The following is a simplified list of ototoxic drugs and lists the most commonly used drugs. (There are many other drugs that are potentially ototoxic, but their effects are minimal, so they are not listed here. But be sure to ask your doctor before taking them) The following drugs are listed for reference. 1. Salicylates – aspirin and drug products containing aspirin; toxicity usually occurs after an average daily dose of 6-8 pills; toxicity is reversible and disappears as soon as drug therapy is stopped. 2. Non-steroidal anti-inflammatory drugs (NSAIDS): Advil, Aleve, Anaprox, Clinoril, Feldene, Indocin (chlorobenzoylmethoxymethylindoleacetic acid), Lodine, Motrin, Nalfon, Naprosyn, Nuprin, Poradol. Toxic effects usually occur after Toxic effects usually appear after an average dose of 6-8 pills per day; they are reversible and disappear as soon as the drug treatment is stopped. 3. Antibiotics – Amino-glycerol glycoside antibiotics, Erythromycin, Vancomycin Amino-glycerol glycoside antibiotics – Streptomycin, Caramycin, Neomycin, Gentamicin, Topomycin, Amino-hydroxybutyl kanamycin A (i.e., antimicrobial BBK8), Neurontin These drugs are ototoxic when administered intravenously when the patient’s life is in danger. The patient’s blood levels are usually monitored to avoid ototoxicity. Hearing loss includes these antibiotics, neomycin and gentamicin, but they have not been shown to be ototoxic. Erythromycin – Erythromycin (antibiotic) EES, Eryc, E-mycin, Ilosone, Pediazole and the newer variants of erythromycin – Biaxin, Zithromax Erythromycin can be ototoxic when administered intravenously at 2-4 grams per 24 hours. It is especially toxic when the patient has kidney problems. The average oral dose of erythromycin per 24 hours is not sufficient to cause ototoxicity. There is no significant documentation that the newer extensions of erythromycin cause ototoxicity at oral doses and lower intravenous doses. Vancomycin-Vancomycin: This antibiotic is administered in a similar manner to antibiotics, meaning that ototoxic reactions may occur when vancomycin is administered intravenously to patients with life-threatening conditions. And vancomycin is usually used with antibiotics, which increases the likelihood of ototoxic deafness. 4. Diuretics – Lasix, Edecrin, Bumex These drugs are ototoxic when given intravenously for the treatment of acute nephritis or acute hypertension. However, there are few reports of ototoxicity when these drugs are administered orally in high doses to patients for the treatment of chronic kidney disease. Chemotherapeutic agents – Cisplatin, Nitrogen Mustard, Vincristine These chemotherapeutic agents are ototoxic when used as treatment for cancer. However, ototoxicity can be minimized by maintaining the drug levels in the blood and implementing continuous hearing acuity charts. However, if a cancer patient is taking antibiotics or diuretics at the same time, the ototoxicity hazard will increase. 6. Quinine – Aralen, Atabrine (for malaria), Legatrin, Q-Vel Muscle relaxation (for night cramps) Quinine causes ototoxicity similar to aspirin, and the effects are usually reversible: once the drug treatment is stopped the toxicity disappears when the drug is stopped. Just as you are solely responsible for your health, you must protect your hearing now or protect what is left of it now. Understanding these ototoxic drugs and the harm they can cause is a good protection for yourself and a worthwhile investment in your health!