Have you started a new medication and suddenly noticed a ringing, buzzing, or hissing in your ears? You’re not alone. Many people experience tinnitus - that persistent sound with no external source - after beginning a new prescription or even an over-the-counter pill. What’s surprising is how common this is. More than 600 medications, from everyday painkillers to life-saving chemotherapy drugs, can trigger or worsen tinnitus. The good news? In many cases, it’s reversible. The key is knowing which drugs to watch for and what to do next.

How Medications Cause Ringing in the Ears

Tinnitus from medication happens because some drugs are ototoxic - meaning they damage the inner ear or the nerve that connects your ear to your brain. This damage can interfere with how sound signals are sent or processed. The exact mechanism isn’t fully understood, but it often involves changes in the fluid balance of the inner ear, disruption of hair cells that detect sound, or interference with nerve impulses.

Not all tinnitus from drugs is the same. Some people notice ringing within hours of taking a high dose of aspirin. Others develop symptoms after weeks or months on an antidepressant. The timing and severity depend on the drug, the dose, and your body’s sensitivity. For example, cisplatin, a chemotherapy drug, can cause hearing loss that starts with high-pitched sounds you can’t even hear - like birds chirping - before it affects speech. Aminoglycoside antibiotics like gentamicin can cause permanent damage even after you stop taking them.

Drugs Most Likely to Cause Tinnitus

Some medications carry a much higher risk than others. Here are the main culprits, ranked by risk level:

• Aminoglycoside antibiotics (gentamicin, tobramycin): Used for serious infections. These are among the most dangerous. Up to 25% of patients on long-term IV treatment develop permanent hearing loss or tinnitus.
• Chemotherapy drugs (cisplatin, carboplatin): Up to 70% of patients on cisplatin experience some degree of hearing damage. The damage often starts in the high-frequency range and can progress.
• Loop diuretics (furosemide, bumetanide): Used for heart failure and fluid retention. High doses - especially when given IV - can cause temporary tinnitus and hearing loss.
• High-dose NSAIDs (aspirin, ibuprofen, naproxen): Tinnitus is common at doses above 4,000 mg of aspirin daily. But here’s the catch: most people never take that much. A standard headache dose of 325 mg is very unlikely to cause ringing. Still, some people are unusually sensitive - even low doses can trigger symptoms.
• Antimalarials (quinine): Used for malaria and sometimes leg cramps. Tinnitus can appear within 1-3 days and usually fades within weeks after stopping.
• Isotretinoin (Accutane): Used for severe acne. Around 5% of users report tinnitus, though the manufacturer claims it’s less than 1%. It’s still a recognized risk.

On the lower-risk side: antidepressants like SSRIs (sertraline, fluoxetine) and benzodiazepines (alprazolam) cause tinnitus in less than 1% of users. But even rare side effects matter if you’re the one experiencing them. Some people report tinnitus when they stop these drugs - not when they start them - which can be confusing.

Is Your Tinnitus Reversible?

This is the most important question. About 60% of medication-induced tinnitus goes away once you stop the drug. But not all of it. Aminoglycosides and cisplatin can cause permanent damage. The sooner you catch it, the better your chances of recovery.

Timing matters. Most people notice symptoms within the first two weeks of starting the medication. But some drugs, like certain antibiotics or chemotherapy agents, can cause delayed reactions - even up to 90 days later. If you’ve been on a new drug for a month and suddenly hear ringing, don’t ignore it.

Recovery isn’t always instant. After stopping a high-dose NSAID, tinnitus might fade in a few days. For gentamicin or cisplatin, it can take weeks or months - or never fully disappear. That’s why early detection is critical. If your doctor knows you’re experiencing symptoms, they can adjust your treatment before permanent damage occurs.

What to Do If You Think a Drug Is Causing Tinnitus

Never stop a prescribed medication on your own. That’s dangerous - especially for drugs like antibiotics, antidepressants, or blood pressure meds. Instead, follow these steps:

1. Write down when the ringing started - and what medication you began around that time. Even if you’re taking several drugs, note the one you started most recently.
2. Check the side effects on the medication’s leaflet or use a trusted source like the FDA’s website or the manufacturer’s prescribing info.
3. Call your doctor. Say: “I’ve started ringing in my ears since beginning [drug name]. Could this be related?” Be specific. Don’t say “I think it’s the pill.” Say the name.
4. Ask about alternatives. Your doctor might lower the dose, switch to a different drug in the same class, or change the timing of your dose. For example, if you’re on furosemide and getting tinnitus, they might switch you to a different diuretic.
5. Request an audiogram. If you’re on a high-risk drug like cisplatin or gentamicin, your doctor should have already ordered baseline hearing tests. If not, ask. A simple hearing test can show if there’s damage and how severe it is.

Some doctors still don’t screen for ototoxicity. A 2022 survey found only 35% of primary care doctors routinely check for hearing changes before prescribing high-risk drugs. If your doctor brushes off your concerns, ask for a referral to an audiologist or an ear, nose, and throat specialist.

Managing Tinnitus While Staying on Necessary Medications

What if you can’t stop the drug? Maybe you’re on chemotherapy, or you need an antibiotic for a life-threatening infection. In those cases, the goal shifts from stopping the tinnitus to managing it.

Sound therapy helps. This means using background noise - like a fan, white noise machine, or soft music - to mask the ringing. It doesn’t fix the cause, but it makes the sound less noticeable. Studies show it helps 60-70% of people reduce their distress.

Cognitive behavioral therapy (CBT) is another proven tool. It doesn’t silence the ringing, but it changes how your brain reacts to it. Over time, many people stop noticing it altogether. CBT is especially helpful if the tinnitus is causing anxiety or sleep problems.

Some patients use hearing aids, even if they don’t have hearing loss. Modern devices can deliver customized sound therapy and are often covered by insurance if linked to tinnitus treatment.

What’s New in Prevention and Research

Science is making progress. In 2024, the NIH funded $12.5 million for research into otoprotective agents - drugs that can shield the inner ear from damage without reducing the effectiveness of the main treatment. Early trials are testing compounds that could be given alongside cisplatin or gentamicin to prevent hearing loss.

Genetic testing is also emerging. Some people have gene variants that make them far more sensitive to ototoxic drugs. In the next few years, doctors may be able to test for these variants before prescribing high-risk medications.

Hospitals are also improving monitoring. In 2018, only 45% of U.S. hospitals tracked hearing changes in patients on ototoxic drugs. By 2023, that number rose to 68%. More clinics now require baseline hearing tests before starting chemotherapy or long-term antibiotics.

Bottom Line: Don’t Panic, But Don’t Ignore It

Tinnitus from medication is more common than most people realize. But it’s rarely the first thing doctors think of. If you’re experiencing ringing, buzzing, or muffled hearing after starting a new drug, it’s worth investigating. Most cases are temporary. A few are serious - and preventable.

Keep a symptom journal. Note the date you started the drug, the dose, and when the tinnitus began. Share this with your doctor. Ask if there’s a safer alternative. Don’t assume it’s “just stress” or “aging.” If you’re on a high-risk medication, ask for a hearing test. Early action can save your hearing.

And remember: you’re not alone. Over 50 million Americans live with tinnitus. A significant portion of those cases are linked to medications. With better awareness and smarter monitoring, many of those cases could be avoided.