A male patient, 61 years of age, has taken ibuprofen 400 mg three times daily for 7 days and therea

Fråga: A male patient, 61 years of age, has taken ibuprofen 400 mg three times daily for 7 days and thereafter two times daily for 60 days because of arthralgia in his hands. After this period he developed unilateral hearing loss and consulted a specialist in ear-, nose- and throat diseases. The doctor could not find the specific cause of this hearing loss. The questioner, who is a GP, withdrew ibuprofen, and according to the patient his hearing has improved slightly over the ensuing six weeks. Could ibuprofen be a causal agent?

Sammanfattning: Reversible and irreversible hearing loss of sensory neuronal type has been related to treatment with aspirin and other NSAIDs.

Svar: A previous question (1) describes a similar event where a woman, born in 1931, developed hearing loss of the right ear after a short treatment period with ibuprofen. The treatment was immediately withdrawn. Conventional audiogram and brain stem audiometry, performed one month later, confirmed sensory neuronal damage in the cochlea. In the literature, both reversible and irreversible hearing loss has been associated with treatment with aspirin and different NSAIDs (2-4). The theory is that the blood supply to the cochlea may be diminished, but the causal relationship has been questioned.

There have been 19 cases of hearing loss related to NSAID treatment reported to the Swedish Adverse Drug Reactions Advisory Committee (SADRAC). A causal relationship has been judged as likely or not excluded. Some of these also involved tinnitus and/or vertigo. The hearing loss was irreversible in five cases. We recommend that the present case be reported to SADRAC.