PSA: Avoid Certain Ototoxic Antibiotics — They Can Cause Tinnitus / Hearing Loss

[Pat Grann]

Some antibiotics are ototoxic.

Ototoxicity is the property of being toxic to the ear (oto-), specifically the cochlea or auditory nerve and sometimes the vestibular system, for example, as a side effect of a drug. The effects of ototoxicity can be reversible and temporary, or irreversible and permanent. Ototoxic drugs can damage your ears, cause hearing loss and tinnitus.

I have had tinnitus for almost 50 years.

I made the mistake of taking Ciprofloxacin for a UTI. I also told the doctor beforehand that I needed a drug that wasn't ototoxic. After I started taking Ciprofloxacin, I noticed a decline in my hearing and an increase in my tinnitus level.

Now my hearing loss has improved a little but my tinnitus has not.

Don't take any antibiotic ending in "CIN". Much is discussed about what to take for tinnitus, but not enough about what NOT to take.

I have some excellent advice for people who have had tinnitus for a short while. Your brain will become partially DESENSITIZED and accept the tinnitus where you will not feel as bad. It took me many years but my brain did partially learn to accept the tinnitus. That's some hope that doctors never tell you.

 

[Wrfortiscue]

Is it just random that people get tinnitus from antibiotics?

 

[serendipity1996]

Is it just random that people get tinnitus from antibiotics?

Certain antibiotics are documented as ototoxic - particularly the aminoglycoside class (typically ending in 'mycin') which tend to be the worst offenders. Azithromycin, from the macrolide class, has also led to cochlear damage in rare cases, and the fluoroquinolones (e.g Ciprofloxacin and Levaquin) can also cause damage. The fluoroquinolones carry a black-box warning now as there is a risk of severe multi-system side effects e.g tendon rupture.

I've personally been on Nitrofurantoin, Trimethoprim, and Amoxicillin with no issues and I think they are generally considered pretty low-risk.

 

[Bimmerboy]

@serendipity1996, my tinnitus was caused by Neomycin ear drops. It's a shame doctors give out such medicine, without knowing it can cause side effects such as tinnitus and hyperacusis.

 

[Steph1710]

Is it just random that people get tinnitus from antibiotics?

My tinnitus was caused by antibiotics.

 

[Wrfortiscue]

My tinnitus was caused by antibiotics.

Oh yeah? What kind and how long were you taking them? Has your tinnitus improved at all over time?

 

[Wrfortiscue]

Certain antibiotics are documented as ototoxic - particularly the aminoglycoside class (typically ending in 'mycin') which tend to be the worst offenders. Azithromycin, from the macrolide class, has also led to cochlear damage in rare cases, and the fluoroquinolones (e.g Ciprofloxacin and Levaquin) can also cause damage. The fluoroquinolones carry a black-box warning now as there is a risk of severe multi-system side effects e.g tendon rupture.

I've personally been on Nitrofurantoin, Trimethoprim, and Amoxicillin with no issues and I think they are generally considered pretty low-risk.

Are you referring to oral or ear drop Ciprofloxacin?

I took Ciprofloxacin months ago, but ear drops. I didn't have a perforated eardrum though.

 

[Steph1710]

Oh yeah? What kind and how long were you taking them? Has your tinnitus improved at all over time?

Yup. And tinnitus is actually listed in the top ten side effects. Never had tinnitus before. Then after six months of taking it, I started having loads of fleeting tinnitus - until one morning, I woke up, and it never disappeared.

I was taking Doxycycline.

Yes, it has improved, but it will never go. The damage is done unfortunately. But never mind - onwards and upwards!

 

[Wrfortiscue]

Yup. And tinnitus is actually listed in the top ten side effects. Never had tinnitus before. Then after six months of taking it, I started having loads of fleeting tinnitus - until one morning, I woke up, and it never disappeared.

I was taking Doxycycline.

Yes, it has improved, but it will never go. The damage is done unfortunately. But never mind - onwards and upwards!

