Famotidine (Pepcid): Tinnitus, Hearing Loss, Ototoxicity

Pepcid (Famotidine) is a popular over-the-counter (OTC) medication that functions as an H2 receptor antagonist (i.e. H2 blocker) to decrease stomach acid production.

Due to its rapid tolerance onset, Pepcid is most commonly used intermittently or on an “as needed” basis to manage heartburn (i.e. acid reflux), acid indigestion, and sour stomach.

Occasionally Pepcid is used as a treatment for: gastroesophageal reflux disease (GERD); laryngopharyngeal reflux (LPR); peptic ulcer disease; esophagitis; and Zollinger-Ellison syndrome – and occasionally as an agent to help transition off of PPIs.

Although Pepcid is considered a cheap, safe intervention for numerous GI symptoms – many users wonder whether it could cause tinnitus (ringing in the ears), hearing loss, and ototoxicity.

Does Pepcid (famotidine) cause hearing loss?

No. There are zero data to support the idea that Pepcid (famotidine) causes hearing loss.

In theory there may be rare cases wherein a specific user is allergic or hypersensitive to famotidine – such that this triggers an immune response, inflammation, and subsequent hearing loss, but this would be extremely unlikely.

It’s also possible that famotidine could interact with a preexisting medical condition or substance (medication, drug, supplement) in systemic circulation at the time of famotidine ingestion – such as to cause hearing loss.

That said, I haven’t been able to find a single case report or anecdote suggesting that famotidine causes hearing loss.

Is famotidine ototoxic?

There’s zero evidence to suggest that famotidine is “ototoxic.” By definition, ototoxic means damaging to structures of the inner ear and/or its nerve supply.

Famotidine ototoxicity could theoretically result from: (1) allergic/hypersensitivity reactions to famotidine; (2) famotidine overdose (direct or indirect effects); and/or (3) famotidine interactions (with other ingested substances) and/or contraindications (with medical conditions).

Most people who aren’t allergic to famotidine and that take medically-safe doses are unlikely to experience famotidine ototoxicity.

Does famotidine cause tinnitus?

Not usually – but it has been reported anecdotally as an adverse reaction by some users.

StatPearls, a reliable source for updated information on various medications, suggests that the most common adverse events associated with famotidine (as of 2020) include: headache; dizziness; diarrhea; and constipation. (R)

It’s possible that someone with severe GERD and/or extra-esophageal reflux (e.g. LPR) might experience tinnitus upon famotidine discontinuation due to rebound acid hypersecretion (RAH) entering the eustachian tubes and/or inner ears.

In the aforementioned scenario, tinnitus would NOT be from famotidine – and instead would be due to inadequate acid management following famotidine dosage reduction/cessation such that the acid blocks and/or damages the inner ears.

How could famotidine cause tinnitus and/or hearing loss? (Hypothetical mechanisms)

Included below are hypotheses of how famotidine might cause tinnitus and/or hearing loss for a subset of users.

Alteration of inner ear homeostasis: Such that repeated dosing may continue inflicting small amounts of damage (via increased oxidative stress, inflammation, etc.) that accrues over time. Or perhaps non-damaging alterations that cause tinnitus but are fully reversible with enough time off of the drug.

Neurochemistry changes: Famotidine functions by blocking H2 receptors – which can alter concentrations/activity of histamine and may have downstream effects on other neurotransmitter systems. Any significant fluctuation in neurotransmission may cause some individuals to perceive “ringing in the ears” – despite zero damage occurring to the inner ear.

Nutrient malabsorption: Famotidine may interfere with the absorption of essential vitamins/minerals such as vitamin B12, magnesium, etc. Interference with nutrient absorption could directly cause hearing loss from disruptions in inner ear homeostasis (due to lack of nutrients) and/or indirectly increase susceptibility to hearing loss (lowering threshold required for damage following noise exposure).

