Is Paxlovid (Ritonavir/Nirmatrelvir) Ototoxic? Can It Make Tinnitus Worse?

[Alexandor]

I've been prescribed Paxlovid, the Pfizer COVID-19 Antiviral treatment, which is a combo of Ritonavir and Nirmatrelvir.

I've done some digging and can't find anything about either of these two drugs causing tinnitus or being ototoxic in any way.

I wanted to check here and ask if anyone else has experience taking Paxlovid and, if so, did it have any impact on your tinnitus levels?

I'd also love any additional input any of you all can offer.

 

[DebInAustralia]

I'm sorry I can't advise.

But I can point you towards Nigella Sativa, which is thought to be protective against COVID-19... I've had no issues taking it.

 

[Julie5022]

I tested positive for COVID-19 this morning and have been prescribed Paxlovid. Did it worsen your tinnitus? I'm very nervous to take it.

 

[Lulu187]

I tested positive for COVID-19 this morning and have been prescribed Paxlovid. Did it worsen your tinnitus? I'm very nervous to take it.

I've had COVID-19 3x and I didn't take any medication for it. Why risk the possible spike? I'd say don't take it unless 100% necessary in a life or death situation.

 

[Julie5022]

I've had COVID-19 3x and I didn't take any medication for it. Why risk the possible spike? I'd say don't take it unless 100% necessary in a life or death situation.

Did your tinnitus spike any of the 3 times? Are you vaccinated?

 

[Lulu187]

Did your tinnitus spike any of the 3 times? Are you vaccinated?

It didn't spike any of the 3 times which was strange, as I had lost my taste and smell for 3 weeks after my second infection with COVID-19.

I am certainly, most definitely NOT vaccinated for COVID-19 and never will be.

 

[Social Maven]

I'm also wondering if Paxlovid had any effect on tinnitus. I will never get the vaccine (as it causes tinnitus in many), but if I ever get COVID-19, I am very afraid to take Paxlovid (which is what they prescribe where I live).

I also wonder about monoclonal antibodies. The one they use where I live is Bebtelovimab.

Since I got tinnitus in January 2019, I had to take a drug twice. BOTH TIMES they made my tinnitus louder. he last one screaming high-pitched loud. So I have never taken another medication since then. It's terrifying living this way.

 

[jennlee]

Did anyone take Paxlovid and have a tinnitus spike? If so, did the spike resolve?

So hard to know if it's COVID-19 causing the spike, or the medication.

 

[Johan82]

Did anyone take Paxlovid and have a tinnitus spike? If so, did the spike resolve?

So hard to know if it's COVID-19 causing the spike, or the medication.

Why do you have to take Paxlovid? Is your COVID-19 severe?

 

[Joe Cuber]

Did anyone take Paxlovid and have a tinnitus spike? If so, did the spike resolve?

So hard to know if it's COVID-19 causing the spike, or the medication.

@jennlee - I had COVID-19 back in May. I started taking Paxlovid after the 4th day. My tinnitus spiked while I had COVID-19 symptoms, but Paxlovid didn't cause me to spike any further. After COVID-19 subsided, my tinnitus went back to baseline.

 

[Bill_]

I am not a doctor nor am I claiming to be able to give medical advice. But I used to work in the scientific field and consider myself somewhat "scientificically literate" - from what I have read Paxlovid does not make any sense unless you have severe pre-existing conditions or your COVID-19 infection is very, very bad.

Under any other circumstances I would not even think about taking it.

 

[Jan64]

@jennlee - I had COVID-19 back in May. I started taking Paxlovid after the 4th day. My tinnitus spiked while I had COVID-19 symptoms, but Paxlovid didn't cause me to spike any further. After COVID-19 subsided, my tinnitus went back to baseline.

Dear Joe,

This is a great result! Unfortunately my hearing was damaged by COVID-19. I researched that the virus affected the hair cells and unlocked the ACE2 receptors. Hair cells are similar to taste and smell cells... and a target of COVID-19. See attached scientific paper explaining how this works.

I am now trying to get Paxlovid and, when I am COVID-19 positive again, I take Paxlovid immediately.

Are there more Tinnitus Talk members who are trying to get Paxlovid in case of a COVID-19 infection?

Kind regards,
Jan

 

[Joe Cuber]

Intersting, I didn't realize that COVID-19 actually affected the hair cells @Jan64. I think if I caught COVID-19 again, I'd want to take Paxlovid again.

 

[Tina V.]

I am just getting over COVID-19 and I am taking Paxlovid. My tinnitus has definitely been exacerbated. It was much less noticeable for quite awhile now, so I noticed the difference.

