Why Is Acetaminophen (Tylenol) Not on the Ototoxicity List?

I read online that Acetaminophen can be ototoxic. If so, why is it not on any list of ototoxic medications?

I had a slight flu that ended two weeks ago and I had taken Acetaminophen for 5-7 days and on only the first 2-3 days did I take it close to the daily maximum recommend dose.

Ever since my tinnitus has been spiking with one of the tones severely spiked for the last week or so. Other tones have also spiked but had gone back down except for this last one. I am taking NAC but it does not seem to be helping.

It's been two weeks now since my last Tylenol pill and I am starting to get worried.

 

It looks like in the last 20 years, only 502 people filed a report with the FDA reporting getting tinnitus as a result of taking Tylenol:

https://www.ehealthme.com/ds/tylenol/tinnitus/

That's not a lot of people, given how popular Tylenol is...

 

I've been using Tylenol for sinus and sleeping problems. It has never given me a spike and I have not had any side effects, plus I felt better.

 

I suspect your spike has more to do with your flu than with Tylenol.

 

Yet again Tylenol causing issues for me. One of my tinnitus tones has significantly spiked within a day after a single 500 mg pill 3 weeks ago. I dismissed my last spike(s) as a coincidence but for sure the Tylenol is doing something. I really don't get it, how's it even medically possible for a single pill to cause ototoxicity? Are there any alternative reasons why it could spike tinnitus? Perhaps the way it affects the brain or something?

The tone that has spiked is mid range, approximately 2 kHz, which is odd considering ototoxicity usually starts affecting the higher frequencies first. I do have high frequency tinnitus and that has remained unchanged.

I dread the day when I'll have to take other ototoxic medications on a regular basis

 

Acetaminophen is known to increase the risk of tinnitus by up to 20% — whatever that means. It is also classified as an Analgesic which are also well known to cause or increase tinnitus and hearing damage by restricting the oxygen and blood flow to the ear.

If you can feel the physical effects of a drug by taking a single pill, there is no logical reason to not believe that your inner ear is also possibly being affected in some way. On the other hand, there is no known correlation between taking a low dose of Aspirin and ear issues, but that does not necessarily mean it will not negatively affect your tinnitus.

Just because there are supposedly only 500 or so documented complaints about Tylenol causing tinnitus does not mean it is not making your tinnitus worse. Statistics have not done me a single favor in the last half dozen years of trying to figure out how I am going to survive living this way.

If your relatively sure that Tylenol or any other medication is making your tinnitus worse, then at this point I see no reason to doubt that it is having a negative effect on your ears even though millions of other people are devouring it and not complaining about their ears.

In other words I believe you and I can relate to your concern.

 

Citation?