Patients experiencing
"ototoxicity" will initially complain of tinnitus or ringing in the
ears due to damage of sensory cells within the inner ear. If the
underlying cause is not eliminated then the patient may go on to develop
hearing loss. Furthermore, this can result in changes in balance, gait,
and overall quality of life. The following medications are most commonly
known to increase the risk for ototoxicity (i.e., hearing loss).
Medications
Known to be Ototoxic:
-
Aminoglycosides
- Amikacin
- Gentamicin
- Tobramycin (TOBI; Tobrex)
- Aspirin
- Carboplatin
- Cisplatin (Platinol)
- Loop Diuretics
- Bumetanide (Bumex)
- Furosemide (Lasix)
- Torsemide (Demadex)
- Quinine (Qualaquin)
- Telavancin (Vibativ)
- Vancomycin
As
with any side effect of a medication, not all patients will experience this
problem, however in certain situations it can manifest or be something to
monitor for. For example, using two or more medications with risk for
ototoxicity. Another example is using too high of a dose for too long of
a period of time, which would increase exposure of the drug to the tissue as
sometimes seen with aminoglycosides. So it needs to be put in context to
the use of the medication(s) and in relation to its cost to benefit ratio.
If you know of other medications that should be
added to this list, please let us know. We appreciate your
contribution.
References:
- Wei
L, Ding D, et al. Salicylate-induced degeneration of cochlea spiral
ganglion neurons-apoptosis signaling. Neuroscience 2010;168:288-299.
- Dobie
RA, Black FO et al. Hearing loss in patients with vestibulotoxic
reactions to gentamicin therapy. Arch Otolaryngol Head Neck Surg
2006;132:253-7.
- Chen
Y, Huang WG. Aspirin attenuates gentamicin ototoxcity: from the
laboratory to the clinic. Hear Res 2007;226:178-82.
- Rybak
LP, Ramkumar V. Ototoxicity. Kidney Int 2007;72:931-5.
- Rybak
LP. Mechanisms of cisplatin otoxicity and progress in
otoprotection. Curr Opin Otolaryngol Head Neck Surg 2007;15:364-9.
- Ikeda
K, Oshima T, Hidaka H et al. Molecular and clinical implications of loop
diuretic ototoxicty. Hear Res 1997; 107:1-8.
- Ochi
K, Kinoshita H et al. Effects of nimodipine on quinine ototoxicity.
Ann Otol Rhinol Laryngol 2003;112:163-8.
- Bailie
GR, Neal D. Vancomycin ototoxicity and nephrotoxicity. A review.
Med Toxicol Adverse Drug Exp 1988;3:376-86.
