Tinnitus from Azithromycin / Zithromax Antibiotic

Does anyone have experience with this antibiotic and tinnitus?

I was prescribed a 3 day, 500mg azithromycin course for chronic sinusitis and possible chest infection.

A few hours after the second pill, the tinnitus began, as well as disorientation. The latter passed in a day, but now, 12 days after the last pill, the tinnitus remains, and due to anxiety in the last couple days has become stronger. I have a feeling of fullness at the back of the ears / throat, but no pain otherwise.

I'm going back to the GP in 48 hours, and then to an ENT specialist if necessary.

I've read all I could about this online and it seems that tinnitus as a side effect of azithormycin is not so rare. It's hard to know if the people who complained about it ended up finding a solution, because the threads go silent (presumably they did then).

I did read one post from someone whose reason for taking it and development to tinnitus matches mine, who said that the doctor found his ear drum rather beat up after the azithromycin course, assuming the mycoplasma migrated to his ear canal during treatment, and then he had to go on another course of antibiotics to deal with the damage.

In any case if anyone has any experience or ideas about this, I'd like to hear it.

Just writing this out is a way of dealing with the issue. I know not to take any ototoxic antibiotics. Cheers.

 

Antibiotics can be ototoxic but usually with strong iv infusions....
I think the mucous in your tubes is the problem and a basic M.O.T can help.
Steam inhalation and mucous linctus should help.
The infection needs clearing and a steroid nasil spray is another option...
Lots of love glynis

 

Did you have tinnitus before taking it?

 

Antiobiotics can absolutely be ototoxic even if taken orally as was the case with me. The aminoglycoside class of antibiotics can be especially damaging to the ears and have been known to cause permanent hearing loss in people who take large doses (TB patients can experience hearing loss because of the prolonged regimen of antibiotics they have to take, for example). For other classes of antibiotics, they can also cause T even if they have not proven to be ototoxic in clinical trials. My T spike from antibiotics is still with me 5 months later. Definitely let your GP know.

 

No, not consistently anyway. I had had ringing in my ears in the past following loud concerts and a middle ear infection a few years ago, but not at a consistent high pitch like now.

Glynis, unfortunately I don't think mucus-related congestion is my issue. My 3-month long sinusitis was more facial / jaw pain and swelling related, and both the doctor and I concluded it was likely caused by bacteria.

Azithromycin falls in the macrolide category of antibiotics, and everything I've read about it says that the chance of it being ototoxic at 500mg oral is very low. It's usually prolonged (multi-month oral) and IV dosage that induces this. I find it strange that tinnitus kicked in just 27 hours after the first dose. I had already taken 2 of the 3, and decided I might as well finish the course with one more 24 hours later. These antibiotics are known for staying in your system 7 - 10 days after the last pill, which is why I waited over a week before making another appointment with my GP.

From non-ototoxic antibiotics?

Thanks to all for discussing this with me.

 

I recently have taken Zithromax for sinus infections several times in the past 3 years for sinus infections. I have not noticed a change while taking them, and I was conscious and monitoring it. I only stick with it because I don't want to take an AB that could cause a worsening. I don't think it affected you taking it. If anything the sinus issues is the likely culprit, but should improve after a few weeks. I had a low hum about 3 weeks ago when I was taking Zithromax I thought was attributed to the sinus infection. The hum lasted about 10 days until the congestion and mucus subsided.

 

I'm glad it's worked out for you Michael. I saw my GP today, 14 days since taking the last pill of azithromycin. She said my ears are clear, and because I don't have a temperature or any balance problems, she doesn't want to give any more antibiotics (which I didn't want anyway). She spoke to the otologist and has given me a 20 day course of Tanakan, which is pharma Ginkgo, supposedly helpful with circulation to the ear. There have been some positive mentions of it on this site, and study results are here:

https://www.tinnitusformula.com/library/19-clinical-studies-on-ginkgo-for-tinnitus/

She's also prescribed a week of NSAIDs, because she feels my lymphs are swollen and I'm complaining about facial pain and feelings of fullness by the ears and throat. I've read that NSAIDs can cause spikes in tinnitus, but I will go with it as I have a sense of inflammation. Third thing given is Curamed for my throat. I have an appointment with an otologist next Friday, and will have further tests to check for bacteria if all these things don't improve by then.

