Just a Warning About Ototoxic Drugs...

Hi....
An orchestra / marching band director as well as a professional musician for over 35 years ...... only to have what looks like permanent tinnitus from taking 6 months worth of Aggrenox as followup treatment for a minor TIA. What a vile drug ....headache every day, than the ringing began clusters of frequencies around 15k, continually for 3 more months increasing in volume. I hoped when I discontinued the drug the tinnitus would leave. It reduced in volume somewhat but rings on in my head. Should you suffer a ministroke, warn others to not take Aggrenox. There are other alternatives...Gaurding my hearing all those years for what......for it to be compromised by a pharmaceutical nightmare....

 

Just reading about Aggrenox-
Aggrenox contains a combination of aspirin and dipyridamole. Aspirin is in a group of drugs called salicylates (sa-LIS-il-ates). It works by reducing substances in the body that cause pain, fever, and inflammation.
Dipyridamole keeps platelets in your blood from sticking together to form clots.
Aggrenox is a capsule containing 25 mg aspirin and 200 mg dipyridamole.

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Aspirin side effect - ringing in the ears

 

Aggrenox is a terrific drug. It is a combination of aspirin and dipyridamole (Persantine), and it may well have spared you from having a major stroke. Aspirin in very high doses can cause temporary tinnitus; dipyradamole does not cause tinnitus.

The amount of aspirin in one or two Aggrenox capsules daily is nowhere near enough to cause tinnitus or to aggravate existing tinnitus. Moreover, even when aspirin is indeed taken in doses large enough to induce or aggravate tinnitus, the effects are 100% reversible upon cessation of the aspirin. Old-time rheumatologists used to tell their patients with joint pain to take aspirin - and to keep taking pill after pill until their pain got better, their stomach hurt, or their ears started ringing; then back off a bit.

You may never know what caused your tinnitus, but one thing is for certain: it wasn't the Aggrenox.

Here's to quieter days ahead for all -

Dr. Stephen Nagler

 

Here's the part most people don't understand about Aggrenox. The second element in the drug turns the 50 mg. Does not only inhibit the aggregation of platelets, but it enhances the action of the aspirin much more than the 50mg. Dose. It also is a vasodilation which has the modified aspirin moving through your brain delivering quite a punch not to mention constant headaches. I was on a baby aspirin 81mg. A day prior to my TIA and never suffered from any tinnitus. In fact I went back to 1 baby aspirin a day plus Plavix as the alternative. Before ibuprofen and Naprosyn became over the counter drugs I would take 2 or 3 aspirin for a Wolloping headache, and yes my ears would ring....but nothing like this ... and the ringing was short lived ason as you weren't habitually popping that much aspirin.
Bottom line...I should have stopped this drug immediately. . As soon as I noticed the ringing. Once again when starting any drug, don't try to tough it out and think the tinnitus will go away...get off immediately. .!

 

Correction...each aggrenox has 1 25mg aspirin tablet in it. Usual dose is 2 each day. 50mg. Definite interaction between the dipyridimol and aspirin. Warnings to get off immediately if tinnitus developed in the literature.

Dr. J. Serrenti ( phd. Music ...lol...)

 

Psssst.................I don't think it is a good idea to suggest that someone should stop taking any medication without first consulting their doctor..........or a doctor.......................
If I had a choice between a stroke and "T", I'd take the T any day!!!

 

@jserrent, I understand how upset and frustrated you are about this turn of events - but I really think it's important to read "the literature" critically. First of all, there are a lot of "CYA" warnings out there. In terms of hard data, however, the overall incidence of adverse reactions from Aggrenox is 80%, which appears to be quite high - until you see that in the same study the overall incidence of adverse reactions from taking placebo was 79%. In terms of tinnitus specifically, if you take the population of those who had any reaction at all to the drug, you find that the incidence of tinnitus was 0.42%. Moreover, as noted earlier even tinnitus from high doses of aspirin is reversible upon cessation of the drug.

I wish you didn't have tinnitus. And I totally get the fact that you wish you never took Aggrenox. But that would be emotion-based thinking rather than logic-based thinking. My concern is that folks might read your post and wind up placing themselves in considerable peril by staying away from a drug that might spare them from having a massive stroke.

