If you’ve started a new medication and suddenly hear a ringing, buzzing, or hissing in your ears-especially when no one else can hear it-you’re not imagining things. This isn’t just stress or fatigue. It could be your medicine. More than 600 prescription and over-the-counter drugs are known to trigger or worsen tinnitus, according to Dr. Julie Prutsman, Au.D., in her 2025 clinical guide. And while many people assume this is rare, it’s actually one of the most common yet underreported side effects of everyday medications.
How Medications Cause Ringing in the Ears
Tinnitus from medication isn’t a mystery-it’s called ototoxicity. That means the drug is damaging the inner ear, specifically the hair cells that send sound signals to your brain. These cells don’t regenerate, so if they’re destroyed, the damage can be permanent. But not all ototoxicity works the same way. Some drugs cause temporary ringing that fades when you stop taking them. Others, like certain antibiotics or chemotherapy drugs, can lead to lasting hearing loss.
The exact mechanism isn’t fully understood, but experts believe these drugs interfere with the electrical signals in the inner ear or disrupt blood flow to the cochlea. Some even affect the auditory nerve directly. The result? Your brain starts making up sounds because the real signals are scrambled or lost.
Drugs Most Likely to Cause Tinnitus
Not all medications carry the same risk. Some are high-risk, some are low, and most fall somewhere in between. Here’s what the data shows:
- Aminoglycoside antibiotics (like gentamicin and tobramycin): These are among the worst offenders. Used for serious infections, they can cause permanent hearing damage in up to 25% of patients on long-term IV therapy. Topical versions (ear drops, creams) are much safer.
- Chemotherapy drugs (especially cisplatin): Between 30% and 70% of patients on cisplatin develop hearing loss or tinnitus. It usually starts with high-pitched sounds you can’t hear anymore, then spreads to speech frequencies.
- Loop diuretics (like furosemide): Used for heart failure or kidney issues, these can cause ringing, especially at high doses or in people with kidney problems.
- High-dose aspirin: You need to take more than 4,000 mg daily for this to happen-far more than anyone takes for headaches today. Still, some people report ringing after just a few pills. A very small number are unusually sensitive.
- NSAIDs (ibuprofen, naproxen): At high doses (like 800 mg three times a day for pain), tinnitus can pop up within days. Most people stop taking it, and the ringing goes away within a week.
- Isotretinoin (Accutane): Used for severe acne, about 5% of users report tinnitus. The manufacturer says it’s less than 1%, but real-world reports suggest otherwise.
- Antidepressants (SSRIs like sertraline): Tinnitus is rare-under 1% of users. But some 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 only after long-term use (6+ months). Stopping them can also trigger ringing.
Here’s the key: ototoxicity is dose-dependent. A low dose of ibuprofen for a headache? Almost never a problem. A high dose for chronic pain? That’s when risk spikes.
Is the Tinnitus Permanent?
This is the biggest fear-and the answer isn’t simple. About 60% of medication-induced tinnitus cases reverse once you stop the drug. But not all. Aminoglycosides and cisplatin often cause irreversible damage. That’s why monitoring matters.
Some people notice ringing within 24 hours of starting a new drug. Others take weeks or even months. Sound Relief’s 2025 data shows 70% of cases begin within two weeks. But delayed reactions up to 90 days have been documented, especially with antibiotics and chemo drugs.
Reversibility also depends on your health. If you already have hearing loss, kidney disease, or are older, your risk of permanent damage goes up. Your body can’t clear the drug as efficiently, so it builds up and causes more harm.
What to Do If You Notice Ringing After Starting a New Drug
First, don’t panic. Second, don’t stop the medication on your own. Third, tell your doctor right away.
Here’s what happens next:
- Track the timing. When did the ringing start? Did it begin the same day you started the drug? Or after a week? Write it down.
- Check the dose. Are you taking more than recommended? Sometimes people double up because they think it’ll work faster.
- Ask your doctor. Say: “I started this medication on [date], and now I hear ringing in my ears. Could this be related?”
- Request a hearing test. A simple audiogram can show if your hearing has changed. Baseline tests are standard before starting high-risk drugs like cisplatin or gentamicin.
- Discuss alternatives. Can your doctor switch you to a different antibiotic? A different painkiller? A lower dose? Many options exist.
For example, if you’re on high-dose ibuprofen for back pain and developed tinnitus, your doctor might switch you to acetaminophen or a non-ototoxic muscle relaxant. If you’re on an SSRI and the ringing started after increasing the dose, they might adjust it or try a different antidepressant.
What Your Doctor Should Be Doing
Doctors aren’t always trained to think about tinnitus as a side effect. A 2022 survey found only 35% of primary care physicians routinely check for ototoxicity risk before prescribing high-risk drugs.
