Ototoxic Medications and Vestibular Disorders: What You Need to Know

Ototoxic Medications and Vestibular Disorders: What You Need to Know

Ototoxic medications are medications that can cause damage to the ear, resulting in hearing loss, imbalance, dizziness and more (1-4). Learn more about ototoxic medications, vestibular disorders, symptoms and strategies to help.

What is Ototoxicity

“Oto” means ear, “toxicity” meaning hazardous or poisonous (1). Certain medicines or medications used for other health conditions can damage the inner ear (1-4). This can lead to hearing and balance changes (1-4).

Not everyone that uses an ototoxic medication experiences these effects. It is important to know if a medication being prescribed is considered ototoxic to monitor and adjust with ones medical team. This if further discussed below in “Preventing or Minimizing Possible Ototoxic Side Effects”. Other considerations is the goal of the medication being prescribed that is listed as ototoxic. Many of these medications are life saving, or helping another condition from progressing where the benefits of the medication outweigh the risks (1,2,4).

What Medications are Ototoxic

Listed below are just a few of the over 200 medications that are ototoxic medications (1,2). Medications have differing severity of ototoxic effect. Some medications are known to cause permanent damage, others may cause temporary damage. Other considerations with ototoxic medications is that the ear may be more susceptible to loud noises, causing more hearing damage than a loud noise would if not taking an ototoxic medication (1,2,4).

Other considerations include personal factors: medical history, family history of sensitivity to ototoxic medications, number of ototoxic medications being taken, dosage and length of time on an ototoxic medication.

Symptoms of Ototoxicity

Symptoms of ototoxicity can be various in type and severity. Listed below are some commonly reported symptoms of ototoxicity. For those living with vestibular conditions, these list of symptoms may feel very familiar, as similar areas of the ear can be impacted. Rehabilitation considerations can include addressing impairments found during evaluation just like any other PT visit. From experience, those with confirmed or suspected ototoxicity can present similar to a vestibular neuritis or labyrinthitis. Addressing balance and other aggravating movements, starting slow and gradually building up the challenge level in vestibular rehab is something that those with ototoxicity can benefit from (1).

Does Everyone Taking An Ototoxic Medication Experience This?

No, this does not happen to every single person that takes an ototoxic medication (1,4). Ototoxicity is a side effect to certain medications. Typically medications have multiple side effects listed but not every person experiences every single side effect. It’s important to remember genetic predisposition (history of family members being sensitive to ototoxic medications), number of medications being taken that are ototoxic, dosage and duration these medications are being taken (1,4). These are all factors that play into someone experiencing ototoxic effects. Learn more about strategies to help prevent or minimize the effects of ototoxicity.

Preventing or Minimizing Possible Ototoxic Side Effects

As noted above, some ototoxic medications have permanent damage, others are temporary. This is why talking with the prescribing doctor to have a plan for monitoring and adjustment based on an individuals response is important. This should also include hearing tests before and during medication use (2,3,4). Hearing tests should consist of high pitch testing, word recognition and and other baseline testing discussed with your provider as beneficial (1-4).

Preventing or Minimizing Possible Ototoxic Side Effects

• Open communication with provider
• Baseline hearing test and during medication use to monitor possible changes
• Use of hearing protection
• Consider whole body health habits that could be impactful

Using hearing protection can be a good habit to begin with. Knowing that taking an ototoxic medication can worsen hearing damage from loud noises, hearing protection can be even more vital (2). Having something on hand to use at a moments notice is ideal. We recommend loop ear plugs or other concert earplugs. Those in Vestibular Group Fit also love loops, you can check them out here.

Another interesting point mentioned when looking into this topic is overall health habits that could be impactful. Healthy foods that provide vital nutrients, anti oxidant and anti inflammatory benefits, exercise to help with improved blood flow and reduced inflammation, proper hydration could all support the body in beneficial ways, including the structures of the ear (4). There isn’t direct research to lifestyle habits and any impact when taking ototoxic medications currently. Having a holistic approach and habits that improve overall health is something we will always have on our radar to improve or implement.

Ready to Take the Next Step Towards Healing?

If you’re looking for a supportive, expert-led space to help you regain confidence, reduce symptoms, and rebuild your life after a vestibular diagnosis, join us in Vestibular Group Fit.

This unique coaching program combines movement, education, nervous system retraining, and community — all designed specifically for people living with vestibular disorders. Whether you’re newly diagnosed or have been struggling for years, you are not alone and you can feel better.

👉Click here to join Vestibular Group Fit and starting your healing journey today.

Citations

1. Ototoxicity. (2025, June 2). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/24769-ototoxicity
2. Barbara Cone, PhD, CCC-A, ASHA Fellow, Professor of Speech Language and Hearing Sciences at the University or Arizona, Tucson; Patricia a. Dorn, PhD, CCC-A, Interim Director of the Rehabilitation Research & Development Service at the Department of Veterans Affairs; Dawn Konrad-Martin, PhD, CCC-A, Research Investigator at the VA National Center for Rehabilitative Auditory Research in Portland, OR; Jennifer J. Lister, PhD, CCC-A, Director of the Audiology Graduate Program at the University of South Florida; Candice E. Ortiz, AuD CCC-A, Clinical Audiologist at Coastal Hearing and Balance Center, New Jersey. (n.d.). Ototoxic Medications (Medication Effects). American Speech-Language-Hearing Association. https://www.asha.org/public/hearing/ototoxic-medications/?srsltid=AfmBOor4rEj_dhA3SrpeyTgsAf3xO6Q4YTngBhY08U18SAxF1rw62zmO
3. Lindeborg, M. M., Jung, D. H., Chan, D. K., & Mitnick, C. D. (2022). Prevention and management of hearing loss in patients receiving ototoxic medications. Bulletin of the World Health Organization, 100(12), 789–796A. https://doi.org/10.2471/BLT.21.286823
4. Admin, & Admin. (2024, December 2). Medications that may harm your hearing. Family Hearing Care. https://familyhearingcare.com/medications-that-may-harm-your-hearing/