Tinnitus and Ringing in the Ears from Medications: What 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 permanent hearing damage. The good news? Most cases can be reversed if caught early. The bad news? Many doctors don’t screen for it, and patients aren’t told what to watch for.

What Exactly Is Medication-Induced Tinnitus?

Tinnitus isn’t a disease. It’s a symptom - the feeling of hearing sound when no external noise is present. For some, it’s a soft hum. For others, it’s a loud, piercing ring that won’t go away. When it’s caused by a drug, it’s called ototoxicity. That means the medication is damaging parts of your inner ear or the nerve that sends sound signals to your brain.

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 pills you might take for headaches, infections, depression, or even acne. The damage can happen fast - sometimes within hours - or slowly, over months. What makes it tricky is that not everyone reacts the same way. One person might get ringing after a single high-dose ibuprofen, while another takes aspirin daily with no issues.

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 offenders. Here’s a breakdown of the most common culprits:

• High-dose aspirin and NSAIDs: Taking more than 4,000 mg of aspirin a day can cause tinnitus in about 15% of people. But don’t panic - regular headache doses (325-650 mg) almost never cause it. Same goes for ibuprofen and naproxen. A Reddit user reported ringing after taking 800 mg of ibuprofen three times a day for dental pain. The sound faded within a week after stopping.
• Aminoglycoside antibiotics: Drugs like gentamicin and tobramycin, often given intravenously for serious infections, carry the highest risk. Up to 25% of patients on long-term treatment develop permanent hearing loss or tinnitus. Topical versions (eye drops, creams) are much safer.
• Chemotherapy drugs: Cisplatin, used for lung, ovarian, and testicular cancers, causes ototoxicity in 30-70% of patients. Hearing loss usually starts with high-pitched sounds first - you might miss birds chirping or doorbells before noticing trouble with speech.
• Loop diuretics: Furosemide (Lasix) and bumetanide, used for heart failure or kidney issues, can trigger tinnitus, especially at high doses or in people with kidney problems.
• Antimalarials: Quinine, sometimes used for leg cramps or malaria, can cause tinnitus within 24-72 hours. It usually goes away after stopping, but not always.
• Isotretinoin (Accutane): This acne drug causes tinnitus in about 5% of users, though the manufacturer claims less than 1%. Many patients report it after months of use.
• Antidepressants and benzodiazepines: These are lower-risk. Tinnitus is rare - affecting less than 1% of users. But some people report ringing when starting or stopping SSRIs like sertraline (Zoloft). In those cases, it’s often tied to withdrawal, not the drug itself.

Is the Damage Permanent?

It depends on the drug. About 60% of medication-induced tinnitus cases reverse completely once you stop the drug. But some drugs are permanent threats.

Aminoglycosides and cisplatin can destroy the hair cells in your inner ear. These cells don’t regenerate. Once they’re gone, the ringing won’t fade. That’s why doctors monitor kidney function and hearing during treatment - they’re trying to catch damage before it’s irreversible.

Even with low-risk drugs, a small group of people are unusually sensitive. Tinnitus.org.uk notes that a tiny fraction of people develop ringing from low-dose aspirin. If you’ve had tinnitus after taking any medication before, you might be one of them.

How Do You Know It’s the Medication?

Timing matters. Most people notice tinnitus within two weeks of starting a new drug. Some feel it after just 48 hours. Others don’t notice it until they’ve been on it for months.

Ask yourself:

• Did the ringing start after I began a new pill?
• Did it get worse when I increased the dose?
• Did it improve after I stopped the drug?

If you answer yes to all three, the medication is likely the cause. But don’t stop taking it on your own. Talk to your doctor first.

What Should You Do If You Notice Ringing?

Step one: Don’t panic. Step two: Don’t quit your meds without talking to your prescriber.

Many conditions - high blood pressure, depression, infections - need treatment. Stopping a drug suddenly can be dangerous. Instead, schedule a quick chat with your doctor. Say: “I’ve noticed ringing in my ears since I started [drug name]. Could this be related?”

Your doctor might:

• Switch you to a different drug with lower ototoxic risk
• Lower your dose
• Order a hearing test to check for damage
• Refer you to an audiologist

For high-risk drugs like cisplatin or gentamicin, clinics now do baseline hearing tests before treatment and check again every 1-2 weeks. If hearing starts to drop, they adjust the dose or pause treatment.

Can You Prevent It?

Prevention starts with awareness. If you’re prescribed a drug known for ototoxicity, ask:

• “Is there a safer alternative?”
• “Will I need hearing tests during treatment?”
• “What symptoms should I report right away?”

Also, avoid combining ototoxic drugs. Taking aspirin and a diuretic together increases risk. Alcohol and loud noise make it worse too.

New research is looking at genetic tests to find people more likely to develop ototoxicity. In the future, a simple blood test might tell you if you’re at higher risk before you even start a drug.

What If the Ringing Doesn’t Go Away?

If the tinnitus sticks around after stopping the drug, you’re not alone. About 40% of cases become chronic. But that doesn’t mean you’re stuck with it.

Sound therapy - using white noise machines, fans, or apps - helps mask the ringing. Cognitive behavioral therapy (CBT) teaches your brain to ignore the noise. Studies show 60-70% of people feel better with these tools, even if the sound doesn’t vanish.

Hearing aids can also help. If you have hearing loss along with tinnitus, amplifying external sounds makes the ringing less noticeable.

Why Isn’t This Talked About More?

A 2022 survey found only 35% of primary care doctors routinely check for ototoxicity risk before prescribing high-risk drugs. Patients aren’t warned. Pharmacists don’t always flag it. And many assume tinnitus is just “part of aging.”

But with over 50 million Americans experiencing tinnitus - and 5-10% of those cases linked to medications - this is a public health blind spot. The FDA now requires stronger warning labels on aminoglycosides. Hospitals are increasing monitoring. But it’s still not standard.

You have to be your own advocate. If you’re on a long-term medication and notice new ringing, buzzing, or muffled hearing - speak up. Your ears might be trying to tell you something.

Final Thoughts

Medication-induced tinnitus isn’t rare. It’s underrecognized. Most cases are reversible. But only if you catch them early. You don’t need to memorize a list of 600 ototoxic drugs. Just know this: if a new sound appears in your ears after starting a pill, it’s worth investigating.

Don’t ignore it. Don’t stop your meds alone. But don’t assume it’s normal either. Talk to your doctor. Get your hearing checked. And remember - you’re not imagining it. The ringing is real. And help is available.