That sucks. Glad you're coping though. My tinnitus was the best yesterday, but spiked double for no reason last night and it hasn't gone down since then. I haven't had a spike last this long from the COVID-19 vaccine. Only thing I did was walk with Decibullz earplugs. I could hear the wind though.

 

[Tweedleman]

Yup. And tinnitus is actually listed in the top ten side effects. Never had tinnitus before. Then after six months of taking it, I started having loads of fleeting tinnitus - until one morning, I woke up, and it never disappeared.

I was taking Doxycycline.

Yes, it has improved, but it will never go. The damage is done unfortunately. But never mind - onwards and upwards!

Omg my homie, you had to take that nastiness for 6 months? That's awful. Sounds like your ears put up a hell of a fight at least! I always hear about people getting it after even only a short round of antibiotics.

I love your attitude, onwards and upwards indeed! Although, in my case, it's probably onwards but not necessarily upwards. Nevertheless, full speed ahead!

 

[Steph1710]

Omg my homie, you had to take that nastiness for 6 months?

Hey buddy! Yeah I was put on it to help with progressive dry eye - unfortunately it didn't do shit to help my eyes, but it did give me tinnitus instead... yay!

Sounds like your ears put up a hell of a fight at least!

I remember getting the fleeting tinnitus quite soon after taking it. I looked in the side effects and saw tinnitus listed in the ten most common. Unfortunately I was under the illusion that if I stopped taking it, the side effects would go. I had no idea that tinnitus could be permanent!

I remember waking up one morning and asking what that annoying sound was? It then hit me, that I had permanent tinnitus. I stopped the Doxycycline straight away, but the damage was done.

I love your attitude, onwards and upwards indeed!

Tbh, we don't have much choice haha! I would prefer to carry on, rather than give up.

Although, in my case, it's probably onwards but not necessarily upwards. Nevertheless, full speed ahead!

I don't doubt that for a second Let's enjoy this crazy ride!

 

[Wrfortiscue]

Hey buddy! Yeah I was put on it to help with progressive dry eye - unfortunately it didn't do shit to help my eyes, but it did give me tinnitus instead... yay!

I remember getting the fleeting tinnitus quite soon after taking it. I looked in the side effects and saw tinnitus listed in the ten most common. Unfortunately I was under the illusion that if I stopped taking it, the side effects would go. I had no idea that tinnitus could be permanent!

I remember waking up one morning and asking what that annoying sound was? It then hit me, that I had permanent tinnitus. I stopped the Doxycycline straight away, but the damage was done.

Tbh, we don't have much choice haha! I would prefer to carry on, rather than give up.

I don't doubt that for a second Let's enjoy this crazy ride!

I want your attitude.

 

[Steph1710]

I want your attitude.

Well I have something I call the "fuck it" button.

When life gets super shit, or problems occur, I press it and say "FUCK IT". Then I move on with things lol.

Anyway, you're welcome to use the "fuck it" button - it's free to anyone.

 

[Wrfortiscue]

Well I have something I call the "fuck it" button.

When life gets super shit, or problems occur, I press it and say "FUCK IT". Then I move on with things lol.

Anyway, you're welcome to use the "fuck it" button - it's free to anyone.

Whatever works, I'm in.

 

[linearb]

Fluoroquinolone antibiotics (of which Ciprofloxacin is one) are absolutely some of the most dangerous drugs commonly prescribed and are, IMO, criminally overused. I believe they should only be used in the case of a clearly cultured pathogen which is treatment resistant to other drugs, or as a last ditch effort in the case someone is septic/etc.

The fact they're routinely given out for stuff like sinus infections (which are almost always viral, and therefore antibiotics do nothing) is just insane to me. These drugs are known to cause random tendon ruptures and neurological damage similar to what benzodiazepine withdrawal can cause if handled incorrectly.

I've only "fired" two doctors in my life, and one was a Primary Care doctor who really wanted me to take Ciprofloxacin for something that probably wasn't even bacterial. When I just refused, she responded by writing me a script for Levaquin (an even MORE dangerous drug in the same class) and suggested that if I didn't want to take it I should find a new healthcare provider. I fucking did, that day.

