Pharmacist warns OTC medications may harm hearing, raising risk of tinnitus

A leading UK pharmacist has warned that regularly taking some over-the-counter painkillers could raise the risk of hearing loss and tinnitus, particularly when used at high doses or for extended periods. Dr Leyla Hannbeck, chief executive of the Independent Pharmacies Association, said there are many medicines that can affect hearing and balance, and the effect often depends on how much and how long they are used.

Analgesics and NSAIDs—such as aspirin and ibuprofen—and acetaminophen, known as paracetamol in the UK, have been linked to tinnitus and other hearing issues. Tinnitus affects an estimated 7.6 million people in the UK. The risk appears to rise with higher doses or prolonged use. “There are many medicines that cause side effects that affect the hearing and balance, but in most cases this depends on the dose and length of use,” Hannbeck told the Daily Mail. A 2022 US study of more than 62,000 women found that frequent use of paracetamol or NSAIDs, even at typical doses, was linked to up to a 24 percent higher risk of hearing loss. In men, a separate US study found that regular use—two or more times per week—of paracetamol, NSAIDs and aspirin was associated with a higher risk of hearing loss. Researchers speculated that these medications may reduce blood flow to the cochlea, the inner-ear structure essential for hearing. The risk appears nuanced: a daily aspirin dose around 100 mg was linked to about a 16 percent increased risk, while doses below 100 mg showed no clear rise in risk.

Beyond these medicines, the same researchers note that some antibiotics, including aminoglycosides, are associated with hearing loss. British research has shown that more than 50 percent of patients who require multiple rounds of intravenous aminoglycosides may experience hearing loss. Gentamicin is one of the more commonly used aminoglycosides and is often administered intravenously to treat severe infections. Studies suggest such drugs can damage the sensory cells inside the ear needed for balance and hearing, and even a single dose can result in permanent hearing loss in patients with certain genetic mutations, according to BMJ.

Dr Hannbeck also told the Daily Mail that some blood pressure medicines that reduce blood flow to the eardrum, along with diuretics — commonly known as water pills — can also affect hearing in some people and potentially cause temporary hearing loss. She added that other medicines, including certain opioids and some acne treatments, can have similar effects in some individuals. However, she stressed that patients should not stop prescribed medicines abruptly and should speak with a pharmacist or doctor if they have concerns.

The overall message, according to experts, is that while these medications are widely available and helpful for many conditions, their potential effects on hearing and balance underscore the importance of following dosing recommendations and seeking medical advice if new hearing-related symptoms arise. Healthcare providers emphasize that most people will not experience these side effects, but risk rises with higher doses and longer use, underscoring the need for individualized medical guidance when managing pain, fever or infection.