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Medications and Hearing Loss Cheat Sheet by

Medications and Hearing Loss
medications     hearing     loss     healthcare

Introd­uction: Hearing Loss

Hearing loss occurs in 80% of people over the age of 85 and is the most common sensory deficit.8 It can lead to severe social and health­-re­lated problems. It's especially proble­matic in the elderly with hearing loss that impairs the exchange of inform­ation, thus signif­icantly impacting everyday life, causing loneli­ness, isolation, depend­ence, and frustr­ation, as well as commun­ication disord­ers.8,9

Symptoms of Ototox­icity

When working with older adults, be mindful of symptoms of ototox­icity including the following:
Tinnitus (ringing in the ears);
Hearing loss (bilateral or unilat­eral);
Incoordination in movements;
Unsteadiness of gait; and
Oscillating or bouncing vision (vertigo).
When working with patients with hearing loss, techniques such as minimizing background noise and speaking in an approp­riate tone can help increase the ease of older adults' intera­ction and partic­ipation in conver­sat­ions.


A number of medica­tions are known to be ototoxic (cause damage to hearing). Medica­tions can influence hearing; this unders­cores the need to minimize unnece­ssary medication use as an essential aspect of hearing function preser­vation. Additi­onally, it's important to remain mindful that medica­tions causing ototoxic symptoms may need to be considered as a potential contri­buting factor if increased fall incidence is noted.


Reduce Risk of Ototox­icity

Consider the following tips to reduce the risk of ototox­icity:
When possible, assess hearing before starting ototoxic medica­tions and monitor over the course of treatment, as symptoms alone are not always reliable.
Educate patients about medica­tions known to be ototox­ic.In some cases, early recogn­ition of changes in hearing may prevent permanent damage, so encourage patients to immedi­ately report to providers any changes in their hearing, especially when new medica­tions are added or doses are increased.
Remind patients that even over-t­he-­counter medica­tions such as aspirin and NSAIDs (eg, ibuprofen, naproxen) may be ototoxic.
Routinely review medication profiles for ototoxic medica­tions.
Avoid using ototoxic medica­tions in the elderly and others with existing hearing deficits when other effective altern­atives are available.
Many medica­tio­n-r­elated side effects are frequently dose related and/or related to duration of therapy, so using the lowest effective dose may minimize risk.
Closely monitor blood levels of known ototoxic medica­tions, such as aminog­lyc­osides and vancom­ycin.
When possible, avoid combin­ation therapy of ototoxic medica­tions with other ototoxic medica­tions, which may further increase the risk of hearing loss.
Suggest patients avoid exposure to loud noises when taking ototoxic medica­tions, as this exposure may increase hearing damage.

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