Allergic/hypersensitivity reaction: Some individuals may experience an allergic/hypersensitivity reaction to the chemical famotidine – characterized by facial swelling, itchiness, rash, shortness of breath, etc. If this occurs, it could theoretically cause tinnitus and/or hearing loss from immune-mediated inflammation and oxidative stress which damage the inner ear. (Prompt treatment of an allergic reaction should help reverse damage.)

Interaction with another substance: Famotidine might interact with another substance (e.g. prescription drug; OTC drugs; dietary supplement; illicit substance; alcohol/nicotine; etc.) that’s: (A) co-administered with OR (B) still in one’s system at the same time as – famotidine. In some cases, the interaction might cause tinnitus and/or hearing changes.

Interaction with a medical condition: Certain medical conditions may be contraindicated with famotidine due to increased risk of adverse reactions. If famotidine is administered by a person with a medical condition for which famotidine is contraindicated – tinnitus and/or hearing change might occur.

Toxicity (?): It’s possible that administering an extremely high-dose of famotidine (e.g. overdose) could induce some degree of toxicity (e.g. directly toxic to the ear) and/or physiological responses to the toxicity (secondary reactions like seizure) that cause tinnitus and/or hearing changes.

Specific famotidine adverse reactions: Some individuals experience kidney impairment or develop more frequent infections as a result of using famotidine. Both kidney impairment and infections might contribute to tinnitus and/or hearing loss (directly or indirectly such as during treatment of these conditions with additional medication).

  • Note: Famotidine could worsen preexisting tinnitus via the above mechanisms as well.
  • Note: Famotidine might also indirectly contribute to tinnitus and/or hearing loss by reducing endogenous protective functions (which could increase susceptibility to inner ear damage following noise exposure, etc.).

Blocking histamine causes or worsens tinnitus? (Random internet hypothesis)

One individual who was affected by transient famotidine-induced tinnitus hypothesized a reason as to why famotidine causes tinnitus.

Logic goes as follows: (1) famotidine is an antihistamine (H2 receptor blocker); (2) a potential treatment for tinnitus is oral histamine; (3) therefore blocking histamine with famotidine could cause/aggravate tinnitus.

Some researchers think that low-dose histamine could be useful for the treatment of vertigo and tinnitus. (R)

Whether low-dose histamine actually helps tinnitus patients hasn’t been well-studied.

(It is known that modulation of histamine receptor activity and histaminergic transmission can alter tinnitus perception for those with preexisting tinnitus.)

If famotidine causes tinnitus and/or hearing loss – will it be permanent?

First of all, it’s extremely difficult to prove that a person’s tinnitus and/or hearing loss was caused by famotidine.

Assuming famotidine was legitimately culpable for causing tinnitus and/or hearing loss – it’s unknown as to whether these reactions will be reversible (i.e. transient) or permanent.

If a person who develops tinnitus and/or hearing changes on famotidine: (1) discontinues the medication as soon as these adverse reactions occur and/or (2) seeks emergency medical treatment (e.g. with corticosteroids for sudden hearing loss) – then likelihood of some degree of recovery is high.

Of 15 anecdotes documenting tinnitus occurring while on famotidine – 3 cases reported complete remission of tinnitus after famotidine cessation. This suggests that, if tinnitus occurs, reversibility is likely for a subset.

Of the remaining 12/15 cases – many individuals failed to provide updates as to whether suspected famotidine-induced tinnitus subsided after stopping famotidine.

Famotidine & tinnitus, hearing loss, ototoxicity (Research)

European Review (2020) (R)

Altissimi et al. performed a comprehensive analysis of audio-vestibular side effects of commercially available drugs based on the British National Formulary, a pharmaceutical reference book that contains a wide range of useful information and advice on prescription and pharmacology.

In this review, famotidine is classified with the number/letter combo “3b” – indicating that it is a drug associated with inducing “vertigo or dizziness” (3) in 1-10% of users (b).

However, there’s zero evidence from this review to support the idea that famotidine causes ototoxicity, tinnitus, hearing loss, or any other hearing disorders.

That said, it is unclear as to whether the British National Formulary solely contains side effect data from clinical trials and pharmaceutical manufacturers – or whether it also considers post-marketing adverse event data.

