What is Ototoxicity?

Ototoxicity is a side effect of medicines that usually provokes damage to the inner ear. The most common symptoms are ringing in the ears, hearing loss, balance problems, and others. In any case, it is advised to consult with your doctor about ototoxic drugs or any others.

What is Ototoxicity?

An inner ear damage that causes hearing problems occurs usually as an adverse reaction to medicines is called ototoxicity. In addition, certain medications used to treat infections and cancer can damage your sensory cells inside the ear and it may lead to hearing and balance problems.


In some cases, symptoms may appear right after you start using the medicines while in others occur gradually. Unfortunately, ototoxicity may happen even after 5 years after you begin using these medications. The first symptom of hearing loss is usually ringing in the ears (tinnitus). Check below some symptoms:

  • Walking problems in the dark or nighttime
  • Balance problems when climbing stairs
  • Hearing loss
  • Tinnitus
  • Oscillopsia (stationary objects moving around you)
  • Dizziness
  • Lightheadedness
  • Tiredness

Check below some symptoms of ototoxicity that occur in children:

  • Trouble staying concentrated in learning environments
  • Getting tired quickly
  • Communications problems


There are known more than 200 medicines that are considered ototoxic. While some require a prescription, others are over-the-counter. Examples include:

Aminoglycoside Antibiotics

  • Kenamycin
  • Amikacin
  • Gentamicin
  • Netilmicin
  • Tobramycin
  • Vancomycin
  • Streptomycin

Chemotherapy Medicines

  • Cisplatin
  • Carboplatin

Loop Diuretics (Water Pills)

  • Bumetanide
  • Ethacrynic Acid
  • Furosemide
  • Torsemide

Other Ototoxic Medications and Chemicals

The following medicines can rarely cause ototoxicity. For example:

  • Quinine – a medication used to treat malaria
  • Salicylates – Common over-the-counter medicines (such as Aspirin)
  • Environmental Substances and Chemicals – For example, tin, lead, carbon monoxide, mercury, and others.

Discuss with your doctor if you experience any of the symptoms listed above or use any medicine listed in this article.

Risk Factors

  • The type of medication
  • The dosage you are administering
  • The duration of the treatment
  • A combination of ototoxic medicines

In addition, ototoxicity may occur in some cases due to a genetic factor. Some people who use aminoglycoside antibiotics have DNA that elevates their risk of developing ototoxicity.


Ototoxicity is a serious problem because it can cause permanent damage to the inner ear. Thus, it may lead to long-term problems with hearing, balance, and others. Furthermore, hearing issues in children may prevent them from learning the verbal skills needed to communicate. However, once you experience permanent damage to your inner ear, there is no way back. As a result, physicians will prescribe a treatment that will help to lessen the symptoms.


Audiologists and otolaryngologists are physicians who treat hearing and balance disorders. They will perform different tests to confirm whether you have ototoxicity or not. Check below some examples:

  • Audiogram – In this test, a physician measures the ability to hear and recognize many sounds.
  • Auditory Brainstem Response (ABR) Test – The ARB test is done to verify how your nerves respond to sound.
  • Otoacoustic Emissions (OAEs) Test
  • Vestibular Test Battery – This type of test helps to check balance problems. For example, videonystagmography (VNG), vestibular evoked myogenic potentials (VEMPs), rotary chair and video head impulse testing (vHIT), and others.

Ask your doctor in case you have any questions.


Unfortunately, interrupting the use of an ototoxic medicine does not reverse any damage that happened. However, it can prevent further damage. Moreover, most ototoxic medications are life-saving, and stop using them may not be possible. Check below some devices or procedures that can help to manage this hearing problem:

  • Vestibular Rehabilitation – This procedure helps you to manage the body’s response to balance and hearing problems.
  • Cochlear Implants – It is a surgical device that helps to improve your hearing and communication when other treatment options do not work.
  • Hearing Aids

Talk with your physician before using any treatment option. Otherwise, it may be useless or cause ototoxicity to worsen.


It cannot be prevented always but early diagnosis and treatment can help to prevent symptoms or treat them sooner. Regular check-ups with your healthcare professional are required if you are using an ototoxic medicine. These regular examinations can help to diagnose the ototoxicity before any serious problems.

Frequently Asked Questions

How long does ototoxicity last?

Commonly, normal hearing returns within a few hours to several days only if there is no significant inner ear damage. Otherwise, you may need to use medicines for longer periods because once damage occurs, it is irreversible. Consult with your doctor for more details.

What is ototoxicity?

When a person experiences inner ear damage that provokes hearing and balance problems due to certain medication use is called ototoxicity. Mostly, high doses of drugs used to treat cancer, infections, or other diseases cause this hearing problem.

What are the most common symptoms of vestibular damage?

In case you experience vestibular damage, you will notice numbness, pain, tingling, or burning in your limbs and extremities. Moreover, unexplained weight loss, loss of muscle or strength, paralysis, or headaches also may occur. If you experience any of the previous symptoms, discuss it with your healthcare provider.

Is ototoxicity curable?

However, once it occurs, there is no way to reverse it. Regular check-ups are recommended in case you are using any ototoxic medication.

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