Why does aspirin (acetylsalicylic acid) cause tinnitus and dizziness?

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From the FDA Drug Label

These could be signs of a serious condition If pregnant or breast-feeding, ask a health professional before use. Stop use and ask a doctor if ringing in the ears or a loss of hearing occurs

Aspirin can cause tinnitus (ringing in the ears) and dizziness as it may be a sign of a serious condition.

  • The exact mechanism is not explicitly stated in the label, but it is listed as a reason to stop use and ask a doctor.
  • It is recommended to seek medical help if these symptoms occur. 1

From the Research

Aspirin can cause tinnitus and dizziness, particularly at higher doses, due to its effects on the inner ear, and individuals should consult their healthcare provider if they experience these symptoms while taking aspirin. The most recent and highest quality study, published in 2022 2, found that frequent moderate-dose aspirin use was associated with a higher risk of incident persistent tinnitus among younger women, while frequent low-dose aspirin use was not associated with an increased risk.

Mechanism of Action

Aspirin affects the inner ear by reducing blood flow to the cochlea and interfering with electrolyte balance in inner ear fluids, specifically by inhibiting prostaglandin production, which normally helps regulate blood flow and fluid balance in the inner ear 3, 4. Additionally, aspirin can directly affect the outer hair cells in the cochlea, altering their function and contributing to tinnitus 5.

Dose-Dependent Effects

The side effects of aspirin on the inner ear are typically dose-dependent and reversible, usually occurring at doses exceeding 2,400 mg per day, although some sensitive individuals may experience symptoms at lower doses 6.

Clinical Implications

If individuals experience tinnitus or dizziness while taking aspirin, they should consult their healthcare provider, who may recommend reducing the dose or switching to an alternative medication 2. These symptoms generally resolve within 24-72 hours after stopping or reducing aspirin intake. People with pre-existing hearing problems or vestibular disorders should be particularly cautious when using aspirin.

Key Points

  • Aspirin can cause tinnitus and dizziness, particularly at higher doses
  • The effects of aspirin on the inner ear are dose-dependent and reversible
  • Individuals should consult their healthcare provider if they experience tinnitus or dizziness while taking aspirin
  • People with pre-existing hearing problems or vestibular disorders should be cautious when using aspirin

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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