If the former is true (only side effect data from clinical trials/pharma manufacturers) – then even if tinnitus does occur from famotidine, it wouldn’t show up in the British National Formulary – such that the result of this review would be inaccurate.

If the latter is true (post-marketing adverse events are considered) – then we can be more confident that famotidine is unlikely to cause tinnitus and hearing loss in most cases.

Lareb (WHO VigiBase) (R)

VigiBase data from the WHO (World Health Organization) contains reports of suspected adverse drug reactions (ADRs) collected by authorities in over 120 countries.

From 2011-2022 there have been 9,710 adverse drug reactions associated with famotidine – and 149 were associated with the “ear and labyrinth” (~1.53% of total ADRs).

It is unlikely that all of the ADRs from famotidine associated with the “ear and labyrinth” caused tinnitus or hearing loss. Moreover, it is unlikely that all of the ADRs from famotidine were completely irreversible (i.e. permanent).

Considering that: (1) few people react adversely to famotidine and (2) “ear and labyrinth” ADRs are a small percentage of total famotidine ADRs – it’s unlikely that most users will experience any tinnitus and/or hearing loss from this drug.

Neil Bauman (HearingLossHelp.com)

Neil Bauman (PhD) is a leading independent researcher in drug-related ototoxicity, tinnitus, and hearing loss – and is the author of “Ototoxic Drugs Exposed” (highly recommend).

Though Neil takes a significant amount of criticism from those who assume he’s exaggerating risks of tinnitus/hearing loss from pharmaceutical drugs to sell books – I disagree.

I’m not aware of anyone who’s dedicated as much time as Neil has to help others determine whether a drug is likely to cause tinnitus or hearing loss – and I think his goal is to disseminate accurate information.

I’m not 100% certain of Neil’s methods, but I believe he analyzes rates of audio-vestibular adverse events (e.g. tinnitus, ototoxicity, vestibulotoxicity, etc.) from various sources: PDR; CPS; FDA reporting system; etc. – and assigns numeric risk to various drugs.

Famotidine is assigned a numeric risk of “1” on a scale from “1” (lowest risk) to “5” (highest risk) – meaning it is very unlikely to cause adverse audio-vestibular reactions (e.g. tinnitus, hearing loss, etc.).

Does tinnitus and/or hearing loss occur rapidly after famotidine or require time to develop?

Everyone reacts differently. In the event of an atypical allergic or hypersensitivity type reaction, it’s possible that tinnitus and/or hearing loss could occur with the first dose.

Famotidine might lower one’s susceptibility to tinnitus and/or hearing loss such that moderate-to-loud sounds/noises that would not typically damage one’s hearing end up inflicting damage as soon as one is exposed to those sounds (which could be after the first dose or the 1000th dose).

It’s also possible that famotidine disrupts cochlear homeostasis and/or interferes with the absorption of certain nutrients (e.g. vitamin B12, magnesium, etc.) – which could directly cause tinnitus and/or hearing loss with high-dose, chronic/frequent, long-term administration or increase susceptibility to hearing loss after moderate or long-term use.

Because famotidine is capable of immediately blocking H2 histamine receptors in the brain – this could cause tinnitus (or alter/enhance perception of existing tinnitus) after the first dose.

Why most people probably don’t experience tinnitus from famotidine…

The primary reason most people don’t experience tinnitus from famotidine is because it doesn’t typically cause tinnitus or hearing loss as adverse reactions.

Also, because most people use famotidine intermittently or “as needed” rather than daily for a long-term – tinnitus risk is significantly reduced. Intermittent use and/or short-term bouts of administration are less likely to induce “permanent” physiological changes associated with tinnitus.

Even if tinnitus does occur from famotidine, many intermittent or “as needed” users may not think much of it because it likely resolves in between doses or upon taking an extended break from famotidine use.

It’s possible that there might be more individuals who experience tinnitus on famotidine than suspected given the fact that many people lack self-awareness to: (A) detect mild tinnitus and (B) realize that famotidine may have caused it.

