When we think about the side effects of medicines, we might think of nausea, fatigue or dizziness. But there’s another, lesser-known risk that can have lasting – and sometimes permanent – consequences: hearing loss. A wide range of prescription and over-the-counter drugs are known to be ototoxic, meaning they can damage the inner ear and affect hearing or balance.

Ototoxicity refers to drug or chemical-related damage to the cochlea, which affects hearing, and the vestibular system, which controls balance. Symptoms can include tinnitus (ringing in the ears), hearing loss (often starting with high-frequency sounds), dizziness or balance problems or a sensation of fullness in the ears.

These effects can be temporary or permanent, depending on the drug involved, the dose and duration and a person’s susceptibility.

The inner ear is highly sensitive, and most experts believe ototoxic drugs cause damage by harming the tiny hair cells in the cochlea or disrupting the fluid balance in the inner ear. Once these hair cells are damaged, they don’t regenerate – making hearing loss irreversible in many cases.

Around 200 medicines are known to have ototoxic effects. Here are some of the most commonly used drugs to watch out for:

Aminoglycoside antibiotics like gentamicin, tobramycin and streptomycin are typically prescribed for serious infections such as sepsis, meningitis, or tuberculosis – conditions where prompt, aggressive treatment can be lifesaving. In these cases, the benefits often outweigh the potential risk of hearing loss.

These drugs, usually given intravenously, are among the most well-documented ototoxic medications. They can cause........

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