Hearing loss isn’t something that just comes with age. Your hearing also can be damaged — sometimes irreversibly — by the drugs you take.
Ototoxic medications, literally “toxic to the ear,” can include common prescription and nonprescription drugs, ranging from the seemingly benign, like aspirin and ibuprofen, to powerful chemotherapy drugs and certain antibiotics. People with hereditary hearing loss may be even more susceptible to their effects.
This month, a Seattle biotech start-up announced that it had received a $2 million National Institutes of Health (NIH) grant to develop a drug to preserve hearing and balance in people being treated with a specific class of antibiotics. Called aminoglycoside antibiotics, they include gentamicin, streptomycin and neomycin — all effective treatments for serious infectious diseases like septicemia and multiple-drug-resistant tuberculosis. They are useful worldwide because of their low cost. But in areas where hearing aids are hard to come by, they can cause disabling loss.
They result in irreversible hearing loss and even deafness in up to 50 percent of patients, according to a Stanford University study published last year in the Journal of Clinical Investigation. The risk is highest in patients who already have hearing problems or have kidney disease. Doctors understandably have been cautious in relying on these drugs.
Oricula Therapeutics, the Seattle company, has completed testing in rats and found that the drug protected the animals’ hearing when taken with a 10-day course of amikacin, another aminoglycoside. The NIH grant will fund the next phase of research, safety and toxicity testing in humans.
This is only a first step, but a promising one. If this is successful perhaps similar protection against ototoxic drugs will follow. Some hearing loss is preventable — noise. But some isn’t, especially for those with serious illnesses. The drugs aren’t an option.
Aminoglycosides aren’t the only drugs that can cause serious hearing problems. Here are some others that have the potential to harm your hearing, especially if you take them in high doses for a long period:
Other antibiotics including Cipro (ciprofloxacin) and Levaquin (levofloxacin). Both of these are prescribed for a wide variety of bacterial infections, and both can cause hearing loss and tinnitus.
Antidepressants, including Prozac, Elavil, Paxil, Zoloft and Celexa. Linked to ringing in the ears, or tinnitus. (Paradoxically, they are also often prescribed to relieve the psychological burden of tinnitus.)
Loop diuretics: A specific group, including furosemide (Lasix), prescribed for heart or kidney problems. They can cause hearing loss if taken in large doses for long periods, although the effect may be reversible once the drug is stopped.
Chemotherapy drugs, including Cisplatin and Carboplatin. These are extremely damaging. If you already have hearing loss, or if you have a family history of it, oncologists may suggest substituting other chemotherapy drugs, if possible. But if it’s a case of your life or your hearing, most people will feel there’s no choice.
Quinine (for treatment of malaria). Like loop diuretics, it can affect hearing if long-term use at large doses is required, but the effect may be reversible.
Drug combos. Taking multiple prescription drugs, or an over-the-counter pain reliever along with a prescription drug, can sometimes exacerbate hearing problems. For example, aminoglycoside antibiotics, like those mentioned above, are even more lethal to the inner ear’s hair cells when combined with drugs like vancomycin, which can cause tinnitus, or a loop diuretic like furosemide.
Over-the-counter pain relief, including frequent high doses of aspirin, ibuprofen (Advil), acetaminophen (Tylenol) and Naproxen (Aleve), can increase the risk of hearing loss, studies show.
If the new drug is successful, it will be the first medication to receive FDA approval to protect the inner ear from damage caused by these antibiotics. Such a drug would be invaluable in allowing more latitude in treating serious disease.
For now, the bottom line is not to take any drugs in larger doses or for longer periods than you absolutely need them.
Adapted from AARP: Conditions & Treatments