Written by Karen Collins
I’ve never heard anyone speak of what may be even more commonly damaging their ears: medications.
Surprisingly, hearing damage isn’t something we often talk or write about in the world of audio. If anything, we associate hearing damage with loud sounds, and we all know to take precautions against any sounds that may cause damage to our delicate and precious organs. We have SPL meters on our phones and gracefully excuse ourselves from situations that top 90dB, knowing that we may be risking some damage if we stay. We use ear muffs when we’re out recording loud sounds. But I’ve never heard anyone speak of what may be even more commonly damaging their ears: medications.
This includes common drugs like aspirin, acetaminophen (paracetamol), and ibuprofen, but also other painkillers, anti-depressants, antibiotics, and other medications.
Medications that damage hearing are called ototoxic (“oto” meaning “ear” and toxic meaning poisonous!). Our ears are very delicate and sensitive organs, and any medication may have some impact on your hearing. You have most likely taken some ototoxic medications without even knowing it. And for the most part, you probably got away with it. But taking any medication for a long period of time, or in large quantities, can cause permanent, irreversible hearing loss. This includes common drugs like aspirin, acetaminophen (paracetamol), and ibuprofen, but also other painkillers, anti-depressants, antibiotics, and other medications. We rarely read the fine print in taking medications (particularly those we buy off-the-shelf like aspirin), assuming that these are safe if they’re sold in stores everywhere. If we do read the fine print, we assume that the effects are rare. But millions of people are affected by ototoxic medications every single year. Some drugs have an almost 100% guarantee of causing hearing loss! Are you willing to take that risk and potentially do permanent damage to your hearing? I’m not a medical doctor, but I put together this brief guide to raise awareness—talk to your own doctor if you take any medication regularly.
How do I know if I’m taking an ototoxic drug?
There are 743 known ototoxic drugs. There is a list of a few here.
Just because a drug is not on that list does not mean it is not ototoxic. Acetaminophen is not on the list, but two studies, in 2010 and 2012, found that acetaminophen is even more toxic than Aspirin and NSAIDs. It is even worse when taken in combination with painkillers (as in the case of Vicodin. I’m always surprised when rock stars get addicted to a drug that will likely cause permanent hearing damage).
There are some studies that suggest that other medications may help to offset the effects (such as melatonin with certain ototoxic anti-cancer drugs)
The first sign of ototoxicity is usually tinnitus (ringing or buzzing in the ears). Other symptoms include light-headedness, vertigo, and hearing loss. If you experience symptoms, talk to your doctor about your medications and if you can, lower the dosage or find an alternative. There are some studies that suggest that other medications may help to offset the effects (such as melatonin with certain ototoxic anti-cancer drugs) . Often the symptoms will go away once the drug has cleared your system. However, sometimes, the damage will be permanent and there is no cure and no treatment to reverse the damage.
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What should I do to protect my hearing?
Be aware of ototoxic medications. If you are on any medication known to be ototoxic, talk to your doctor about finding an alternative. Avoid taking any painkillers if you can tough it out, since pretty much all analgesics and anti-inflammatories are known to be ototoxic. If you are on medication and you get tinnitus, weigh the pros and cons of the medication and talk to your doctor. Let your doctor know that you work in sound and you don’t want to take any ototoxic medications unless absolutely necessary. Do your own research and educate yourself on the risks and benefits of any medication.
A drug I take is not on the list of ototoxic medications, but I still have tinnitus.
Talk to your doctor and ask if the drug may be ototoxic. Remember, just because it’s not on the list does not make it safe, and your doctor may not be aware of the risks. Do a Google Scholar search through medical journals and see if others have reported hearing loss or tinnitus with your medication. It could be it’s just not reported, yet, but it may be ototoxic.
Left untreated, and with continued use, ototoxic medications can lead to permanent hearing damage. Be aware. Be careful taking any drug, and let your friends in the audio world know about ototoxicity. Take your health into your own hands and become knowledgeable about your ears.
A big thanks to Karen Collins for the insights on this overlooked risk!
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Cinematic & Trailer Sound Effects Four Elements – Elemental Magic Play Track 3050 sounds included, 251 mins total $149
Master the Art of Bending the Elemental Forces
Unleash the raw power of fire, water, earth, and air with this comprehensive 9 GB sound library featuring 3050 high-quality sound effects across 630 files. Whether you’re designing cinematic soundscapes or enhancing video games Four Elements delivers the tools you need to harness the energy of the natural world.
Construction Kit – 2443 Sounds
A treasure trove of raw, organic, and processed sounds including seamless loops divided into Fire, Water, Air, Earth and Explosion categories. Customize every detail with an extensive selection of sound components.
- Organic Fire: Campfire sizzles, torch whooshes, and flame bursts.
- Processed Fire: Distorted impacts and unique crackles.
- Organic Earth: Rock crashes, gravel scrapes, and heavy stone hits.
- Processed Earth: Stylized rumbles and granular textures.
- Organic Water: Ocean waves, hydrophone bubbles, and fluid splashes.
- Processed Water: Underwater whooshes and stylized liquid smashes.
- Organic Air: Bamboo swishes, cloth movements, and pressure bursts.
- Processed Air: Filtered gusts and dynamic noise sweeps.
- Explosion: Firework detonations, Butane bursts, and cinematic impacts.