Moreover, it’s possible that some people don’t bother reporting famotidine-induced tinnitus because it doesn’t bother them (e.g. ears ring a bit but so what?).

Anecdotes: Tinnitus & hearing loss from Famotidine

Included below are summarized anecdotes from individuals who reported tinnitus and/or hearing loss while using famotidine across various websites (e.g. Reddit, TinnitusTalk, etc.).

Keep in mind that onset of tinnitus and/or hearing loss while using famotidine does NOT mean that famotidine was necessarily the underlying cause – it may have been a sheer coincidence.

Anecdote 1: After Pepcid, my ears made a sound then got “stuffed” for 48 hours post-administration. Now both ears are fluctuating between being plugged and I hear white noise and a low bell in my left ear. I’m scared and this is going on 5 days now. I was anxious previously. Never had tinnitus before Pepcid. Update: The tinnitus did NOT resolve after stopping.

Anecdote 2: I’ve been having ringing in my ears and started taking Pepcid 3 weeks ago. I’m curious about whether this is a side effect.

Anecdote 3: Pepcid caused tinnitus for me but it went away when I stopped using it.

Anecdote 4: I have been taking Pepcid for the past 4-5 years for acid reflux. I have bad tinnitus. (Individual did not state whether Pepcid was the suspected cause of his/her tinnitus.)

Anecdote 5: Have been on famotidine for 4 years (40 mg AM & PM). Over the past 1.5 months I developed tinnitus. One doctor thinks it’s acoustic trauma due to a combination of headphones & internet gaming – but another doctor said cause unknown. (Individual admitted to playing “loud” games.)

Anecdote 6: I recently made a connection between Pepcid and tinnitus. I’ve been on GERD medication for many years before my tinnitus started and switched to Pepcid about 2 years ago. I think Pepcid may have damaged my ears. I had been off of Pepcid a while and my tinnitus was getting better – then GI doctor prescribed Pepcid 40 mg (twice daily). After 3 days of this prescription, tinnitus became so much worse. Stopped taking it for several days and tinnitus is now better. There is relatively clear causality for this individual.

Anecdote 7: Have been on Pepcid (Famotidine) 40 mg per night and morning (80 mg per day) for about 2 years for bad acid reflux. I just made the connection between Pepcid and tinnitus. One doctor thought it was noise-induced tinnitus. I’m hoping the tinnitus subsides when I stop Pepcid. (Individual has a lot of mucus production from asthma as well.)

Anecdote 8: I think I got tinnitus from taking Pepcid AC (10 mg) one dose – but am not certain. I have acid reflux which started January 2020 and began using Omeprazole 20 mg/day in February 2020 but it had no effect on my ears. On February 27, 2020 I took Pepcid 10 mg and felt stimulated – couldn’t sleep for 2 nights. Also experiencing severe stress/anxiety upon GERD onset. Had a brief bout of loud noise exposure via phone (80-90 dB). Also listened to nature sounds regularly at a reasonable volume. Admittedly isn’t sure whether: Pepcid, Omeprazole, GERD, nature sounds, stress/anxiety, or brief phone noise caused the tinnitus.

Anecdote 9: I made an account (TinnitusTalk) because I took my first prescription drug, Pepcid (Famotidine) and my tinnitus began 48 hours later. ENT said it was stress-induced by I really do not know what could’ve caused it. I only took one 25 mg pill 7 weeks ago. (User admits that tinnitus could’ve been caused by an airplane and/or going to a nightclub.)

Anecdote 10: I struggle with acid reflux and think that the medications used to treat it may have contributed to my tinnitus. Am not sure why but decided to take famotidine to help with bad reflux and woke up with ringing in my ears louder than ever.

Anecdote 11: Was taking Prilosec for gastric reflux but stopped due to osteoporosis. Then tried Zantac but it didn’t work. Tried famotidine 40 mg, twice daily about 3 days ago and experienced awful tinnitus – so I stopped. (User admits that other factors like: Atenolol, Wellbutrin, and hearing loss may have started the tinnitus.)

