-shaped part of your inner ear that turns sound into nerve messages. They might disrupt the balance of ions, damage hair cells that detect sound, or overload the auditory nerve.

Some people are genetically more vulnerable. New research is looking at genetic markers that predict who’s at higher risk. For now, we can’t test for it-but doctors are starting to consider it, especially for cancer patients on cisplatin.

Another factor is kidney function. Many ototoxic drugs are cleared by the kidneys. If your kidneys aren’t working well, the drug builds up in your blood-and your ears pay the price. That’s why doctors monitor kidney levels during treatment with high-risk drugs.

How Fast Does It Happen? Timing Matters

Most people notice ringing within the first two weeks of starting a new medication. But it’s not always that simple:

• Aspirin or NSAIDs: Often within a few days, especially at high doses.
• Antibiotics like gentamicin: Can show up in 24-72 hours.
• Chemotherapy: May take weeks to appear, and it often gets worse with each dose.
• Antidepressants and benzodiazepines: Sometimes don’t appear until after months of use-or even after stopping.

One Reddit user reported ringing after just 48 hours of taking 800 mg of ibuprofen for a toothache. The noise faded within a week after quitting. That’s typical for NSAID-induced tinnitus-it’s usually temporary.

What Should You Do If You Notice Ringing?

Don’t stop your medication on your own. That’s the one rule every expert agrees on. If you’re on a drug for high blood pressure, depression, or cancer, stopping suddenly could be dangerous.

Instead:

1. Write down when the ringing started and what you’ve taken since then.
2. Check if it’s worse after taking a pill or better after skipping a dose.
3. Call your doctor. Don’t wait. Mention the tinnitus specifically-don’t just say “my ears are weird.”

Your doctor might:

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

For people on long-term, high-risk meds like cisplatin or gentamicin, baseline hearing tests are standard. Follow-ups every 1-2 weeks help catch damage early.

Can You Fix It? Treatment and Management

If the drug is stopped and the tinnitus is reversible, the ringing often fades over days to weeks. But if the damage is permanent, you can’t undo it. That’s why prevention is everything.

For those stuck with persistent tinnitus, here’s what helps:

• Sound therapy: White noise machines, fans, or nature sounds can distract your brain from the ringing. Studies show 60-70% of people feel less bothered by it after using sound therapy.
• Cognitive behavioral therapy (CBT): This doesn’t make the sound go away-but it changes how you react to it. Many people report less anxiety and better sleep after CBT.
• Avoiding triggers: Caffeine, alcohol, and loud noise can make tinnitus louder. Cutting back helps, even if the root cause is still the drug.

There’s no pill to cure drug-induced tinnitus. But managing how you feel about it can make a huge difference in your quality of life.

Who’s at Highest Risk?

Some people are more likely to develop ototoxic tinnitus:

• Older adults (hearing naturally declines with age)
• People with existing hearing loss
• Those with kidney disease (slows drug clearance)
• Patients on multiple ototoxic drugs at once
• People taking high doses for long periods

It’s also worth noting: many primary care doctors don’t routinely ask about hearing changes when prescribing these drugs. A 2022 survey found only 35% of them screen for ototoxicity risk. That means you might need to speak up first.

What’s New in Research?

Scientists are working on ways to protect the ears while still treating serious illnesses:

• The NIH has invested $12.5 million in research on “otoprotective agents”-drugs that shield the inner ear without reducing the effectiveness of chemotherapy or antibiotics. Some are in early clinical trials.
• Hospitals are using genetic testing to find patients who are more sensitive to ototoxic drugs.
• More clinics now include audiologists in treatment teams for cancer and chronic illness patients.

The global market for hearing monitoring tools is growing fast-projected to rise 6.8% yearly through 2030. That’s because awareness is rising. But the problem hasn’t gone away. Tinnitus affects over 50 million Americans, and 5-10% of those cases are linked to medications. That’s hundreds of thousands of people every year.

Final Takeaway: Stay Informed, Don’t Panic

You don’t need to memorize a list of 600 ototoxic drugs. But you do need to know this: if you start hearing ringing, buzzing, or muffled sounds after beginning a new medication, it’s worth talking to your doctor. Don’t assume it’s harmless. Don’t assume it’s permanent. And don’t stop your meds without help.

Many cases are temporary. Many are preventable. And if caught early, the damage can often be stopped before it becomes permanent. Your ears are listening-so make sure your doctor is too.