Can Lisinopril Cause Tinnitus?

Are you taking lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, and experiencing symptoms of new hearing loss, or changes to hearing? If so, it’s possible that this medication may be the source of your tinnitus or other hearing changes. In this article, we will explore the possible relationship between lisinopril and the onset of tinnitus.

Tinnitus Symptoms and Causes

What exactly is tinnitus? Tinnitus is a hearing condition that can best be described as ringing, buzzing, hissing, or clicking in the ears. In some cases, individuals may also experience hearing loss or sensitivity to loud noise. For some, these symptoms are persistent, and can be heard continually. For others, symptoms come and go, and can grow better or worse based on environmental factors such as external noise level or even the health and wellness of the individual in question. 

Tinnitus has been linked to various causes, such as exposure to loud noises, ear infections, and ototoxic medications, with some links suggested between certain conditions and the development of tinnitus.

Tinnitus and Ototoxic Medications

Ototoxic drugs, so named for their links to hearing loss or damage, can cause damage in the inner ear resulting in hearing loss, tinnitus, and or dizziness. It’s essential to be aware of any ototoxic medications you may be taking or are being prescribed. Though lisinopril is not currently classified as an ototoxic medicine, there is some anecdotal evidence that it can lead to tinnitus for some patients.  More commonly, antibiotics, chemotherapy drugs, and NSAIDs have been found to be ototoxic.

You should communicate any concerns you may have regarding tinnitus to your healthcare provider, as there may be a safer alternative for you to treat any ailments you may have. This may be especially important for individuals who have existing issues with hearing, or those who are at greater risk for developing hearing difficulties and damages. Many ototoxic medications have counterparts without links to ototoxicity, and a physician may be able to find a substitution better suited to your auditory needs. 

Understanding Lisinopril: ACE Inhibitors and High Blood Pressure

By taking Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor medication, you can reduce your risk of arterial hypertension and its associated health risks. ACE inhibitors actively minimize the creation of angiotensin II, a hormone that narrows blood vessels. As this drug relaxes the blood vessels, it helps lower high blood pressure levels, which otherwise may lead to serious heart ailments, like a heart attack or stroke, as well as kidney problems. While improved heart health may positively impact hearing, some lisinopril users have reported difficulty with hearing while on the drug. Lisinopril does have dizziness and vertigo listed as possible side effects, both of which can be tied to the inner ear.  

Other Blood Pressure Medications and Tinnitus

ACE inhibitors are the usual go-to medication for those with hypertension, but there are other blood pressure medicines that may induce tinnitus, apart from lisinopril. Beta-blockers, which reduce heart rate and output of blood by the heart, can cause tinnitus in certain individuals.

In addition to blood pressure medication, loop diuretics and angiotensin receptor blockers (ARBs) have been linked to tinnitus. Loop diuretics are usually prescribed to decrease excess fluids in the body, mainly for those suffering from heart failure or kidney disease. Not all individuals taking loop diuretics will experience tinnitus. ARBs are a pharmacological treatment option for high blood pressure, as they counteract the effects of angiotensin II, a hormone that narrows blood vessels. A small percentage of individuals taking ARB medication will experience tinnitus, and any symptoms experienced are likely to only be temporary, rather than life-long effects.

Treating high blood pressure is important, but it is also important to be made aware of any possible side effects that can impact hearing or balance, whether that means the onset of tinnitus or generalized hearing loss.  If you have worries about hearing-related issues due to your drug regimen, contact and discuss them with your doctor. Some medications possess alternatives with fewer side effects or risk factors. 

Beta Blockers and Tinnitus

Beta blockers are commonly prescribed for hypertension, heart disease, and several other conditions related to heart health. Most individuals will not experience any adverse symptoms, but some users may experience side effects, such as tinnitus. If you think your beta blocker usage has caused the ringing in your ears or exacerbated an existing issue, talk to your physician about it immediately. They’ll help ascertain whether the medication could be causing this symptom and if any modifications can be made to reduce your side effects, including switching to another medication or considering alternative treatments. 

Alpha Blockers and Tinnitus

Alpha blockers are medicines used to treat high blood pressure, benign prostatic hyperplasia, and similar concerns. Although these medications generally have few side effects, some patients may experience tinnitus after use. If this happens to you, discuss it with your physician, as there may be modifications or alternative medications that you can use to treat your condition without increasing the risk of developing an inner ear condition or experiencing a change to hearing. 

Risk Factors for Developing Tinnitus While Taking Lisinopril

There are certain risk factors that can increase the likelihood of developing tinnitus while using this medication and others like it. These risk factors include a history of autoimmune conditions, kidney illness, or cardiovascular issues. Moreover, combining lisinopril with other medications, such as tricyclic antidepressants or certain painkillers that have ototoxic properties, can further increase your odds of developing tinnitus. Therefore, it is essential to disclose existing risk factors you may have for developing tinnitus with your doctor prior to starting lisinopril, as well as giving a detailed review of any medications you are currently taking or plan to begin taking.

Pulsatile Tinnitus and Lisinopril

Pulsatile tinnitus is when the sound of rhythmic pulsing in one’s ears corresponds to their heart rate, though it can also sound like a “whooshing” sound, not unlike the “whoosh” of blood flowing through blood vessels. This is commonly from high blood pressure and narrowed vessels limiting the circulation of oxygenated blood. By taking ACE inhibitors like lisinopril, your arteries will dilate, enabling improved flow and possible relief from this form of tinnitus. That being said, because this particular form of tinnitus can be associated with serious illness and injury, it is important to bring these symptoms to your healthcare provider to rule out the possibility of any serious issues leading to the development of pulsatile tinnitus. 

Treatment Options for Tinnitus

If you develop tinnitus after taking lisinopril, there are a few different treatment options available to target the symptoms of tinnitus. Tinnitus retraining therapy can be especially helpful; it combines sound therapies with cognitive-behavioral techniques to help manage the symptoms of tinnitus to provide relief. With proper care and attention, many patients experience a reduction in symptoms and relief from the most substantial impacts of the condition. 

Hearing aids with built in sound therapy or ear level maskers can help improve the perception of tinnitus, as well. Although the two do not always go hand in hand, the majority of individuals with tinnitus also have some degree of hearing loss. Treating hearing loss may help target the issue at its root, thereby reducing the symptoms of tinnitus. Additionally, many modern hearing devices include built in tinnitus masking sounds and bluetooth capability to help provide sound therapy alongside amplification for those with tinnitus. Sound therapy is one of the most effective methods of treating tinnitus, making this an excellent option for those with existing hearing loss and accompanying hearing aids. 

In some cases, medications can help minimize some of the symptoms associated with tinnitus, like insomnia, depression, anxiety, and more. For some, controlling those other conditions can further improve the perception of tinnitus. Make sure to discuss these medication options with your physician to determine if this course of treatment is appropriate for you and your needs. 

Conclusion

Lisinopril is a common medication prescribed to manage high blood pressure and kidney disease. Most patients report no issues while taking lisinopril, but some may have experienced tinnitus as an adverse effect of this drug. Consequently, if you experience ringing in your ears while using lisinopril, it’s important to meet with your doctor right away for further diagnosis and tinnitus treatment and care. Because a healthy heart may be able to positively impact hearing and the health of the inner ear, taking lisinopril can present something of an issue: the medication is designed to improve heart health, but can be accompanied by one of the symptoms of declining health to the inner ear via hearing loss and changes to hearing. If you experience any changes to hearing once beginning lisinopril, it is important to bring this to your doctor, as it could indicate the presence of warring medications or another issue that may be more effectively treated using a different type of medication.