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

Have you started a new medication and now you hear a constant ringing, buzzing, or hissing in your ears-even when it’s completely quiet? You’re not alone. For many people, this isn’t just a weird side effect-it’s a sudden, unsettling change that makes them question everything. The good news? In many cases, it’s not permanent. The bad news? It can be hard to connect the dots between the pill you’re taking and the noise in your head.

What Exactly Is Medication-Induced Tinnitus?

Tinnitus isn’t a disease. It’s a symptom: the perception of sound without any external source. That ringing, roaring, clicking, or whistling you hear? It’s your brain interpreting signals from your inner ear that shouldn’t be there. When it’s caused by a medication, we call it ototoxicity. That means the drug is damaging parts of your inner ear or the nerve that connects your ear to your brain.

Over 600 prescription and over-the-counter drugs are known to trigger or worsen tinnitus, according to recent clinical data from 2025. That’s more than you might think. Some are obvious, like powerful antibiotics or cancer drugs. Others? You’d never guess-like common painkillers or antidepressants. The key isn’t knowing every single one. It’s recognizing the patterns and knowing when to speak up.

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 what the evidence shows:

• Aminoglycoside antibiotics (like gentamicin, tobramycin): These are among the worst offenders. Used for serious infections, they can cause permanent hearing damage-even after you stop taking them. Up to 25% of patients on long-term IV therapy experience lasting tinnitus or hearing loss.
• Chemotherapy drugs (especially cisplatin): Between 30% and 70% of people treated with cisplatin develop some level of ototoxicity. Hearing loss often starts with high-pitched sounds you can’t even hear anymore-like birds chirping or a phone ringing-before it moves to speech frequencies.
• Loop diuretics (like furosemide): Used for heart failure or swelling, these can cause temporary tinnitus, especially at high doses. It usually fades once the drug is stopped.
• High-dose aspirin and NSAIDs: You need a lot of aspirin to trigger this-usually over 4,000 mg daily. That’s far more than anyone takes for headaches. Still, some people report ringing after taking large doses of ibuprofen or naproxen for pain, like after dental surgery. In most cases, it goes away within days of stopping.
• Antimalarials (like quinine): Rare today, but still used in some regions. Tinnitus can appear within a day or two and last up to two weeks after stopping.
• Isotretinoin (Accutane): Used for severe acne, this drug has a moderate risk. About 5% of users report tinnitus, though the manufacturer claims it’s less than 1%. The disconnect suggests some people are more sensitive than others.
• Antidepressants (SSRIs like sertraline, fluoxetine): Tinnitus is rare here-under 1% of users. But some people report it starting when they begin the drug, or even when they stop it. Case studies go back over 20 years.
• Benzodiazepines (like Xanax, Valium): Usually linked to long-term use (6+ months). The ringing often fades after tapering off, but not always.

What’s interesting? Not all drugs in a class are equal. For example, carvedilol (Coreg) has been linked to tinnitus, but atenolol hasn’t. It’s not about the category-it’s about the specific molecule.

How Fast Does Tinnitus Show Up After Taking a Drug?

Timing matters. If you notice ringing within 48 hours of starting a new medication, especially something like ibuprofen or an antibiotic, it’s highly likely the drug is the cause. Most people experience symptoms within the first two weeks.

But some drugs are sneaky. Chemotherapy agents and certain antibiotics can take weeks-or even 90 days-to trigger tinnitus. That’s why doctors monitor hearing during long-term treatments. If you’ve been on a drug for months and suddenly hear ringing, don’t assume it’s stress or aging. Ask your doctor: Could this be the medication?

Is the Ringing Permanent?

This is the biggest fear-and the answer isn’t simple. About 60% of medication-induced tinnitus cases are reversible. You stop the drug, and the ringing fades over days or weeks.

But not all drugs play fair. Aminoglycosides and cisplatin can cause permanent damage. Once the hair cells in your inner ear die, they don’t come back. That’s why early detection is so critical. If you catch it early, you might be able to switch to a safer drug before the damage becomes irreversible.

Some people are just more sensitive. A tiny number report tinnitus after taking just 325 mg of aspirin-the standard dose for heart health. These individuals may have a genetic vulnerability. We’re still learning who they are, but if you’ve had tinnitus after low-dose aspirin before, avoid it.

What Should You Do If You Think a Medication Is Causing Tinnitus?

Don’t stop taking your medicine on your own. That’s dangerous. Instead:

1. Write it down. Note when the ringing started, how loud it is, whether it’s in one ear or both, and if it’s constant or comes and goes.
2. Check your meds. Look up your medications on a trusted site like the American Tinnitus Association’s list or the Cleveland Clinic’s ototoxicity guide. Don’t rely on random blogs.
3. Call your doctor. Bring your list. Say: “I started this drug on [date], and since then I’ve had ringing in my ears. Could this be related?”
4. Ask about alternatives. Can your doctor switch you to a different antibiotic? Lower the dose? Use a different painkiller? Many options exist.
5. Request a hearing test. If you’re on a high-risk drug, ask for baseline and follow-up audiograms. This isn’t optional for people on cisplatin or gentamicin-it’s standard care.

Doctors don’t always screen for this. A 2022 survey found only 35% of primary care physicians routinely check for ototoxic risk before prescribing. You have to be your own advocate.

Can You Manage the Ringing While Still Taking the Drug?

Yes-if you can’t stop the medication. For example, if you’re on cisplatin for cancer, stopping isn’t an option. But you can still reduce the impact.

Sound therapy works for 60-70% of people. That means using white noise, fans, or specialized apps to mask the ringing. It doesn’t fix the cause, but it helps your brain ignore it.

Cognitive behavioral therapy (CBT) for tinnitus is also proven to help. It doesn’t make the sound disappear-but it reduces the anxiety, frustration, and sleep problems that make it feel worse. In one 2024 study, patients using CBT reported a 50% drop in how much the tinnitus affected their daily life.

Some clinics now offer tinnitus retraining therapy (TRT), which combines sound therapy with counseling. It’s not a cure, but it helps people live with it.

What’s Being Done to Fix This?

Researchers are working on solutions. The NIH just funded $12.5 million in new studies to find drugs that protect the ear from ototoxic damage-without reducing the effectiveness of antibiotics or chemotherapy. Early results are promising.

Genetic testing is also emerging. Some people have gene variants that make them far more likely to suffer hearing damage from certain drugs. In the next few years, doctors may test for these before prescribing.

Hospitals are also improving monitoring. In 2018, only 45% of hospitals tracked hearing in patients on high-risk drugs. By 2023, that jumped to 68%. More awareness. More protocols. More protection.

But here’s the bottom line: You can’t wait for science to catch up. If you’re on a medication and you hear ringing, don’t ignore it. Talk to your doctor. Get tested. Ask questions. Your hearing is worth it.

Final Thoughts: Don’t Panic, But Don’t Stay Silent

Most people who develop tinnitus from medication never lose their hearing. The sound fades. But for those who don’t speak up, the damage can be permanent. You don’t need to memorize a list of 600 drugs. You just need to know this: if something new starts happening in your ears after you start a new pill, it’s worth investigating.

Medications save lives. But they can also quietly harm your hearing. The key is balance. Work with your doctor. Monitor your symptoms. And never assume that ringing in the ears is just ‘normal’ or ‘in your head.’ It’s real. And it’s often preventable.