Aspirin’s ototoxicity

Aspirin is known to be an ototoxic drug. This means it can potentially cause damage to the inner ear and affect hearing and/or balance.

Here are the key points regarding aspirin’s ototoxicity:

1. Main Effects:
   • Tinnitus: This is one of the most common symptoms of aspirin ototoxicity. It’s the perception of ringing, buzzing, or other noises in the ears in the absence of an external sound source.
   • Hearing Loss: Aspirin can cause hearing loss, usually sensorineural (damage to the inner ear or nerve pathways). This hearing loss often affects high frequencies and can range from mild to moderate.
2. Dose Dependency:
   • Aspirin’s ototoxicity is generally dose-dependent. The risks and severity of symptoms increase with higher doses and prolonged use.
   • Low doses of aspirin (e.g., those used for cardiovascular prevention, like 75 mg or 100 mg daily) are much less likely to cause significant hearing problems than higher doses used to treat pain, fever, or inflammation (e.g., 325 mg to 650 mg or more per dose, several times a day).
3. Reversibility:
   • In most cases, the ototoxic effects of aspirin, such as tinnitus and hearing loss, are temporary and reversible after stopping the medication or reducing the dose. Hearing usually returns to normal within a few days.
   • However, very high doses (overdose) or prolonged use of high doses could potentially lead to more persistent damage, although this is rarer.
4. Mechanism:
   • Aspirin is thought to affect the function of the outer hair cells in the cochlea (a part of the inner ear crucial for hearing). It might also influence blood flow to the inner ear or have effects on neurotransmitters in the auditory pathways.
5. Individual Sensitivity:
   • Some individuals may be more sensitive than others to the ototoxic effects of aspirin, even at lower doses.

If you are taking aspirin (including brand names like Askardil®) and you develop tinnitus, a feeling of fullness in the ear, or a decrease in hearing, it is important to inform your doctor. They can assess the situation and advise you on the best course of action. Never change or stop a prescribed treatment without first consulting a healthcare professional.

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