A Review: “Pharmaceutical Induced Ototoxicity”

Year 2025, Volume: 29 Issue: 4, 1419 - 1436, 05.07.2025

Çağatay Oltulu , Mustafa Daşman

https://doi.org/10.12991/jrespharm.1633782

Abstract

Ototoxicity, defined as drug-induced damage to the auditory and vestibular systems, manifests as hearing loss, tinnitus, dizziness, and balance disorders, representing a critical challenge in clinical practice and pharmaceutical development. This review aims to consolidate advancements in the understanding of pharmaceutical-induced ototoxicity, focusing on its mechanisms, diagnostic methodologies, and preventive strategies. A comprehensive analysis of existing literature was conducted, encompassing clinical findings and experimental data on the ototoxic effects of major drug classes, including aminoglycosides, platinum-based chemotherapeutics, and loop diuretics. The review evaluates the underlying biochemical mechanisms and explores innovative approaches for mitigating ototoxic effects. Ototoxicity predominantly results from oxidative stress, mitochondrial dysfunction, disruption of calcium homeostasis, and activation of inflammatory pathways. Significant progress has been achieved in the development of therapeutic drug monitoring protocols, antioxidant therapies, and targeted drug delivery systems, including nanoparticles and hydrogels. Emerging technologies, such as gene-editing and caspase inhibitors, demonstrate potential for preserving hair cell integrity and mitigating auditory damage. Early detection and management of ototoxicity are paramount for maintaining auditory and vestibular function. This review provides a comprehensive framework for clinicians, researchers, and pharmaceutical professionals to address ototoxic effects effectively and highlights promising directions for future research and therapeutic development.

Keywords

Hearing loss , cisplatin , aminoglycosides , oxidative stress , auditory hair cells

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