But they should. Best practice includes:
- Asking about existing hearing issues or tinnitus before prescribing
- Monitoring kidney function for drugs cleared by the kidneys (like gentamicin or furosemide)
- Checking serum drug levels when possible
- Ordering baseline and follow-up hearing tests for high-risk medications
- Informing patients about warning signs before they start the drug
Some hospitals now use automated alerts in electronic records to flag ototoxic drugs for patients with kidney disease or prior hearing loss. That’s progress.
Managing Tinnitus While Still Taking the Medication
What if you can’t stop the drug? Maybe it’s life-saving-like chemo or an antibiotic for a severe infection. You still need relief.
Sound therapy helps. White noise machines, fans, or apps that play gentle background sounds can mask the ringing and help your brain ignore it. Studies show 60-70% of people feel better with consistent use.
Cognitive behavioral therapy (CBT) for tinnitus also works. It doesn’t make the sound go away, but it changes how your brain reacts to it. Less stress, less focus on the noise, less suffering.
And don’t ignore your ears. Avoid loud music, use earplugs in noisy places, and don’t use cotton swabs. Anything that stresses your hearing further makes tinnitus worse.
What’s Changing in the Future
Researchers are working on otoprotective drugs-medications that shield the ear from damage without reducing the effectiveness of the main drug. The NIH funded $12.5 million in research in 2024, with several compounds in phase 2 trials.
Genetic testing is also emerging. Some people have a gene variant that makes them extra sensitive to ototoxic drugs. In the future, a simple blood test could tell you if you’re at higher risk before you even start a drug.
Regulators are paying attention too. The FDA updated labeling requirements for several aminoglycosides in 2023 to include stronger warnings about hearing loss. More drug companies are now required to test for ototoxicity during development.
But the biggest change needed? Better awareness. Patients need to know this can happen. Doctors need to ask about it. And no one should feel like they’re overreacting if they mention ringing in their ears after starting a new pill.
Bottom Line: You Have Power
Tinnitus from medication isn’t inevitable. It’s preventable-with the right questions, the right monitoring, and the right communication.
If you’re on a medication and notice ringing, buzzing, or muffled hearing:
- Don’t ignore it.
- Don’t stop the drug yourself.
- Do talk to your doctor.
- Do ask for a hearing test.
- Do ask if there’s a safer alternative.
Most of the time, the solution is simple: a dose change, a different drug, or a short break. But if you wait too long, you could lose hearing you can’t get back.
Your ears are listening. Make sure your doctor is too.
Can aspirin cause tinnitus?
Yes-but only at very high doses, usually above 4,000 mg per day. That’s far more than the 325-650 mg used for headaches or heart health. At normal doses, tinnitus is very unlikely. However, a small number of people are unusually sensitive and may experience ringing even at low doses. If this happens, talk to your doctor about switching to acetaminophen or another pain reliever.
Do antidepressants cause ringing in the ears?
Tinnitus from antidepressants is rare, affecting less than 1% of users. It’s been reported with SSRIs like sertraline and fluoxetine, sometimes when starting the drug or when stopping it. While the risk is low, if you notice new ringing after beginning or ending an antidepressant, mention it to your doctor. It doesn’t mean you need to stop the medication-just that you should be monitored.
Is tinnitus from medication permanent?
It depends on the drug. About 60% of cases are reversible once you stop taking the medication. But drugs like aminoglycoside antibiotics (gentamicin) and chemotherapy agents (cisplatin) can cause permanent damage. The longer you take them and the higher the dose, the greater the risk. Early detection is key-report ringing right away to increase your chances of recovery.
Can I still take my medication if I have tinnitus?
Yes, if the medication is essential-like for cancer, a serious infection, or heart failure. But you should work with your doctor to monitor your hearing and explore ways to reduce risk. This might include lower doses, shorter treatment times, or adding protective therapies like sound therapy or CBT. Never stop a prescribed medication without medical advice.
How can I prevent medication-induced tinnitus?
Ask your doctor before starting any new medication: "Could this cause ringing in my ears?" If you have a history of hearing loss, kidney disease, or are over 65, mention it. Request a baseline hearing test if you’re starting a high-risk drug like an antibiotic or chemotherapy. Avoid combining multiple ototoxic drugs (like NSAIDs + diuretics) unless necessary. Stay hydrated and avoid loud noise while on these medications.
Lashonda Rene
November 9, 2025 AT 14:25i started taking ibuprofen for my back and suddenly my ears started buzzing like a broken microwave lol i thought i was going crazy but then i read this and now i feel less alone. i didnt even know meds could do that. i stopped the ibuprofen and the ringing faded after 3 days. my doctor was like oh yeah that happens sometimes but no one ever told me. why dont they just put warnings on the bottles??
Andy Slack
November 10, 2025 AT 08:46just want to say this is one of the most useful posts i’ve read all year. thank you for breaking it down like this. if you’re on meds and hear ringing, don’t ignore it. your ears are telling you something. listen.
Rashmi Mohapatra
November 11, 2025 AT 11:43lol american doctors always act like everything is normal. in india we know if u take too much painkiller u get ear noise. we call it 'khan khan' sound. people just switch to paracetamol. why make it so complicated?