I am positive this tinnitus will pass. However I feel that azithromycin has been the cause of it for me. Although it's relatively rare, there are still too many complaints about tinnitus from it (askapatient.com). Perhaps it's due to inflammation, I don't know. I am not congested with mucus.

I will update this next week. Past complaints of azithromycin-induced tinnitus on this site were unfortunately not followed up. Cheers

 

Yes. In my case, Cipro doubled the intensity of my T and then Amoxocillin a couple of weeks later doubled the intensity again. Prior to that, my T had pretty consistent for more than 10 years. I think there's a threshold for how many antiobiotics your ears. Mine unfortunately have surpassed that threshold.

 

I have an update and a question about eustachian tube dysfunction (ETD). I saw an ENT specialist 4 days ago, and she thinks I'm going through ETD. I have some matching symptoms (tinnitus, clicking when swallowing and yawning, and a blocked / muffled feeling to the ears and sound), but no dizziness or vertigo thankfully. She did the Rinne and Weber tests -- the former normal, the latter showed conductive hearing loss on my right ear, which rings louder than the left one. Attempts to open the tubes with air didn't work. She's given me a 2 week course of a decongestant (Pseudoephedrine).

My question is about the valsalva maneuver to pop the ears. I've been doing it today, without too much force, and it feels like the air is reaching all the way to the end of my ear, even possibly bulging the eardrum. However I only feel full and more muffled without a pop. How do I know if my tubes are really blocked? The maneuver feels like it reaches the end, and I don't want to push too hard because of possible injury.

I'm considering seeing a second ENT specialist next week.

 

Hi @Terje788 I am new to the TT. I have had tinnitus for a long time, but never noticeable except in quiet rooms and before bed. I took Azithromycin (six 250mg tabs) the beginning of may 2017, and I experienced a huge spike in tinnitus. I actually found out that I took Azithromycin in November of 2016 for bronchitis and didn't experience any spike or bad side effects. I wasn't very lucky in may. I still have the spike. Did your Azithromycin induced spike ever go to baseline? Thanks

 

I doubt azithromycin will cause tinnitus .

 

Im faced with either having to take doxy or azith.

What do you base your opinion on?

So hard to decide ...

 

Go to www.ata.org and check ototoxic drug list .

 

Hi. No unfortunately I still have the tinnitus from the azithromycin in January. It's been a long and complicated journey since then, with another dose of antibiotics needed along the way, though they worked well (amoxicillin-clavulanic). I am still searching for ways to remove the tinnitus, and I have tried many things. Improving the gut has helped. I also still have a bad mucus-like sensation in my ears, which crunch every time I swallow. In my opinion it's not mucus as my eustachian tubes appear to be clear and I have used some ET clearing supplements and techniques. So what it is I don't know--fungus? bacteria? something else?--but there is something in the middle ear or tubes. I think that if I can sort it out, the tinnitus will go too.

 

Terje,

I’m so sorry about your condition.

My tinnitus onset was 13 years ago because of two ototoxic antibiotics and it never went away.

Azithromycin is listed as ototoxic, and tinnitus is one of the side effects of this drug.

I can’t understand how some doctors have such a low knowledge on pharmacology, there was an alternative non ototoxic to Azithromycin, so there was no reason to expose your ears to ototoxicity.

Ototoxic medications can be much more aggressive for people who has already a vestibular disorder than for others who have not. Amoxicilin (but without clavulanic acid) is the only antibiotic 100% safe concerning our ears, all the rest are a Russian roulette for us. So, next time that you need an antibiotic, make sure you get a safe one, don’t take for granted that doctors know best, because sometimes they don’t. You, me and thousands more are a living proof of it.

From my own experience, you will get better with time, but you must keep away from laud noise exposure or any thing with an ototoxic potential, that will help your ears to heal to a certain point. The tinnitus won’t go away, but it might become milder, like mine did after three years.

Unfortunately for me, last April a serious onset started after a medical procedure possibly because of a bad reaction to the anaesthetic propofol. I must say that never was informed that there was a 1% risk for my ears, otherwise I would have taken the procedure without sedation. Once again, the poor training of some doctors can make your life unbearable and, sadly, they are not aware.

