There is a silent epidemic in this country. When we say silent, that is actually paradoxical because the condition we are talking about is known as tinnitus. It is silent because only the victims can hear the sounds. Their ears ring in ways that can only be described as torture.
Over 20 million Americans suffer from these sounds and about a third have near constant symptoms (JAMA Otolaryngology Head & Neck Surgery, Oct. 1, 2016). Friends, family and co-workers cannot fully understand or appreciate the challenges of tinnitus. The causes are varied, but a surprising number of drugs can trigger tinnitus.
What Does It Feel Like When Your Ears Ring?
Have you ever tried to fall asleep with a mosquito whining near your ears? The sound can be nerve wracking. Now imagine crickets chirping or a tea kettle whistling without stopping. That’s what millions of people have to contend with day and night.
The constant ringing, hissing, buzzing, humming, chirping, whooshing or roaring can be disabling. It can be hard to concentrate or get a good night’s sleep when you are listening to noises you cannot turn off.
One reader describes how his ears ring this way:
“I’ve had problems sleeping due to the sound of helicopters and lawn mowers in my ears. I was sure that a helicopter was flying overhead, way up in the sky. As a result, I couldn’t sleep for a week straight. When I looked it up, I found that this might be tinnitus.
“I used to wear headphones and turn the volume way up when I was in my teens. There should be a warning about this disease!”
Jimmy’s ears ring in a different way:
“I’ve been hearing the crickets in my ears 24/7 for the last two to three months and it’s starting to drive me crazy. I’ve been on prednisone for a few months for a rash on my left foot and now that I have this problem I would rather have the rash back than to hear this all day. It never goes away.”
Another reader also hears crickets. She actually thought:
“A nest of crickets were hanging out in my ear canal.”
She tried to record the sound until she realized the sound was actually in her head and not in her ears. No one else could hear it.
Drugs That Make Ears Ring:
Many readers report that their tinnitus is triggered by medications. Many are searching for solutions.
Q. Are there are any updates on possible solutions for tinnitus? My ears just started hissing in the last two weeks, and it’s quite distressing.
I take Tylenol and Aleve for severe arthritis in my knee. I read that these pain relievers might cause tinnitus. This spring and summer, I’ve taken more Aleve and Aleve PM than before.
I could forgo the Aleve. I also have taken Tylenol PM for years to sleep, but I could just take plain Benadryl.
I’ve seen advertisements for a cure for tinnitus, and I am curious. Is there really help out there?
Common Culprits Behind Tinnitus:
A. Nonsteroidal anti-inflammatory drugs such as aspirin, naproxen (Aleve, Naprosyn), ibuprofen (Advil, Motrin IB), celecoxib (Celebrex), diclofenac (Voltaren) and (meloxicam (Mobic) can all trigger ringing in the ears (tinnitus). Even acetaminophen (Tylenol) has been linked to this adverse drug reaction (Journal of General Internal Medicine, Nov. 2022).
There are no FDA-approved medications to treat ringing in the ears, although we list a few treatments below. In March 2023, the agency did approve a “bimodal neuromodulation device” to ease tinnitus symptoms. It is called Lenire, from the Latin word meaning “to relieve.” This device works by “pairing mild electrical stimulation of the tongue with sound stimulation.” It will require a prescription and may cost a few thousand dollars. Insurance companies may decline to cover it.
Another reader had a bad experience with meloxicam:
“Please warn everyone out there—meloxicam worsens tinnitus! I had been living with very mild tinnitus for years when my doctor prescribed meloxicam for pain caused by spondyloarthropy. He told me it was a very strong drug and to watch for signs of gastric trouble, but he didn’t mention ototoxicity despite knowing I have tinnitus.
“Within a few days of being on meloxicam, suddenly one night while I was reading peacefully in bed, it was as if someone turned up the volume on my tinnitus to three times what it was before. It’s been three years now, and it has never returned to its formerly mild condition. Let your readers know about meloxicam. Pain is bad, but a constant ringing in your ears can be much worse.”
Ears Ring After Naproxen (Aleve):
M.J. shared this story about tinnitus and NSAIDs:
“I was prescribed Aleve for a foot fracture several years ago. After a day or two on Aleve my ears started ringing when it was quiet. It sounded like machinery and I actually hobbled out of bed to see if something had been left on somewhere in the house.
“I did a little reading the next day and immediately stopped the Aleve. While the tinnitus lessened as time went on, it didn’t stop for months. Fortunately, it was only at night. I haven’t had a similar reaction on ibuprofen or Tylenol.”
Steve used NSAIDs for 40 years and his ears ring:
“I first started having tinnitus a little over 20 years ago. My hearing tests indicated that I’d lost hearing in the upper range. I was told that I’d lost that forever.
“When I was a young man some 40 years ago I’d had bouts of vertigo which may have been a precursor to Meniere’s. But I never had the tinnitus that I have now.
“Eventually the dizziness subsided. The tinnitus has remained and can be deafening. I don’t know how I do it, but I’m able to ignore it for the most part. While I’m writing this it’s very loud and noticeable but as soon as I divert my attention to something else, I’ll be able to block it out.