Abigail Chrisma
November 12, 2025 AT 19:37thank you for sharing this. i’ve been living with tinnitus for 8 months after starting sertraline. i was terrified i’d never get my hearing back. my audiologist said it was likely the med and we tapered me down slowly. the ringing didn’t vanish overnight but it’s 80% better now. if you’re going through this, you’re not broken. your body’s just reacting. give it time and speak up to your doctor. you deserve to feel safe in your own body.
Ankit Yadav
November 13, 2025 AT 01:14Meghan Rose
November 14, 2025 AT 12:48okay but have you considered that maybe you’re just stressed? i mean i get ringing sometimes when i’m overworked and it’s not the meds it’s your brain being dramatic. also why are you so quick to blame pharmaceuticals? maybe you just need to meditate more.
Steve Phillips
November 15, 2025 AT 18:40Oh. My. God. This is the most *epic* piece of medical journalism since the discovery of penicillin. I mean, 600+ drugs causing tinnitus?? Who knew Big Pharma was secretly running a sonic warfare program? Cisplatin? More like Cis-PLAGUE. And aspirin? Please. I’ve taken 800mg daily for years and my ears are fine - so obviously everyone else is just weak. Also, if you're not getting a baseline audiogram before every new Rx, you're not living, you're just existing. #OtotoxicityIsReal #ListenToYourEars #PharmaIsEvil
Rachel Puno
November 16, 2025 AT 14:14when i started my antidepressant, i thought the ringing was anxiety. turns out it was the med. i didn’t stop it right away - i told my doctor and we lowered the dose. the ringing didn’t disappear but it got quieter. you don’t have to suffer in silence. your voice matters. even if it’s just a buzz.
Clyde Verdin Jr
November 18, 2025 AT 11:53soooo… let me get this straight. You’re telling me that after I take my Xanax for 6 months, my brain starts hallucinating noises?? And I’m supposed to believe this isn’t just me being a hypochondriac?? 🤡 I’ve been hearing this since 2020. It’s just my soul screaming. Also, why do doctors always act like they’re surprised? They write the prescriptions. They know. They just don’t care.
Key Davis
November 19, 2025 AT 18:52It is imperative that clinicians prioritize ototoxic risk assessment prior to initiating pharmacotherapy, particularly in geriatric populations and those with preexisting renal impairment. The current standard of care remains insufficiently proactive, and institutional protocols must be revised to incorporate mandatory baseline audiometry for high-risk agents. Patient education must be formalized, not anecdotal.
Cris Ceceris
November 20, 2025 AT 18:04it’s wild how our bodies are these fragile little machines and we just pop pills like candy. i used to think tinnitus was just ‘in your head’ - but now i see it’s more like your brain trying to fill a silence your ears can’t make anymore. it’s not just noise. it’s a warning. like a smoke alarm that’s been broken for years and now it’s just… humming.
Brad Seymour
November 22, 2025 AT 11:56brilliant post. i’m from the UK and we don’t talk about this enough. my mate got tinnitus after a course of amoxicillin - he thought it was just tinnitus and moved on. turned out he had a kidney issue too. doctors missed it. he’s fine now but it could’ve been worse. please, people - speak up. it’s not a small thing.
Malia Blom
November 24, 2025 AT 00:27oh wow, so now we’re blaming meds for everything? what’s next? is your bad mood caused by vitamin D? your laziness by your toothpaste? this is just medical paranoia dressed up as ‘awareness’. people used to live without audiograms and they were fine. maybe you just need to stop obsessing over every little noise in your head.
Erika Puhan
November 24, 2025 AT 09:13the fact that this is even a topic is a testament to the systemic failure of Western medicine. You're telling me that in 2025, we're still not screening for ototoxicity before prescribing? The FDA only updated labeling in 2023? That’s not progress - that’s negligence. And the fact that patients are left to Google this themselves? Pathetic. This isn't a ‘side effect’ - it's a breach of the Hippocratic Oath.
Edward Weaver
November 24, 2025 AT 23:19why are we even talking about this? in America we just take meds and shut up. if you’re hearing things, you’re weak. in Russia, China, or even Mexico, people don’t whine about ringing ears. they take the pill and deal with it. this is why our country is falling apart - everyone’s too sensitive.
Lexi Brinkley
November 25, 2025 AT 21:05OMG I had this!! 🥺 after my Accutane treatment I heard this high-pitched whistle for 3 weeks 😭 I thought I was going deaf. I told my dermatologist and she was like ‘oh yeah that happens’ and didn’t even write it down. I’m so glad someone finally said it out loud. 🙏❤️
Kelsey Veg
November 26, 2025 AT 18:33soo… you mean to tell me that if i take advil for my cramps i might get ear noise?? i take like 4 a day for a week every month. i think i’m doomed. also why is this even a thing?? who thought this was okay??