I would always recommend to READ the leaflets of whatever medication you are prescribed and reject it if ototoxicity is listed as a side effect because then you can ask for a safer alternative that don’t put your ears (and your sanity) in danger.

I wish you all the luck and give time to time, it will get better.

 

Thank you very much Anima. I wish you all the best as well, and a recovery from the reaction to the anaesthetic.

Back when this began, I read case studies about the negative effects of azithromycin. There was basically nothing about a normal course (3-7days) negatively affecting hearing. All the aural damage was done on stronger, longer courses or intravenously, and even then the reviews stated that the damage was reversed after 3 to 11 weeks. I had to visit user review websites of drugs--like askapatient.com--in order to read personal stories about how a regular dose of azithromycin caused tinnitus, even if only for a short time. Some people said that it passed, but most people left their review and did not follow up. I know what you mean when you say that most doctors don't know about ototoxicity. I even emailed a noted otolaryngologist in the US, who had the best website about ears and ototoxicity that I could find, and even he had not heard about short-term use of azithromycin causing any damage. My feeling is that for a person with a relatively strong and sound immune system, it won't do any damage. Mine was completely depleted and I had been run down for months beforehand, and I figure that that allowed it to happen. I agree with you about being very thorough in reading about medication before taking it.

I disagree with you about one point though:

I am confident it will go, with time and recovery and overall healing of the stomach and body. My immune system was so depleted that in the 9 months since taking the antibiotics, I've only recovered to a normal state in the past 3 months. I'm better now than I was before becoming sick last year. Diet and lifestyle changes have helped enormously. I think I will find a way to heal whatever is causing the ringing, and like you said, time will also heal it slowly. Cheers and best wishes to you.

 

I've had very mild tinnitus for a couple years now. It has only become bothersome during the last two weeks when I seem to have had a sinus infection that I was prescribed azithromycin for, I took the first dose and then read that it can increase tinnitus, I tried to puke it up but couldn't.

I am filled with anxiety please someone give me some information.

 

Millions of people take azithromycin each year, and only a tiny percentage get tinnitus from it, and then only a tiny percentage of them have it stay for a longer time. It's very unlikely it will happen to you. Relax, take deep breaths, exercise, eat well, and do something you enjoy. The medication will be out of your body within a few days.

 

@Terje788 hi how is your T? I took Azithromycin (2 500mg pills) and a week later a course of Augmentin (I stopped it early (on 12/16) after 3 days) and my T set in permanently on 12/17 I noticed it on 12/15 but it was so low. At first I blamed a lumbar puncture I had in the ER on 12/8 because I ended up having a CSF leak and terrible side effects (headache, head pressure, ears popping) but the tinnitus set in during the time any of these could have been a culprit, so I am unsure. Mine is a high pitched tone in my head 24/7 (sometimes my ears ring but only for a few seconds then fades). Has anything helped specifically for you? I also have crackling when I yawn or swallow but ENT said my ears look great and hearing test was fine

 

Hi Dginobile,

I still have tinnitus, 13 months so far, but first of all, I don't think it's permanent, and secondly my situation is a bit different from others who have macrolide-induced tinnitus as I had something like an allergic reaction to the drug, my head swelled horribly, and I lost about half my hearing for a few weeks (but fully recovered it).

From what I've read, most who incur this macrolide-induced T just have it appear without any head swelling or other effects like I had. What I've learned from visits to otolaryngologists is that our understanding of the ear and hearing is still in its early days. There's lots and lots that doctors don't understand about it, and you tend to notice this as they grope around for answers and sometimes throw out the word 'idiopathic'.

In my opinion, if you have T from antibiotics, what you should do is work on your intestinal health. There is a strong connection between the gut and mind, and nerves (Vagus) which run from your colon to your ears. Antibiotics can destroy the health of your stomach and the effects of this can, in my opinion, work out into destroying the weaker parts of your body and nerves. If you can repopulate your intestines with good bacteria and improve your microbiome, you have a good chance of removing the T. This has been documented, at least anecdotally if not in medical reports, and you can read about it online. A combination of diet (cutting sugar & bad yeast), exercise / lifestyle changes, and supplements (quality probiotics) will help to correct it.

