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Ototoxic Drugs That Impact Hearing

The following list contains drugs that can have a temporary or permanenteffect on hearing such as hearing loss or tinnitus. They were identified through the reading of Dr. Susan Kunkel from the Poison Center at the University of New Mexico College of Pharmacy where she is a Toxicology Fellow.. Please note that this is not an all-inclusive list of every ototoxic drugnor an exhaustive list of all drugs in each category. The fewthat are especially important are displayed in bold.Some drugs have more than one use and/or may fit into more than onecategory.

Certain non-drug substances (e.g., various metals, chemicals and asphyxiant gases) as well as noise have been associated with hearing loss.In some cases, the medications listed can cause hearing changes even atregular doses. Nonetheless higher-than-recommended doses are nevera good idea and this practice would certainly increase risk of changes inhearing. Users of these (or any other drugs) are advised to not exceed recommended dosages and to ask your doctor or pharmacist specificallyif there are any potential ototoxic effects associated with any new drugor over-the-counter medication you are told to take.

Ototoxic Drugs by Category, with Examples


  • Aminoglycosides (amikacin, gentamicin, tobramycin…)
  • Amphotericin B
  • Ampicillin
  • Antihelminthics (Praziquantel, thiabendazole)
  • Chloramphenicol
  • Chlorhexidine (for topical use)
  • Chloroquine
  • Colistin
  • Griseofulvin (antifungal)
  • Macrolides (azithromycin, erythromycin)
  • Metronidazole
  • Nalidixic acid
  • Sulfonamides
  • Tetracyclines (Minocycline, tetracycline)
  • Thiabenzazole (antihelmintic)
  • Vancomycin

Anti-inflammatory agents (NSAIDs, salicylates)

  • Aspirin (salicylic acid)
  • Ibuprofen
  • Naproxen
  • Fenoprofen
  • Indomethacin
  • Ketoprofen
  • Piroxicam
  • Sulindac

Antineoplastic agents

  • Bleomycin
  • Cisplatin
  • Cytarabine
  • Mechlorethamine
  • Methotrexate (also for RA)
  • Nitrogen mustard
  • Vinblastine
  • Vincristine

Cardiovascular agents

  • Enalapril
  • Captopril
  • Digitalis
  • Guanethidine
  • Guanfacine
  • Metroprolol
  • Minoxidil (also for alopecia)
  • Quinidine
  • Tocainide


  • Acetazolamide
  • Bumetanide
  • Ethacrynic acid
  • Furosemide
  • Mannitol

Tricyclic antidepressants

  • Amitriptyline
  • Amoxapine
  • Desipramine
  • Doxepin
  • Imipramine
  • Nortriptyline

Substances with abuse potential

  • Alcohol
  • Caffeine
  • Cocaine
  • Nicotine
  • Phencyclidine (PCP)

Miscellaneous agents

  • Albuterol
  • Antihistamines
  • Atropine
  • Bromates
  • Carbamazepine (anticonvulsant)
  • Haloperidol
  • Hydroquinone (antipigmentation agent)
  • Lithium
  • Local anesthetics (Bupivacaine, lidocaine, mepivacaine)
  • Metal chelators (Deferoxamine, penicillamine)
  • Methylphenidate
  • Oral contraceptives
  • Pentobarbital
  • Quinine
  • Theophylline