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

Many people notice a ringing, buzzing, or hissing in their ears and immediately worry it’s something serious. But sometimes, the culprit isn’t aging, noise exposure, or stress-it’s a medication you’re taking. Tinnitus caused by drugs is more common than most people realize, and it’s often reversible-if you catch it early.

What Exactly Is Medication-Induced Tinnitus?

Tinnitus isn’t a disease. It’s a symptom: your brain hears sound when no external noise is present. When it’s caused by medication, it’s called ototoxicity. This means a drug is damaging the inner ear or the nerve that connects it to your brain. The result? Ringing, roaring, clicking, or even a high-pitched tone that won’t go away.

Over 600 prescription and over-the-counter drugs are known to trigger or worsen tinnitus, according to Sound Relief’s 2025 review. These include common pills you might take for headaches, infections, depression, or even acne. The damage can be temporary or permanent, depending on the drug, dose, and how long you’ve been taking it.

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

Not all drugs carry the same risk. Some are high-risk, others rare. Here’s what the evidence shows:

• High-dose aspirin (over 4,000 mg daily) can cause tinnitus in about 15% of users. But don’t panic-regular headache doses (325-650 mg) almost never cause it. The Tinnitus Organization UK says only a tiny fraction of people react to low doses.
• Aminoglycoside antibiotics like gentamicin and tobramycin are among the worst offenders. Used for serious infections, they can cause permanent hearing loss in up to 25% of patients on long-term IV treatment. Topical versions (ear or skin drops) are much safer.
• Cisplatin and other chemotherapy drugs damage hearing in 30-70% of patients. The damage often starts with high-frequency hearing loss, which can later affect speech. This is why oncologists often check hearing before and during treatment.
• Loop diuretics like furosemide (Lasix), used for heart failure or fluid retention, can cause temporary tinnitus and hearing loss, especially with high doses or kidney problems.
• NSAIDs like ibuprofen and naproxen may cause ringing when taken in large amounts-like 800 mg three times a day for several days. Many people report symptoms starting within 48 hours, but it usually goes away after stopping the drug.
• Isotretinoin (Accutane), used for severe acne, is linked to tinnitus in about 5% of users, though the manufacturer reports less than 1%. If you notice ringing after starting this drug, talk to your dermatologist.
• Antidepressants like sertraline (Zoloft) and fluoxetine (Prozac) are rarely the cause. Less than 1% of users report tinnitus. But some people notice ringing when they stop taking them, not when they start.
• Benzodiazepines like Xanax or Valium are linked to tinnitus mostly after long-term use (6+ months). Stopping them suddenly can also trigger ringing.

Why Do Some Drugs Damage Your Ears?

The exact reason isn’t fully understood. But researchers believe ototoxic drugs interfere with the delicate hair cells in your inner ear that turn sound into electrical signals. They may also disrupt the balance of fluids or chemicals in the cochlea, or mess with the auditory nerve’s ability to send signals to your brain.

Some drugs, like aspirin, seem to temporarily change how these cells function-like a glitch you can undo by stopping the drug. Others, like cisplatin or gentamicin, actually kill the cells. Once those hair cells die, they don’t grow back. That’s why the damage from those drugs can be permanent.

How Fast Does Tinnitus Show Up After Starting a Drug?

Timing varies. For many, symptoms appear within days:

• Aspirin or NSAIDs: 1-3 days
• Quinine (for malaria): 24-72 hours
• Loop diuretics: Within hours to a few days
• Aminoglycosides: Often within a week, but can be delayed
• Chemotherapy: May take weeks or months to show up
• Antidepressants: Sometimes only after stopping the drug

Sound Relief’s 2025 data shows about 70% of people notice tinnitus within the first two weeks of starting a new medication. But in rare cases, it can take up to 90 days-especially with antibiotics or chemo drugs.

Is the Tinnitus Permanent?

It depends. About 60% of medication-induced tinnitus cases are reversible. That means if you stop the drug, the ringing fades. But not all drugs are created equal:

• Reversible: Aspirin, NSAIDs, diuretics, some antidepressants (if caught early)
• Often permanent: Aminoglycosides, cisplatin, high-dose quinine

If you’ve been on a high-risk drug for weeks or months, the chances of full recovery drop. That’s why early detection matters. The sooner you report ringing to your doctor, the better your odds of preventing lasting damage.

What Should You Do If You Notice Ringing?

Don’t stop your medication on your own. That’s the most important rule. Stopping a drug suddenly-especially antibiotics, antidepressants, or blood pressure meds-can be dangerous.

Instead:

1. Write down when the ringing started and what meds you’re taking.
2. Check the dosage. Are you on the highest possible dose? Could it be lowered?
3. Call your doctor. Say: “I’ve started ringing in my ears since I began [drug name]. Can we look at alternatives?”

Your doctor might:

• Switch you to a different drug with less ototoxic risk
• Lower your dose
• Order a hearing test to check for damage
• Monitor your kidney function (many ototoxic drugs are cleared through the kidneys)

Can You Prevent Medication-Induced Tinnitus?

Yes, to some extent. Here’s how:

• Ask your doctor: “Does this drug carry a risk of hearing damage?” before starting any new prescription.
• If you’re on a high-risk drug (like cisplatin or gentamicin), request a baseline hearing test before treatment begins.
• Get follow-up hearing checks during treatment-especially if you’re on IV antibiotics or chemo.
• Don’t take more than the recommended dose of NSAIDs or aspirin.
• Report any changes in hearing, balance, or ringing immediately. Don’t wait.

The American Academy of Audiology now recommends that audiologists be part of the care team for patients on high-risk medications. That’s still rare in practice, but you can ask for it.

What If You Can’t Stop the Medication?

Sometimes, the drug you need is also the one causing the ringing. For example, someone with life-threatening infection might need gentamicin. Or a cancer patient might need cisplatin.

In those cases, managing the tinnitus becomes the goal-not eliminating the cause. Sound therapy (like white noise machines or hearing aids with tinnitus masking) helps about 60-70% of people cope better. Cognitive behavioral therapy (CBT) is also effective at reducing the emotional distress tied to tinnitus.

These don’t cure the ringing, but they make it less noticeable and less upsetting. Many people learn to live with it-even if it doesn’t fully disappear.

Why Isn’t This Better Known?

A 2022 survey found only 35% of primary care doctors routinely check for ototoxicity risk before prescribing high-risk drugs. Most patients aren’t warned. Pharmacists often don’t mention it either.

That’s changing slowly. The FDA now requires stronger warning labels on aminoglycosides. Hospitals are starting to use therapeutic drug monitoring-checking blood levels of drugs like gentamicin to avoid overdose.

Research is also moving forward. The NIH is funding studies on drugs that might protect the ear during chemo. Genetic tests are being developed to find people who are extra sensitive to ototoxic drugs.

But for now, the best defense is you: knowing the risks, asking questions, and speaking up when something feels off.

Bottom Line

Tinnitus from medication isn’t rare. It’s often overlooked. But it’s also often treatable-if you act fast. If you’ve noticed new ringing, buzzing, or hearing changes after starting a new drug, don’t ignore it. Don’t assume it’s just stress. Don’t stop the medicine yourself.

Talk to your doctor. Get your hearing checked. Ask if there’s a safer alternative. Most of the time, the answer is yes.