Anecdote 12: Developed a “brain tinnitus” with echoing metallic sounds all throughout head. It all started when switching from a PPI to famotidine (Pepcid). I also increased the dose of famotidine from 10 mg to 20 mg at about the same time the tinnitus began. (Individual already had acoustic trauma and associated tinnitus but famotidine spiked it.)

Anecdote 13: Developed tinnitus but am not sure of the cause. Possibilities listed: pregnancy, stress, betamethasone injection, Q-tip ear cleaning, wax impaction, flu shot, TDAP shot, TMJ & lockjaw, and/or small amount of Pepcid AC. Had zero tinnitus prior to the betamethasone injection – but other possible causes were around this time as well. 14 months after onset the tinnitus remains in both ears.

Anecdote 14: I almost cured my tinnitus but then took half a pill of Pepcid AC and developed a new tinnitus tone that switches ears and competes with other sounds.

Anecdote 15: I took famotidine and it seems to make my tinnitus louder but the tinnitus fades back to normal when I stop taking it.

What can we learn from these anecdotes?

There were ZERO anecdotal reports of famotidine causing hearing loss/ototoxicity.

There were numerous reports in which famotidine was reported as either a possible cause or likely cause of: (A) new tinnitus onset OR (B) preexisting tinnitus worsening (i.e. amplification/spike, new tones, etc.).

In 3 of the 15 anecdotes – the tinnitus reversed relatively quickly after Pepcid (famotidine) was discontinued, suggesting: (1) a causal relationship between Pepcid use and tinnitus and (2) reversibility of Pepcid-induced tinnitus for a subset of those with this reaction.

Other anecdotes in which Pepcid (famotidine) was suspected by users as being the most likely cause of tinnitus reported that the tinnitus did NOT fade following discontinuation – suggesting that tinnitus from famotidine may be permanent in some cases.

It is unclear as to whether persistent tinnitus following Pepcid (famotidine) use and subsequent discontinuation is due to a legitimate ototoxic reaction OR protracted changes in neurochemistry (e.g. H2 receptor alterations, histamine levels, etc.) – or both.

Because many anecdotes noted having tinnitus and/or hearing loss prior to using famotidine – it is most likely that famotidine modified neurochemistry in ways that altered and/or spiked preexisting tinnitus (as opposed to inflicting an ototoxic effect).

There were also a few anecdotes in which one small dose of famotidine was thought to have caused permanent tinnitus. Though this is theoretically possible – it’s unlikely that one small dose would have a permanent impact on the audio-vestibular system of most.

In a couple of anecdotes, it’s relatively obvious that famotidine was the clear-cut cause of new tinnitus onset or preexisting tinnitus exacerbation – as evidenced by tinnitus stopping when famotidine is stopped and tinnitus restarting when famotidine is reinstated.

Is it the famotidine or the reflux condition causing tinnitus & hearing loss? (Critical thinking)

Since most people take famotidine for the treatment of acid reflux conditions (e.g. GERD, LPR, etc.) – it’s difficult to know whether the famotidine was the underlying cause tinnitus and/or hearing loss that develops during treatment.

Why? Refluxate (i.e. refluxed materials such as: pepsinogens, stomach acid, bile salts, etc.) can backflow up into the laryngopharynx such that it may:

  1. Block the eustachian tubes (causing a transient tinnitus until the blockage is resolved)
  2. Interact with inner ear structures (possibly inflicting damage – some of which might become permanent).

It has not been definitively proven that “refluxed contents” can cause tinnitus and/or hearing loss – but there are studies implying that refluxate (e.g. pepsinogens, acids, etc.) could block the eustachian tubes (causing transient tinnitus and hearing loss) and/or induce inflammation and direct damage to the inner ear such as to cause permanent tinnitus and hearing loss.

Additionally, there studies suggesting that acid-reducing agents like PPIs may be otoprotective such that they modify homeostasis within the inner ear to make it less susceptible to damage from refluxate, inflammation, and oxidative stress. Other studies suggest the exact opposite (increased risk of hearing loss).