Dr. Stephen Nagler

 

You're right, I do get worked up about this, because I feel I failed to move to an alternative more quickly. And the debate still goes on about Aggrenox vs. Plavix + baby aspirin. Bleeds are higher, not by much, with Aggrenox. Also I didn't come to this decision willy nilly........I let the cardiologist and neurologist figure it out. Cardiologists like the Plavix regime....neuro's like the standard protocol..
Aggrenox.

Also.... catscan....neg.
MrI ..... neg.
Mra ...... neg.
Carotid ulta.... neg.
Heart chambers neg.

Could have been from arterial spasms, but who's going to take that chance?

What I know is I had no tinnitus through or after the episode. The worst headaches were while on aggrenox and the blistering tinnitus joined the headaches 3 months into it. When I got off....the headaches stopped almost immediately, the tinnitus reduced in intensity but is still there. It's been almost a year, perhaps it will fade in time.

 

If possible stay off plavix.. its side effects are worst.. personal experience. .
For few percentage of people who take plavix the side effects are very bad.. i am one of the few who had very bad reaction to it..
fish oil and beet root juice are perfect alternative for blood pressure medication and blood thinners..
Blood thinners are not long term solution healthier life style is

 

I repeat...from numerous postings in the past. Please note this "equation":

Rx + HS + SXp = PT > 0

Where Rx is a drug of any kind.

Where HS is that drug having any possible or potential "Hearing Signature".

Where SXp is Sound Exposure in terms of "volume" and/or "exposure time".

Where PT is the potential for tinnitus.

Where > 0 is the chance that bad things will happen regarding your hearing/tinnitus.

Translation for the non mathematically inclined: If you are taking any drug that has the potential to be ototoxic (and there are a great deal of them) AND you add above 'normal level' sound exposure or duration, then the potential for getting tinnitus IS EXPONENTIALLY GREATER!!!

This FACT is just not considered when people blithley leave out the SOUND part of "ototoxic" discussion. It is not considered at all and I am convinced it is a huge issue.

This thread will explain what I mean in more detail for those who wish to get a clearer picture:
https://www.tinnitustalk.com/threads/warning-volume-x-exposure-time-x-meds-drugs.2897/#post-26025

Oh, and you can add another factor to this if you wish... "potential gut issues"! If you have a compromised intestinal lining the theory that 'large molecule drugs cannot go extra-intestinal' is garbage. They can!!! Ask me for details.

Stay safe. Do your homework on drugs if you have T...or don't want more of it.

Best Zimichael

 

Actually Z, I have noticed that since my T did not totally dissappear after I discontinued the aggrenox, not only are sounds being generated in my head...both sides....but the threshold I used to have for loud sound has greatly diminished. The tinnitus increases in volume if I am exposed to loud sounds even for a short time. And I always made a special effort to protect my hearing by using earplugs when rehearsing band and playing out. So what I'm saying is....not only is there noise in my head, but any exposure to loudness now increases the volume of the tinnitus. I don't know if everyone experiences that effect?

 

js...read the 'information tab' in my Zimichael 'Profile', and you will see that what you are experiencing is not at all unfamiliar to me (or many others). Yeah, this is "hyperacusis" or "reactive tinnitus" or "whatever-the-hell- xxxx'isis". If you keep exposing yourself to sound 'abuse' (and your hearing will tell you when that happens ) you may end up like me with continual increases over your life. I suggest NOT doing that! Even with great care, I have not been able to predict when my "body" will decide to pay a price, that "I" was not hip to at the time.

If you delve into this a bit, you will also see all kinds of stuff about "hyperacusis" and "over-protecting" making it worse. And so on, and so on. A lot of it is only relevant for more 'standard category T' and associated H. Being as you work with sound as a profession, I would suggest boning up on all this while you have the chance. This link below should give you something to chew on, then make up your own mind as to how to proceed.
https://www.tinnitustalk.com/threads/tinnitus-vs-tinnitus-hyperacusis-some-basic-differences.5110/
Good luck. Best...Zimichael

 

I have been advised that most drugs can cause the possible side effect of t. I am pretty sure that ototoxic usually refers to loss of hearing, i.e. damage to inner hair cells. That is why the ototoxic list is smaller.