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Ototoxic Drug
Aka: Ototoxic Drug, Ototoxic Medication, Ototoxicity, Ototoxic Hearing Loss
- See Also
- Hearing Loss
- Sensorineural Hearing Loss
- Causes: Medications
- Analgesics
- Aspirin (>2.7 g/day) and other Salicylates
- NSAIDs
- Acetaminophen
- Sulfasalazine (Azulfidine)
- Hydrocodone
- Antibiotics
- Aminoglycosides (Gentamicin, Streptomycin)
- Starts with Tinnitus and rapidly progresses to Hearing Loss
- Ototoxicity symptoms are permanent if last >2-3 weeks after stopping the Aminoglycoside
- Streptomycin
- Vancomycin
- Erythromycin (dose >2 g/day) and other Macrolides
- Chloramphenicol
- Tetracyclines such as Doxycycline or Minocycline (transient vestibular toxicity)
- Imipenem-Cilastin (Primaxin)
- Linezolid (Zyvox)
- Sulfonamide
- Fluoroquinolones
- Voriconazole
- Amphoteracin B
- Ganciclovir
- Ribavirin
- Loop Diuretics (especially at high dose with rapid infusion)
- Ethacrynic Acid
- Furosemide (Lasix)
- Antineoplastic
- Cisplatin
- Carboplatin
- Bleomycin
- Vincristine and other Vinca Alkaloids
- Nitrogen Mustard
- Methotrexate
- Etoposide
- Protein kinase inhibitor
- Other medications
- Quinine
- Chloroquine
- Mefloquine
- PDE5 Inhibitors (e.g. Sildenafil or Viagra)
- Caffeine
- Atorvastatin (Lipitor)
- Bupropion (Wellbutrin)
- Risedronate (Actonel)
- Verenicline (Chantix)
- Misoprostol (Cytotec)
- Causes: Industrial and Home Poisonings
- Background: Exposure Settings
- Automotive repair
- Boat building
- Manufacturing (leather, metal, battery, petroleum)
- Painting
- Pesticide spraying
- Fueling vehicles including aircraft
- Asphyxiants
- Carbon Monoxide Poisoning
- Tobacco Smoke
- Heavy metal Poisoning
- Mercury Poisoning
- Lead Poisoning
- Organic Tin Compounds
- Nitriles
- Acrylonitrile (Hydrogen cyanide with a replaced ethenyl group)
- 3-Butenenitrile (Allyl Cyanide)
- Solvents
- Toluene
- Styrene
- P-Xylene
- Trichloroethylene
- Causes: Ilicit Drugs and Poisonings
- Ilicit Drugs
- Ecstasy
- Symptoms
- Sensorineural Hearing Loss from Ototoxic Drugs typically develops over weeks after exposure
- Hearing Loss be transient for some agents used at therapeutic levels (e.g. Erythromycin, Tetracyclines, Analgesics)
- Hearing Loss is often reversible after decreasing or stopping the offending agent
- Evaluation
- See Sensorineural Hearing Loss
- Resources
- Preventing Hearing Loss Caused by Chemical (Ototoxicity) and Noise Exposure (CDC NIOSH)
- https://www.cdc.gov/niosh/docs/2018-124/
- References
- Cianfrone (2011) Eur Rev Med Pharmacol Sci 15(6): 601-36 [PubMed]
- Ganesan (2018) J Audiol Otol 22(2): 59-68 [PubMed]
- Seligmann (1996) Drug Saf 14(3): 198-212 [PubMed]