ADRs Affecting the Ears

Dizziness was the most common potential ADR associated with therapeutic dosages of the top 200 drugs dispensed by U.S. community pharmacies in 2008.¹⁵ It is an imprecise term describing various related sensations such as faintness, a feeling of impending syncope; light-headedness; and a feeling of imbalance.³⁵ A false sensation of movement of self or the environment is called vertigo.^14,35 Because these symptoms overlap, patients often use the terms dizziness and vertigo interchangeably.

Ototoxic drugs that affect the vestibular apparatus result in vertigo; cochlear ototoxicity results in  hearing loss.¹⁴ Ototoxic drugs may also cause tinnitus described by patients as noise in the ears such as buzzing, ringing, roaring, whistling, hissing, or pulsating.^14,35 Potentially ototoxic drugs include salicylates; antibiotics such as vancomycin, metronidazole, clindamycin, aminoglycosides (e.g., gentamycin and tobramycin), and macrolides; diuretics (e.g., furosemide); and antineoplastic agents (e.g., cisplatin).³⁵