Ototoxicity refers to drug or chemical-related damage to the inner ear, resulting in damage to the organs responsible for hearing and balance. Such damage can lead to temporary or permanent hearing loss, and/or loss of balance
What are the side effects?
Ototoxic side effects can damage our ears in many different ways. You may experience one, several or no side effects from taking a given drug. The average ototoxic drug exhibits about 3.5 ototoxic symptoms. Here are a number of ototoxic side effects that you could experience.
Common Cochlear Side Effects:
- Tinnitus: Commonly called ringing in the ears is the number one indicator that you may be damaging your ears from an ototoxic drug. It may a ringing, buzzing, clinking, chirping, humming, blowing, hissing, roaring, clinking whistling, rumbling, etc.
- Hearing Loss: Hearing loss can range from mild to profound and may be temporary or permanent. Ototoxic damage usually begins in the very high frequencies, often frequencies above 8,000Hz, which are not usually tested.
- Hyperacusis: Hyperacusis is a condition when normal sounds are being perceived as too loud.
- Auditory Hallucinations: Hearing phantom sounds—voices and music that are not there. Auditory hallucinations are the result of a damaged auditory system rather than the effects of mental illness.
Common Vestibular Side Effects:
- Dizziness: the feeling of being lightheaded, woozy, or unbalanced is the most common ototoxic symptom.
- Vertigo: the perception of movement (normally a spinning sensation) when the body is not really moving.
- Ataxia: Loss of ability to coordinate your muscles properly as the result of a damaged vestibular system.
- Nausea and/or vomiting
How Common are Ototoxic Side Effects?
The short answer is “no one really knows”. We apparently only see and record the tip of the “iceberg”. There are at least 743 drugs that are known to be ototoxic. With extremely ototoxic drugs such as Cisplatin, used in the treatment of cancer, virtually everyone that takes this drug ends up with hearing loss, usually irreversible.
How to Reduce the Risk:
- Beware of early warning signs (dizziness, tinnitus, etc)
- Tell your doctor if you have a history of hearing loss
- Follow dosage instructions exactly
- Use the same pharmacy for all your prescriptions as they may be able to advise you of dangerous combinations
- Drink plenty of fluids, especially important if you have a fever or are taking loop diuretics
- If possible, avoid taking multiple ototoxic drugs at a time
- Avoid noisy environments for at least six months after you have completed a course of an Aminoglycoside antibiotics or platinum compound such as Cisplatin
- Have baseline testing done prior to treatment with extremely ototoxic medications (such as Aminoglycoside antibiotics or platinum compound such as Cisplatin) and then testing during and after treatment.