 

[linearb]

Don't take any antibiotic ending in "CIN". Much is discussed about what to take for tinnitus, but not enough about what NOT to take.

We can't go on this because antibiotic naming is weird. A lot of the macrolides (Erythromycin, Z-Paks) end in `cin` and even though these drugs can very very rarely cause audiological impacts, they are almost always fleeing, generally regarded as safe, and if you search this forum for Z-Pak etc IIRC you find more people who had zero effect or a temporary effect on their tinnitus, than any long term problems.

Fluoroquinolones do all end in `cin` as far as I know and the common ones to watch out for are Ciprofloxacin (Cipro), Levofloxacin (Levaquin), Moxifloxacin. These are on the list of drugs I tell providers I have had a severe reaction to in the past and am unwilling to take barring massive obvious medical necessity.

Doxycycline ends `ine` and is generally considered safe but has a few more unhappy anecdotes about tinnitus than I am generally comfortable with. I do take this when I have potential Lyme exposure from ticks, I also work like hell to avoid getting ticks, I'd rather bathe in Permethrin than take Doxycycline after the fact. Ticks are gross.

Some of the `mycin` ending antibiotics are not great for the ears but user reports seem to vary a lot and IV use seems much more.

By far the worst for the ears are probably the aminoglycosides which end in `micin` (not i vs y), common drugs here are Gentomycin and Streptomycin. I have never taken any drug in this class so I can't speak to them, except that their ototoxicity is probably better documented than anything else here.

@Pat Grann, sorry this happened; I would be hopeful things will continue to improve, and maybe take some gentle supporting supplements like Magnesium glycinate.

 

[Wrfortiscue]

We can't go on this because antibiotic naming is weird. A lot of the macrolides (Erythromycin, Z-Paks) end in `cin` and even though these drugs can very very rarely cause audiological impacts, they are almost always fleeing, generally regarded as safe, and if you search this forum for Z-Pak etc IIRC you find more people who had zero effect or a temporary effect on their tinnitus, than any long term problems.

Fluoroquinolones do all end in `cin` as far as I know and the common ones to watch out for are Ciprofloxacin (Cipro), Levofloxacin (Levaquin), Moxifloxacin. These are on the list of drugs I tell providers I have had a severe reaction to in the past and am unwilling to take barring massive obvious medical necessity.

Doxycycline ends `ine` and is generally considered safe but has a few more unhappy anecdotes about tinnitus than I am generally comfortable with. I do take this when I have potential Lyme exposure from ticks, I also work like hell to avoid getting ticks, I'd rather bathe in Permethrin than take Doxycycline after the fact. Ticks are gross.

Some of the `mycin` ending antibiotics are not great for the ears but user reports seem to vary a lot and IV use seems much more.

By far the worst for the ears are probably the aminoglycosides which end in `micin` (not i vs y), common drugs here are Gentomycin and Streptomycin. I have never taken any drug in this class so I can't speak to them, except that their ototoxicity is probably better documented than anything else here.

@Pat Grann, sorry this happened; I would be hopeful things will continue to improve, and maybe take some gentle supporting supplements like Magnesium glycinate.

Geez, is anything safe these days? Now I'm worried for my son lol. He had to use antibiotic ear drops when he was younger and that's with ear tubes.

 

[Jebbis]

Ugh... A few years back, i had a time where I was having chronic UTIs. I had like 7 in 6 months, which is more than 1 infection per month. That also meant 6 rounds of different antibiotics, and when those didn't work, they put me on a month long round to kill off the bacteria. (Little did I know, stupid me was eating contaminated cheap chicken from Costco, causing the infections. Yuck.)

There was one antibiotic that gave me a rash and made me puke. I think the month long dose might've been Amoxicillin, I'm not sure. I'm allergic to Penicillin and Nitrofurantoin (or however you spell it). I wonder if my many experiences with antibiotics made my ears sensitive. I also had chronic ear infections as a baby. I'm the perfect patient!

