Do Ambien (zolpidem) or Adderall (amphetamine and dextroamphetamine) have ototoxicity as an adverse effect?

From the Guidelines

Neither Ambien (zolpidem) nor Adderall (amphetamine/dextroamphetamine) is typically associated with ototoxicity as an adverse effect. Ototoxicity, which refers to damage to the inner ear or auditory nerve leading to hearing loss or balance problems, is not a commonly reported side effect for these medications. Ambien is a sedative-hypnotic medication used for short-term treatment of insomnia, with common side effects including drowsiness, dizziness, headache, and potential for dependence. Adderall is a stimulant used to treat ADHD and narcolepsy, with common side effects including increased heart rate, elevated blood pressure, insomnia, decreased appetite, and anxiety.

Key Points to Consider

• Medications that are known to be ototoxic typically include certain antibiotics (like aminoglycosides) 1, chemotherapy drugs (like cisplatin), loop diuretics (like furosemide), and high doses of aspirin or NSAIDs.
• The provided evidence 1 discusses ototoxicity in the context of aminoglycoside antibiotics, which is not relevant to Ambien or Adderall.
• If you're experiencing hearing changes while taking either Ambien or Adderall, you should consult your healthcare provider as this could be related to another cause or an uncommon reaction that should be evaluated.

Important Considerations for Ototoxicity

• Ototoxicity is a significant concern with certain medications, particularly aminoglycoside antibiotics, as it can lead to permanent hearing loss or balance problems 1.
• Regular audiometric testing is recommended for patients receiving ototoxic medications to monitor for signs of hearing loss or vestibular disturbances 1.

From the Research

Ototoxicity of Ambien and Adderall

• There is no direct evidence in the provided studies that Ambien (zolpidem) or Adderall (amphetamine and dextroamphetamine) have ototoxicity as an adverse effect 2, 3, 4, 5, 6.
• The studies primarily discuss ototoxicity associated with other classes of drugs, such as diuretics, anti-inflammatory agents, antineoplastic agents, aminoglycoside antibiotics, and certain chemicals 2, 5.
• Some studies mention the importance of monitoring for ototoxicity and the challenges in diagnosis and treatment 3, 4.
• One study identified potential ototoxic adverse drug reactions for certain drugs, including hydroxyzine and sucralfate, but did not mention Ambien or Adderall 6.

Classes of Drugs with Known Ototoxicity

• Aminoglycoside antibiotics 2, 4, 5
• Antineoplastic agents 2, 4
• Diuretics 2, 5
• Anti-inflammatory agents 2
• Loop diuretics 4, 5
• Calcium channel blockers 4
• Non-steroidal anti-inflammatory drugs 4
• Antimalarial drugs 4, 5
• Salicylates 4, 5

Importance of Monitoring and Prevention

• Monitoring for ototoxicity is crucial in preventing permanent hearing loss and balance impairment 3, 4.
• Early detection of toxicity through prospective ototoxicity monitoring allows for consideration of treatment modifications to minimize or prevent permanent hearing loss and balance impairment 3.