Due to mixed data on the otic effects of acid reducers, it’s relatively difficult to know whether famotidine and other acid-reducing agents are otoprotective OR mildly ototoxic (such as to inflict a small amount of damage).

I’d guess that if a person’s reflux: (A) is of mild severity and/or (B) doesn’t affect the nasopharynx or laryngopharynx (such as in LPR) – then refluxate is unlikely to cause tinnitus and hearing loss.

I’d also guess that if a person notices new tinnitus onset or preexisting tinnitus exacerbation around the time of: (A) starting famotidine or (B) increasing famotidine dose – and no other confounds can be identified (e.g. person is in good health, isn’t on other medication, no loud noise exposure) – then famotidine is likely the cause.

Obviously if stopping the famotidine results in tinnitus resolution – then the user can be even more confident that famotidine was the cause.

Have you considered other possible reasons for tinnitus onset while using famotidine?

  • Noise exposure during treatment
  • TMJ & jaw/neck tension
  • Medical conditions
  • Other substances (meds, drugs, supplements)
  • Psychological stress

Risk factors for famotidine tinnitus and/or hearing loss

  • High-dose (using high doses of famotidine)
  • Daily use (using famotidine every day without breaks)
  • Frequent administration (e.g. several times daily)
  • Long-term use (taking famotidine for longer than 2-4 weeks)
  • Older age
  • Loud noise/sound exposure
  • Preexisting tinnitus and/or hearing loss
  • Allergy or hypersensitivity reaction
  • Smoke exposure
  • Kidney and/or liver impairment
  • High stress & poor sleep
  • Medical conditions
  • Using other substances (medications, drugs, supplements)
  • IV famotidine (as opposed to oral)

How to minimize risk of famotidine-induced tinnitus and hearing loss…

Assuming famotidine is capable of causing tinnitus and/or hearing loss, below are strategies that can might be useful for risk reduction.

  1. Minimal effective dose: Take the lowest possible dose of famotidine needed to sufficiently control reflux symptoms.
  2. Minimal frequency of admin: Administer famotidine as infrequently as possible (“as-needed”) for sufficient reflux management. This will not only minimize risk of side effects/adverse events associated with chronic use – but may even help prevent tolerance onset.
  3. Limit duration of use: H2 blockers like famotidine are associated with rapid tolerance onset (such that physiological tolerance can occur in ~2 weeks of daily use). Additionally, since susceptibility to adverse reactions like tinnitus/hearing loss may increase over time – it’s best to keep duration of use as brief as possible.
  4. Avoid potential interactions: Be cognizant of any potential interactions that famotidine may have with other medications, drugs, or supplements that you use. Even if no interaction is listed online – an interaction effect could still be possible.
  5. Contact doctor ASAP if tinnitus/hearing loss occurs: Do not hesitate to contact a medical doctor if you develop tinnitus and/or hearing loss while using famotidine. There may be medications to prevent tinnitus/hearing loss from becoming permanent if administered shortly after onset (e.g. corticosteroids). Additionally, you’ll likely want to explore alternative reflux treatment options since famotidine has become problematic.
  6. Nutrient-dense diet: While taking any acid-reducing agent like famotidine, consuming a nutrient-dense diet is critical – as this may help protect the ears from medication-induced damage.
  7. Quality sleep: Sufficient quality sleep each night helps reduce oxidative stress and inflammation – both of which might decrease susceptibility to famotidine-induced tinnitus/hearing loss.
  8. Stress reduction: Maintaining a low-stress lifestyle might help prevent and/or improve ability to cope with tinnitus/hearing loss.
  9. Avoid loud noises & protect ears: While taking medications like famotidine – avoid exposure to loud noises/sounds (e.g. construction, concerts, aircrafts, sporting events, etc.) and/or protect hearing with earplugs, noise-reduction earmuffs, etc.
  10. Otoprotective agents: Various supplements might help reduce likelihood of developing tinnitus and/or hearing loss while using famotidine. (However, you should beware that some of these supplements could exacerbate reflux.)
  11. Organ function tests: Famotidine is metabolized by the liver and excreted by the kidneys. Dysfunction/impairment in the liver and/or kidneys could affect systemic concentrations of famotidine – potentially increasing risk of adverse reactions.
  12. Hydration: Sufficient hydration while taking famotidine should help the body secrete famotidine efficiently to reduce likelihood of adverse reactions associated with systemic accumulation.
  13. Gradual withdrawal: Unless you’re on the lowest dose, it makes sense to gradually taper off of famotidine. Why? Abrupt cessation of famotidine could trigger significant rebound acid hypersecretion and possibly other physiological reactions (all of which might cause/worsen tinnitus).

