EBM Consult

Common Medications Associated with Ototoxicity


  • Patients experiencing "ototoxicity" will initially complain of tinnitus or ringing in the ears due to damage of sensory cells within the inner ear. 
  • Below is a list of medications that have been associated with otoxicity, especially when used together or in combination.

Anthony J. Busti, MD, PharmD, FNLA, FAHA
Last Reviewed:
August 2015


  • 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. 


    1. Wei L, Ding D, et al.  Salicylate-induced degeneration of cochlea spiral ganglion neurons-apoptosis signaling.  Neuroscience 2010;168:288-299.
    2. 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.
    3. Chen Y, Huang WG.  Aspirin attenuates gentamicin ototoxcity: from the laboratory to the clinic.  Hear Res 2007;226:178-82. 
    4. Rybak LP, Ramkumar V.  Ototoxicity.  Kidney Int 2007;72:931-5. 
    5. Rybak LP.  Mechanisms of cisplatin otoxicity and progress in otoprotection.  Curr Opin Otolaryngol Head Neck Surg 2007;15:364-9. 
    6. Ikeda K, Oshima T, Hidaka H et al.  Molecular and clinical implications of loop diuretic ototoxicty.  Hear Res 1997; 107:1-8. 
    7. Ochi K, Kinoshita H et al.  Effects of nimodipine on quinine ototoxicity.  Ann Otol Rhinol Laryngol  2003;112:163-8. 
    8. Bailie GR, Neal D.  Vancomycin ototoxicity and nephrotoxicity. A review.  Med Toxicol Adverse Drug Exp 1988;3:376-86.

MESH Terms & Keywords

  • Ototoxic, ototoxicity, hearing loss, hearing, ototoxic medications, aminoglycosides, gentamicin, tobramycin, cisplatin, loop diuretics, telavancin, vancomycin