Also for the record, I would 100% rather have tinnitus than chronic bladder infections. I was constantly afraid the infection would reach my kidneys. Peeing felt like knives. I couldn't sleep because of the pain, couldn't eat because of the antibiotics... I know tinnitus sucks so bad, but chronic painful internal infection is a different level of discomfort.

 

[Bill Arsenault]

Hey - I'm on my way to hospital with Lyme disease. I was wondering why my tinnitus has been off the charts last few days.

Should I go with Amoxicillin or Azithromycin? Or do you know any safe ones - I won't hold it against you if I go deaf.

I got a huge bullseye infection on my leg from a tick I could not successfully get out and it's very infected and spreading rapidly and definitely without a doubt having one of the biggest tinnitus spikes I have ever had.

I need to go to the hospital informed. Any suggestions.

 

[tormentingtandh]

Hey - I'm on my way to hospital with Lyme disease. I was wondering why my tinnitus has been off the charts last few days.

Should I go with Amoxicillin or Azithromycin? Or do you know any safe ones - I won't hold it against you if I go deaf.

I got a huge bullseye infection on my leg from a tick I could not successfully get out and it's very infected and spreading rapidly and definitely without a doubt having one of the biggest tinnitus spikes I have ever had.

I need to go to the hospital informed. Any suggestions.

I don't have any advice and just now seeing your post. What did you end up doing to treat your Lyme disease? Which antibiotics did you take and how did this affect your hearing, tinnitus, and/or hyperacusis?

 

[Bill Arsenault]

I don't have any advice and just now seeing your post. What did you end up doing to treat your Lyme disease? Which antibiotics did you take and how did this affect your hearing, tinnitus, and/or hyperacusis?

Hi.

I went with @linearb's experience and asked for the Amoxicillin 500 mg 3 times daily for 3 weeks.

The huge classic Lyme disease bullseye that I had literally stopped spreading with the first dose and then disappeared before my eyes over the next couple days so there was no way I was gonna continue for 3 weeks. I used it for 1 week total and saved a 2 week supply because tick bites are unfortunately very common for me.

Except for some stomach issues I did not notice any negative effects but it's extremely hard to tell with how complex and unstable my tinnitus is.

Here's the deal with ticks. It's the nymph deer ticks (tiny and black with a red spot like a Black Widow) that carry Lime. They were unavoidable this year in Northern New England between the first day of spring thru the end of April unless you stayed indoors or on pavement. They were actually falling from the trees by the hundreds this year during that time and they are amazing little pilots - so there was almost no escape.

As long as you shower when you get home and remove any that have attached themselves I guess your relatively safe from what I have read.

For your blood to get infected they need to be attached for at least 24 hours in most cases. If the tick was attached long enough to become fully red and engorged with blood then you dropped the ball.

The nymph deer ticks pretty much disappeared in May and were somewhat replaced by those big ole American dog ticks which are much easier to deal with and have a much less risk of spreading disease - but are surely just as gross.

I mention all this because I read somewhere that the infection from full-blown untreated Lyme disease has been well known to cause permanent tinnitus and other hearing issues.

I have been bitten by a lot of ticks over recent years and I also now have a raging out of control case of tinnitus - so there's that along with all the nasty meds I was using.

So those things may have opened the door initially - or it could have simply been noise over-exposure alone.

I think it is self-evident that human ears are not even close to being able to handle what modern life subjects them to.

I'm sure I'm not alone when I am horrified on a daily basis at the things I see people subjecting their ears to.

So I'm coming around to the fact that now it's mostly the harsh noises of everyday life - along with all the stuff that normal ears seem to be able to handle - that is the primary culprit for the on-going worsening progression.

I feel like I have have recently made some progress by doubling down on the ear protection and noise awareness but It's likely a case of too little too late because its all been trial and error so far and I just cannot afford it at all anymore.

That said - I am positively over the moon right now with just a shred of hope that I might survive another year. Seriously.