Hearing loss

In addition to the intense sounds, there are some drugs that can cause damage to the inner ear. These drugs are called ototoxic (property of being toxic to the ear) and can cause hearing loss and balance problems. They are a common cause of hearing loss, especially in older adults who have to take medicine regularly. The effects of ototoxicity can be reversed when the therapy is discontinued but sometimes the damage is permanent.1

There are more than 200 known ototoxic medications on the market nowadays, which are used in the treatment of serious infections, cancer, and heart disease. They are only prescribed after a health care team consider the effects of the medications in the hearing and balance systems of the patient.2


1Schacht, J., & Hawkins, J. E. (2006). Sketches of otohistory. Part 11: Ototoxicity: drug-induced hearing loss. Audiology & Neuro-Otology11(1), 1–6.

2 American Academy of Audiology. (2009). Position Statement and Practice Guideline on Ototoxicity Monitoring.

Zhao, T., Zheng, T., Yu, H., Hu, B. H., Hu, B., Ma, P., … Zheng, Q. Y. (2021). Autophagy impairment as a key feature for acetaminophen-induced ototoxicity. Cell Death & Disease12(1), 3.

Ingersoll, M. A., Malloy, E. A., Caster, L. E., Holland, E. M., Xu, Z., Zallocchi, M., … Teitz, T. (2020). BRAF inhibition protects against hearing loss in mice. Science Advances6(49), eabd0561.

Favrelière, S., Delaunay, P., Lebreton, J.-P., Rouby, F., Atzenhoffer, M., Lafay-Chebassier, C., & Pérault-Pochat, M. C. (2020). Drug-induced hearing loss: a case/non-case study in the French pharmacovigilance database. Fundamental & Clinical Pharmacology34(3), 397–407.

VanHook, A. M. (2019). Protecting the organ of Corti from damage. Science Signaling12(580), eaax8884.

Guo, J., Chai, R., Li, H., & Sun, S. (2019). Protection of hair cells from ototoxic drug-induced hearing loss. Advances in Experimental Medicine and Biology1130, 17–36.

Brown, C. S., Emmett, S. D., Robler, S. K., & Tucci, D. L. (2018). Global hearing loss prevention. Otolaryngologic Clinics of North America51(3), 575–592.

Layman, W. S., & Zuo, J. (2015). Preventing ototoxic hearing loss by inhibiting histone deacetylases. Cell Death & Disease6(9), e1882–e1882.

Müller, U., & Barr-Gillespie, P. G. (2015). New treatment options for hearing loss. Nature Reviews. Drug Discovery14(5), 346–365.

Kros, C. J., & Desmonds, T. (2015). Drug-induced hearing loss: Infection raises the odds. Science Translational Medicine7(298), 298fs31.

Steffens, L., Venter, K., O’Beirne, G. A., Kelly-Campbell, R., Gibbs, D., & Bird, P. (2014). The current state of ototoxicity monitoring in New Zealand. The New Zealand Medical Journal127(1398), 84–97.

Atkinson, P. J., Wise, A. K., Flynn, B. O., Nayagam, B. A., & Richardson, R. T. (2014). Viability of long-term gene therapy in the cochlea. Scientific Reports4(1), 4733.

Shepherd, R. K., & Wise, A. K. (2014). Gene therapy boosts the bionic ear. Science Translational Medicine6(233), 233fs17.

Robertson, C. M. T., Juzer, M. T., Peliowski, A., Philip, C. E., & Cheung, P.-Y. (2007). Ototoxic drugs and sensorineural hearing loss following severe neonatal respiratory failure: Ototoxic drugs and hearing loss. Acta Paediatrica (Oslo, Norway: 1992)95(2), 214–223.

Yoshikawa, S., Ikeda, K., Kudo, T., & Kobayashi, T. (2004). The effects of hypoxia, premature birth, infection, ototoxic drugs, circulatory system and congenital disease on neonatal hearing loss. Auris, Nasus, Larynx31(4), 361–368.

 Lefebvre, P. P., Malgrange, B., Staecker, H., Moonen, G., & Van de Water, T. R. (1993). Retinoic acid stimulates regeneration of mammalian auditory hair cells. Science (New York, N.Y.)260(5108), 692–695.

  • Michigan Medicine – University of Michigan
  • American Academy of Audiology
  • The Centre for Adverse Reactions Monitoring (CARM)
  • American Speech-Language-Hearing Association
  • Johns Hopkins Medicine

Hearing loss affects both men and women, but men are more prone to hearing loss, mainly due to their higher engagement in activities associates with noise-induced hearing loss.1 In the case of the women, some studies have shown that they are more protected against hearing loss until menopause thanks to the estrogen.2


1Niskar, A. S., Kieszak, S. M., Holmes, A. E., Esteban, E., Rubin, C., & Brody, D. J. (2001). Estimated prevalence of noise-induced hearing threshold shifts among children 6 to 19 years of age: the Third National Health and Nutrition Examination Survey, 1988-1994, United States. Pediatrics108(1), 40–43.

2 Delhez, A., Lefebvre, P., Péqueux, C., Malgrange, B., & Delacroix, L. (2020). Auditory function and dysfunction: estrogen makes a difference. Cellular and Molecular Life Sciences: CMLS77(4), 619–635.

  • The European Agency for Safety and Health at Work estimates that 25-33% of the workforce in Europe is exposed to high-level noise at least a quarter time of their working time.
  • The increasing of the cases in hearing loss may well be rising due to increasing industrialization that is not always accompanied by protection.
  • Concurrent vibration or exposure to chemicals enhances the harmful effects of noise hearing.
  • Noisy leisure activities as the use of firearms or other recreational settings, can cause the same damage to hearing as exposure to occupational noise.
  • The World Health Organization estimates that over 50% of people aged 12-35 years listen to music over their personal audio devices at volumes that pose a risk to their hearing. Among those who frequently visit entertainment venues, nearly 40% are at risk of hearing loss.
  • Cochleotoxic and neurotoxic effects of ototoxic chemicals is the most likely cause of hearing loss.
  • Incidence of ototoxic hearing loss is estimated to be 63% with aminoglycosides and 6-7% with furosemide.
  • Cisplatin has been shown to cause tinnitus and hearing loss in 23%-50% of adults and up to 60% of children receiving it.
  • Up to 50% of those treated with injectable medicines for drug-resistant tuberculosis, could develop permanent hearing loss.

*All above data is from the World Report On Hearing-WHO