My experience with famotidine: Any tinnitus or hearing loss?

I developed some intermittent, high-pitched tinnitus while using famotidine (20-40 mg per day) and esomeprazole (20 mg, b.i.d.) – but cannot prove that famotidine was the underlying cause.

Famotidine may have been the culprit – but blame could just as easily be assigned to esomeprazole or the combination of famotidine and esomeprazole. Moreover, it’s possible that the reflux condition itself (LPR) caused tinnitus due to refluxate damaging my inner ears.

Because I have refractory reflux that does not respond to lifestyle changes (e.g. calorie restriction, maintenance of healthy weight, head-of-bed elevation, small meals, low acid diet, etc.) – medications are needed or symptoms become debilitating.

Although I have some anxiety, I’m certain that what I’m hearing is legitimately “tinnitus” and not “phantom sounds.” I’m very familiar with phantom sounds in complete silence and can distinguish them from my tinnitus relatively easily (phantom sounds = like a low-pitched echo vs. tinnitus = a high pitched buzzing).

Obviously I would NOT continue taking famotidine or any proton-pump inhibitor if there were effective alternatives for reflux management. And believe me – I’ve tried nearly every non-surgical intervention hypothesized to have benefit.

Thankfully I haven’t experienced any objective change in hearing ability, however, conventional hearing tests do NOT detect changes in high frequency hearing. For this reason, it’s possible that ultra-high frequencies have been affected to some degree by famotidine and that I have lost a small amount of hearing.

It’s also possible that the tinnitus is from famotidine altering neurochemistry in my brain such that I have more of a “neurochemical” tinnitus that will eventually fade as soon as the medication is stopped and neurochemistry recalibrates to functioning without famotidine.

Update: The high-pitched tinnitus seemingly improved back to baseline a few days after stopping famotidine.

Have you experienced tinnitus and/or hearing loss from famotidine?

What level of confidence do you have that famotidine was the underlying cause of your tinnitus and/or hearing loss? If you’re extremely confident – explain why.

Have you ruled out other possible causes of tinnitus and hearing changes such as: usage of other substances (medications, drugs, supplements); nutrient deficits; medical conditions that can impact hearing; infections (e.g. SARS-COV-2); and/or loud noise exposure?

Assuming you strongly believe that famotidine is the primary cause of your tinnitus and/or hearing loss – leave a comment with some additional details:

  • Reason for taking famotidine (e.g. GERD)
  • Frequency of famotidine administration (e.g. three times, every day)
  • Total daily dosage of famotidine (e.g. 20-80 mg)
  • Cumulative duration of famotidine usage (e.g. 1 month)
  • Other substances used (e.g. caffeine, nicotine, alcohol, etc.)
  • Medical conditions (e.g. anxiety, GERD, hypothyroidism)
  • Age, BMI, general health
  • Stress level & sleep quality
  • Tinnitus and/or hearing loss prior to famotidine use (?)

If you experienced ZERO change in hearing while taking famotidine – feel free to share that as well.

1 thought on “Famotidine (Pepcid): Tinnitus, Hearing Loss, Ototoxicity”

  1. Hi, I am profoundly hard of hearing thanks to the genes my dad passed down to me. Tinnitus is something I cope with but recently I took 4 20mgs of Pepcid throughout one day and developed severe tinnitus. It’s been over a month now and there hasn’t been a minute of relief. Today my doctor prescribed me steroids. I am hoping for the best.


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