Over-the-counter pain relievers linked to hearing loss

– Regular use of pain relievers in the course of many years may increase the risk of hearing loss, a recent study suggests.

Researchers analyzed long-term data on nearly 56,000 AMERICAN women and found the use of non-steroidal anti-inflammatory drugs (nsaids) such as naproxen (Aleve) and ibuprofen (Motrin) acetaminophen (Tylenol) for six years or more is linked to a greater risk of hearing damage than taking these drugs for a year or less.

“Hearing loss is very common in the United States and can have a profound impact on the quality of life,” said senior study author Dr Gary Curhan, a researcher at the University of Harvard and the Brigham and Women’s Hospital in Boston.

Risks of the painkillers in the study go further than the hearing loss, and patients should do their best to prevent the long-term use, Curhan added by e-mail.

“Although these medications are sold without a prescription, they have potential side effects, one of which is of a higher risk of hearing loss; they have also been shown to be associated with a higher risk of hypertension (high blood pressure) and other significant medical conditions,” Curhan said.

“They are generally safe, when taken in the usual doses for a short period of time,” Curhan noted. “However, there should be a strong justification for long-term use.”

Women in the study who used nsaids at least twice a week for six years or more with 10 percent more likely to report hearing loss than participants taking these medications for less than one year.

With acetaminophen, regular users for at least six years, with 9 percent more likely to report defective hearing than short-term users, researchers report in the American Journal of Epidemiology.

The researchers did not find a statistically significant association between hearing loss and the duration of use of aspirin.

Aspirin is linked to a ringing in the ears in the past, and Vicodin, a pain reliever that contains acetaminophen, is tied to hearing loss with excessive use, noted Dr. Jennifer Derebery of the House Ear Clinic and the University of California, Los Angeles.

Ibuprofen is less commonly recognized by the public as a potential cause of hearing damage, Derebery, who was not involved in the study, said by e-mail.

Although the magnitude of increased risk is small for other painkillers in the study, hearing loss is so common in the population that a small bump in risk can translate into a widespread public health problem, the authors note.

During the study, almost 19,000 women developed hearing loss.

The researchers estimate that about 5.5 percent of these hearing loss cases can be attributed to an NSAID or paracetamol use.

Previous research has found a similar connection between painkillers and hearing loss in men, although the studies up to now have to explain how the medications can affect the hearing, said Dr. Wilko Grolman, a researcher at the University of Utrecht in the Netherlands which is not involved in the study.

“I consider this as a confirmation that we should always be critical in the decision to use medication, including painkillers,” Grolman said by e-mail. “Our hearing is very valuable and if it is possible, we must preserve.”

However, the study is observational and does not prove that painkillers cause hearing loss.

“The hearing loss was self-reported and not objectively measurable with the result of the test,” Dr. David Haynes, a researcher at the Vanderbilt University Medical Center in Nashville, who was not involved in the study, said by e-mail.

It is also possible that some of the hearing loss associated with pain relievers may be associated with the underlying medical problems that people took painkillers to treat it, says Dr. Michael McKee, a researcher at the University of Michigan in Ann Arbor, which is not involved in the study.

For example, people with chronic pain or arthritis are more prone to heart disease and diabetes, both of which are linked to hearing problems, McKee said by e-mail.

“Exercise and physical therapy can be effective ways to manage chronic pain,” Mckee said. “Protection against excessive noise still remains the best way to keep your life of the risk of hearing loss.”

SOURCE: American Journal of Epidemiology, online December 14, 2016.

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