Granted in your case it could be related to something else as you mentioned. You'll have to explore it. My situation is like yours in that doctors have looked into my ears and see that all is healthy, and my hearing is good, so they don't know why I have T.

Like I said, there's only so much they can do based on how understanding of the human ear has developed so far.

And based on that, I would say that you should not listen to anyone who says that your tinnitus is permanent. There have been lots of personal stories of people who cured their tinnitus many months and years after it began. It's not true when some doctors say it's permanent, particularly not if you have otherwise good, in-range hearing. In my opinion that's basically just another way of saying 'I give up'. You'll have to do some exploratory work and be disciplined in finding a cure, but one is very likely out there if you search for it.

 

@Terje788 I am so sorry I am just now seeing this, but thank you for that information I’ve actually been thinking of getting a probiotic, I was just diagnosed with Gallbladder disease as well so I need to get my gut health in check. How are you?

 

I have had tinnitus for 4 years now as a result of taking Z-pack. I have a sinus infection now and the hi pitch ringing is at its worst. In order to sleep I listen to a TV series that I’ve heard again & again just to create a background noise.
There’s no longer ‘Silence is Golden’ in my life.

 

I am taking azithromycin for months, along with atovaquone and proguanil. I'm also taking doxycycline.

I have not really sensed any difference in my tinnitus, except it may be a bit more on the bassy side now, which is a bit more easy to live with I guess (not really sure actually) as it tends to disappear more easily in ambient sounds out of bed.

But yet it will be interesting to see if it goes back to before when I stop.

To all of you: what happened when you stopped the med which started your tinnitus? Has it vanished or did it stay with no change?

 

Did anyone get relief or did it stop eventually after taking a Z pack? Mine has been bad for 3 weeks.

 

Hi all, I've been reading this thread after taking Azithromycin over a week ago and now appear to have developed a new tinnitus. I was wondering if anyone has had any relief from theirs? I was initially a little worried about taking this drug but now quite a bit.

I also hope everyone is ok and getting better / some relief from their tinnitus.

I've had tinnitus from an ear infection 8 years ago which is now quite mild and I've learnt to habituate to it well. When I first noticed it I went through the whole anxiety / stress spiral but luckily got through it all ok. It flares up occasionally though i can manage quite well.

Recently (last week) I was prescribed Azithromycin (Z-pack) 500mg per day for a month to clear up some Acne. Being sensible I took one tablet and waited to see what happened! Jeez! After a few hours i got a head ache, felt a bit dizzy and developed not so much a ringing but a high pitched sensation of sound in my head, similar to coming out of a noisy night club drunk. This perceived noise drowned out my last tinnitus though has reduced a little a week on. I'm now worried this is here to stay, has anyone else in this group experienced anything like this?

I've read other threads that say with Azithromycin/Z-pack it normally takes a high and prolonged dose to cause problems - have i just been unlucky, or will this spike go away in a few weeks? It's not really what I thought tinnitus would be like since I've only had it in my ears before.

Thanks, all for reading this and any help will be welcome. I'm currently a little anxious and drinking lots of water to see if that helps too.

Thx, Nick

 

I would be very careful! I got tinnitus and hyperacusis from azithromycin and doxycycline-combo for Lyme disease. There is no going back so mind your ears.

 

@Willie Discus I also got tinnitus from doxycycline. Not sure if ototoxic tinnitus ever recovers, which is shit.

 

@Willie Discus & @Steph1710 , sorry to hear guys and i hope yours is manageable. If mine is permanent then i'll haver to go through the whole habituation cycle again . I'm just hoping that because i took such a low dose (1 x 500mg) tablet that it hasnt done any damage and is just spiking right now.

 

Thanks @Nick116! I've only had T for six weeks, but it has already impacted my life in a huge way. Still, I'm trying not to let it get the better of me.

As for antibiotics - I wished someone would have told me that stuff could damage your ears before hand. I was on it for six months to help with an eye problem... However, it didn't help my eyes, but gave me tinnitus instead! Whoop!

I'm sure you'll habituate again, just give it time. And like you said, because you weren't on it long, hopefully it's just a temporary spike - fingers crossed!

<3

 

@Steph1710, thanks . It does get easier once you habituate and you can get back on with life, you'll get on top of yours im sure of it!