Building Blocks – 416 Sounds
Game-ready sound layers featuring Impacts, Whooshes, and Textures as seamless loops. Elevate transitions and enhance atmospheres with loops and pre-designed sound layers.
- Fire: Explosive bursts, blazing infernos, and warm embers.
- Earth: Ground-shaking impacts, crumbling terrain, and heavy collisions.
- Water: Cascading waves, serene rivers, and underwater ambiences.
- Air: Whispering breezes, stormy turbulence, and slicing gusts.
Design Kit – 192 Sounds
A collection of ready-to-use sound effects divided into Attack, Bend, and Explosion categories for quick integration into your projects. Perfect for high-energy scenes and immersive storytelling.
- Fire: Crackling flames, fiery bursts, and roaring infernos.
- Earth: Crushing impacts, shifting ground, and massive land eruptions.
- Water: Splashes, fluid manipulations, and crashing tidal waves.
- Air: Slicing winds, swirling currents, and thunderous gusts.
Four Elements gives you complete creative control, blending organic recordings with processed sound layers to meet the demands of any project. Master the forces of nature with Four Elements. Let your creativity ignite.
Keywords:
Elements, Fire, Water, Earth, Air, Wave, Water, Liquid, Rock, Cast, Stone, Pebble, Torch, Gas, Flame, Campfire, Sizzle, Burst, Scrape, Whoosh, Impact, Texture, Attack, Bend, Bending, Explosion, Processed, Surge, Quake, Hit, Flow, Burn, Ignite, Drop, Smack, Destruction, Rumble, Hiss, Blow, Wind, Cloth, Movement, Underwater, Bubble, Ocean, River, Lake, Firework, Firecracker, Bang, Blast, Detonation, Magic, Fantasy, Forces, Fire Magic, Water Magic, Earth Magic, Fire Air, Fire Effect, Fire Whoosh, Water Whoosh, Seamless Loop, Loop, Fire Cast, Water Cast, Earth Cast, Air Cast
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THE RAW SOUND OF CINEMATIC FIGHTING VIOLENT COMBAT is a professional sound effects library built for fight scenes that demand impact. Packed with punch sound effects, fight sound effects, and powerful combat sound effects, it delivers everything from raw realism to over-the-top cinematic action. With improved fidelity and greater variation than its predecessor CLOSE COMBAT, this collection gives sound designers production-ready audio for film, TV, and games.
From Realism to Cinematic ExaggerationDial in the tone you need with dedicated categories: Martial Arts, Grounded, Over The Top, and Gory. Whether it’s kung fu sound effects, karate sounds, or exaggerated wrestling hits, you can shift seamlessly from authentic to stylised.
Successor to Close CombatVIOLENT COMBAT builds on the legacy of CLOSE COMBAT with higher fidelity recordings, better-organised categories, and more variation. It’s the ideal companion, giving you the flexibility to cover every style of fight scene.
Sounds That Land With ForceRecorded with a wide range of props and techniques, each fighting sound effect has real weight. Where needed, selective pre-processing boosts impact, avoiding the flat results of real fight recordings.
Production-Ready and VersatileEqually at home in film, TV drama, high-end game audio, or immersive theatre. From knockout sound effects to stylised fight sequences, Violent Combat is ready to drop straight into your mix.
Included Sounds – KEYWORDS
AIR, BODYFALL, CLOTH, CRUNCH, FINISHER, FURNITURE, GORE, GRAB, GRAPPLE, IMPACT, KICK, LEATHER, MARTIAL ARTS, METAL, MOVEMENT, PLASTIC, PUNCH, SLAP, SWISH, SWOOSH, THROW, WHOOSH
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638 meticulously processed stereo fire spells sound effects recorded in 96 khz and 24 bits for high audio definition.
The collection comes with hundreds of variations, more than 1 hour of content and many different type of fire spells. It also includes source sounds for more flexibility for your projects.
This collection is perfect for any films, video games or trailers.
The library is fully focused on fire spells. You will find simple one shot magic firebolt, powerful high level fire spells, fire sword, berserker enchantments and so on. Spells such as fireball, firewall, rain of fire, meteor, fire nova, magma storm, pyroblast, sword of Avernus, etc. are included in this library.
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Here are the references for the article:
M. Bisht and S.S. Bist. Ototoxicity: The Hidden Menace. Indian Journal of Otolaryngol head and Neck Surgery, 2011, July Vol 63/3 255-259
There are separate more in-depth lists of drugs and their effects here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3138949/
S. Curhan, J. Shargorodsky, R. Eavey and G.C. Curhan, Analgesic Use and the Risk of hearing Loss in Women. American Journal of Epidemiology, Volume 176, Issue 6, 15 September 2012, Pages 544–554;
J. Yorgason, G. Kalinec, W.Luxford, et al. Acetaminophen ototoxicity after acetaminophen/hydrocodone abuse: Evidence from two parallel in vitro mouse models, Otolayrngology—Head and Neck Surgery Vol 142, Issue 6, 2010.
R.J. Reiter, D.X. Tan, A. Korkmaz, L Fuentes-Broto. Drug-mediated ototoxicity and tinnitus: alleviation with melatonin. Journal of Physiological Pharmacology. April 2011, Vol 62/2 151-7.