From the Guidelines
Several antihypertensive medications, including diuretics, beta-blockers, ACE inhibitors, and calcium channel blockers, have been associated with tinnitus as a potential side effect. The most common culprits are:
- Diuretics (water pills): Especially loop diuretics like furosemide (Lasix) and bumetanide (Bumex) 1
- Beta-blockers: Such as metoprolol, atenolol, and propranolol 1
- ACE inhibitors: Including lisinopril and enalapril 1
- Calcium channel blockers: Like amlodipine and nifedipine 1 If you're experiencing tinnitus and taking one of these medications, don't stop taking them abruptly. Instead, consult your doctor about potentially adjusting your dose or switching to an alternative medication. The mechanism behind this side effect is often related to changes in blood flow or electrolyte balance, which can affect the inner ear 1. In many cases, the tinnitus may be temporary and resolve once your body adjusts to the medication or if the medication is changed. Always report any new or worsening symptoms to your healthcare provider to ensure proper management of both your blood pressure and potential side effects.
The choice of antihypertensive medication should be based on the individual patient's needs and medical history, taking into account the potential risks and benefits of each medication 1. It's essential to weigh the benefits of blood pressure control against the potential risks of side effects like tinnitus. In general, the benefits of antihypertensive therapy, including reduced morbidity and mortality, outweigh the risks of side effects like tinnitus 1.
In terms of management, a triple drug regimen of an ACE inhibitor or ARB, calcium channel blocker, and a thiazide diuretic can be effective and generally well tolerated 1. However, the treatment of hypertension should be individualized, and the choice of medication should be based on the patient's specific needs and medical history. If tinnitus occurs, alternative medications or adjustments to the current regimen can be considered to minimize this side effect.
From the Research
Antihypertensive Medications Associated with Tinnitus
- The study 2 mentions that certain medications, including ototoxic antibiotics and diuretics, can induce unwanted tinnitus.
- Specifically, diuretics are listed as a class of medications that can cause tinnitus 2.
- Another study 3 discusses the adverse reactions of anti-hypertensive drugs, including diuretics, and mentions that they can cause various skin symptoms, but does not specifically mention tinnitus.
- However, the study 3 does mention that certain anti-hypertensive drugs, such as hydralazine, can cause lupus erythematosus-like eruptions, eczema, or urticaria, which may be related to tinnitus in some cases.
- The study 4 discusses the use of vasodilators, including hydralazine and prazosin, in the treatment of hypertension, but does not mention tinnitus as a side effect.
- The study 5 mentions that certain prescription drugs, including nonsteroidal anti-inflammatory drugs and steroids, can affect blood pressure, but does not specifically discuss tinnitus.
- The study 6 discusses the blood pressure lowering efficacy of beta-blockers as second-line therapy for primary hypertension, but does not mention tinnitus as a side effect.