“I’ve always wondered if the heavy use of NSAIDs has been the root cause of my tinnitus. Due to some nearly debilitating orthopedic issues I’ve been a regular user of them for nearly 40 years. I started with aspirin to help with swelling in my knee (at my surgeon’s advice) before moving on to Naprosyn. Neither was good for my stomach so I gave ibuprofen a shot. I’m talking about heavy continuous use to ease the pain and swelling. There seems to be a link, but I haven’t been able to confirm.”
Most definitely there is a link between NSAIDs and tinnitus. It is hard to prove, though, that when a particular person’s ears ring it is caused by aspirin, ibuprofen or naproxen.
Antibiotics and Tinnitus:
Antibiotics may also be culpable. Another reader offered this story:
“Tinnitus is an exhausting, chronic, invisible, anxiety-producing, depressing affliction. No one understands the toll it takes unless they too are sufferers.
“I believe a lifetime of sinus infections and antibiotics might have caused mine. An audiologist suggested using a box fan to help me sleep at night.
“I have suffered for at least 20 years. The only time I escape the noise is when I’m asleep.”
Can Tonic Water Make Your Ears Ring?
Tonic water is another potential trigger, and most people don’t think of it.
We heard from a reader about reversible tinnitus linked to tonic water:
“A few decades ago, I would frequent the bars after work. My drink of choice–vodka tonic. My ears rang all the time. After I stopped drinking all that tonic water, my tinnitus resolved.
“I didn’t connect the dots until years later when reading about the side effects of quinine to treat malaria. There might not be side effects with small amounts, but if you develop tinnitus, perhaps you should drink less tonic water.”
Other Drugs That Can Make Ears Ring:
The list is long, so we cannot include every drug that triggers tinnitus here.
Some of the medications that can causes ears to ring include:
Drugs That Trigger Tinnitus:
- Acitretin (Soriatane)
- Bumetanide (Bumex)
- Bupropion (Wellbutrin)
- Chloroquine (Aralen)
- Ciprofloxacin (Cipro)
- Clarithromycin (Biaxin)
- Desvenlafaxine (Pristiq)
- Divalproex (Depakote)
- Erythromycin (E.E.S)
- Escitalopram (Lexapro)
- Ethacrynic acid (Edecrin)
- Frovatriptan (Frova)
- Furosemide (Lasix)
- Gentamicin (Gentafair)
- Hydroxychloroquine (Plaquenil)
- Ibuprofen (Advil, Motrin)
- Isotretinoin (Accutane)
- Moxifloxacin (Avelox)
- Naproxen (Naprosyn)
- Paroxetine (Paxil)
- Pregabalin (Lyrica)
- Rivastigmine (Exelon)
- Tobramycin (Tobrex)
- Vancocin (Vancomycin)
- Venlafaxine (Effexor)
- Zonisamide (Zonegran)
No one should ever stop any medication without checking with the prescriber. Sudden discontinuation of many medicines can produce dangerous complications.
Treatments for Tinnitus?
There are no cures for tinnitus. Health care professionals have found that counseling, cognitive behavioral therapy or acoustic therapy may help some people (Neural Plasticity, July 1, 2020). Health professionals have tried many other strategies with variable success. They include:
- Stress reduction to help people cope
- Hearing aids to help with hearing and mask sounds
- Medications to ease anxiety (not recommended by the American Academy of Otolaryngology-Head and Neck Surgery Foundation)
- Biofeedback therapy to adapt
- Tinnitus Retraining Therapy when ears ring
- Masking devices that are worn
- Music Treatment to retrain the brain
- Nutritional Supplements
You can learn more about Tinnitus Retraining Therapy (TRT)and Neuromonics Tinnitus Treatment (NTT) to change how the brain processes the sounds that make the ears ring at this link:
We cannot make any recommendations for tinnitus treatments. In addition to TRT and NTT there are other approaches including Serenade, Widex Zen and Coordinated Reset Neuromodulation, and of course the Lenire device we mentioned above.
A review of such therapies in the journal Noise & Health (March-April, 2013) concluded:
“Many of the clinical interventions reviewed here comprise treatment regimes, which include sound stimulation in the context of a structured assessment and counseling package that is individualized to each patient profile. It has been argued that sound therapies actually result in little or no benefit over and above that offered by the psychological component of tinnitus therapy. Indeed psychological therapies, including cognitive behavior therapy, are well known to be effective at relieving tinnitus distress.
“…Although many of the recent technological innovations for individualized sound-based interventions make reference to central auditory mechanisms as a key, underlying principle for their efficacy, there is insufficient rigorous neurophysiological evidence as yet to strongly support those claims.”
Final Words When Your Ears Ring:
We would not discourage anyone from trying cognitive behavioral therapy or even one of the sound retraining strategies. Such treatments are not inexpensive, though. We would love to hear from you, our reader, to find out what has worked for you.
It is better to avoid the triggers that can cause tinnitus or make it worse. That means discussing tinnitus as a side effect at the first sign of ear ringing. There may be an alternative medicine that does not cause such a serious and potentially irreversible adverse reaction. Avoiding loud noises can also be important in preventing tinnitus.
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