However, COVID-19 itself can attack the stereocilia in the ear, so the question is, which is the culprit, the drug or the virus?

I do not like so many other side effects of Paxlovid, like dizziness and strange dream. So many people I know said it would help me get better faster. Well, my doctor did not prescribe it to me when I had COVID-19 last year (which incidentally caused complete hearing loss in one ear, the same one that has the tinnitus) and she wasn't adamant about me taking it this time, either, but I felt that because my asthma often gets worse when I'm sick, I should give the Paxlovid a go. I have been quite sick for a week now, so it might have been much worse without the Paxlovid. Who knows? My asthma/bronchitis was not an issue.

I don't think I will take it again the next time I get COVID-19, since I likely will. I had 3 total vaccinations, but reluctant to receive any more. I did so, because I am a Dental Hygienist and exposed to people in close proximity. But the vaccines obviously do not keep you from getting COVID-19!

Anyway, the biggest help for my tinnitus is having a water fountain outside of the bedroom. My brain can focus on that vs. the rumbling in my ear.

I won't give up my coffee, however!

 

[spedgas]

Yeah, I got COVID-19 for the first time in early August 2023. I'm a nurse so it's amazing it took that long. Eleven days after the positive test and 4 days after symptoms disappeared, I lost my decent habituation overnight. Not sure what to make of this. I will hit 3 week in spike status later this week. Stress, anxiety, and COVID-19 did a number on me. I had a hearing test and it was equal to or better than my last one from four years ago.

 

[GregCA]

Are there more Tinnitus Talk members who are trying to get Paxlovid in case of a COVID-19 infection?

Day 2 of symptoms here. Finally tested positive this morning. Started Paxlovid right away (i.e. around noon time).

 

[RocketJSquirrel]

I contracted COVID-19 some time between September 7th and 10th and started Paxlovid on the 13th.

Paxlovid had no effect at all on my tinnitus.

The only side effect I had was diarrhea, which was OK because I was isolating at home with toilets nearby. I believe Paxlovid shortened my symptoms and I tested negative on the 19th.

Just another one person anecdote.

 

[Matchbox]

I also did Paxlovid. I was fine.

 

[Rainer]

Unfortunately I will be able to participate in this thread: I tested positive for COVID-19 on December 25, which is an inconvenient time to require Paxlovid. I got my hands on it not before today.

OT: If I had had to pay the full price for it, it would've been €59.95. I find it bewildering that the US price for Paxlovid used to be 8 times higher than in Germany, and from now on it'll be 21 times higher.

 

[dd314]

Day 2 of symptoms here. Finally tested positive this morning. Started Paxlovid right away (i.e. around noon time).

Did Paxlovid have any effect on your tinnitus?

 

[GregCA]

Did Paxlovid have any effect on your tinnitus?

No effect on tinnitus. But it did leave a horrible taste in my mouth.

 

[2noist]

No effect on tinnitus. But it did leave a horrible taste in my mouth.

Did the horrible taste go away eventually?

 

[GregCA]

Did the horrible taste go away eventually?

Yes, within a day or two of the last pills in the treatment.

 

[From9to<1]

I've had COVID-19 3x and I didn't take any medication for it. Why risk the possible spike? I'd say don't take it unless 100% necessary in a life or death situation.

Paxlovid doesn't work that way. It's prescribed for people who have an increased risk of severe outcomes from COVID-19, and is only effective if you take it early, before it gets bad. If you take the "wait and see" approach... it's not effective.

I am not a doctor nor am I claiming to be able to give medical advice. But I used to work in the scientific field and consider myself somewhat "scientificically literate" - from what I have read Paxlovid does not make any sense unless you have severe pre-existing conditions or your COVID-19 infection is very, very bad.

Under any other circumstances I would not even think about taking it.

Taking Paxlovid if your COVID-19 is "very, very bad" is exactly the condition in which it WON'T work. It's a drug meant to slow/stop replication of the virus in the very early stages. It is to be taken based on PREDICTION of risk... not severity of current symptoms.

 

[Eric N]

It didn't spike any of the 3 times which was strange, as I had lost my taste and smell for 3 weeks after my second infection with COVID-19.

I am certainly, most definitely NOT vaccinated for COVID-19 and never will be.

Are you feeling better now? Did you experience any long-term effects from COVID-19? I just tested positive two days ago. So far, I only have a headache and a fever of 38.5°C. The pharmacist mentioned that medication isn't usually prescribed for people under 65 or without pre-existing conditions, but I'm also not vaccinated.