ADRs Affecting the Ears

Dizziness is the most common potential ADR associated with therapeutic dosages of the top 200 drugs dispensed by U.S. community pharmacies.9 It is an imprecise term describing various related sensations such as faintness, a feeling of impending syncope; light-headedness; and a feeling of imbalance.25 A false sensation of movement of self or the environment is called vertigo.8,25 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.8 Ototoxic drugs may also cause tinnitus described by patients as noise in the ears such as buzzing, ringing, roaring, whistling, hissing, or pulsating.8,25 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).25