Can Lisinopril Cause Tinnitus? Possible, Unproven

Lisinopril may be associated with tinnitus, but available information does not establish that it causes tinnitus in a particular person. If ringing, buzzing, or another unexplained ear sound began after you started lisinopril or changed the dose, record the timing and contact your prescriber. Do not stop, reduce, replace, or otherwise change lisinopril without medical guidance.

This article provides general information. It cannot determine the cause of an individual symptom or replace advice from the clinician managing your medication.

The short answer: a possible link, not a proven cause

Some secondary health sources link ACE inhibitors, including lisinopril, with tinnitus. For example, GoodRx includes ACE inhibitors among medications associated with tinnitus. However, that discussion provides no lisinopril-specific incidence rate, clinical trial, dose-response evidence, or proof that lisinopril caused the symptom in an individual patient.

Tinnitus is the perception of sound without an external source. Although commonly described as ringing, it may sound like buzzing, roaring, hissing, humming, clicking, whistling, or another noise. It can be perceived in one ear, both ears, or elsewhere in the head.

A symptom that starts after beginning lisinopril—or after a dosage change—raises a reasonable question about a connection. The timing is worth documenting, but it cannot prove causation. Another medication, a change in blood-pressure control, hearing loss, an ear condition, illness, injury, or recent noise exposure may have occurred during the same period.

Available information does not support describing lisinopril-related tinnitus as common, rare, dose-dependent, permanent, or reversible. It also does not establish a typical interval between taking lisinopril and noticing tinnitus.

What official drug information does—and does not—show

Official drug information supports a narrower conclusion than the direct claims made by some commercial health and hearing-clinic articles.

The DailyMed prescribing-information highlights for this lisinopril tablet product do not identify tinnitus among the listed common adverse reactions. For hypertension treatment, the highlights name headache, dizziness, and cough. The highlights are a summary, however, and expressly direct readers to the full prescribing information. Their omission of tinnitus therefore shows only that it is not identified as a common reaction in that summary; it does not prove that tinnitus is impossible or resolve whether an individual symptom is medication-related.

Similarly, MedlinePlus does not include tinnitus in its specified list of lisinopril side effects. Its list includes cough, dizziness, headache, tiredness, nausea, diarrhea, weakness, nasal symptoms, reduced sexual ability, and rash. MedlinePlus also states that other side effects may occur, advises contacting a doctor about unusual problems, and says not to stop lisinopril without consulting the doctor.

Taken together, these official summaries do not provide:

• A reliable incidence rate for tinnitus among people taking lisinopril
• Evidence of a dose-response relationship
• A typical onset period
• Evidence showing whether the symptom would be temporary or permanent
• A lisinopril-specific clinical study establishing causation

The defensible conclusion is limited: tinnitus is not presented as a common reaction in the DailyMed highlights or as a specified side effect on MedlinePlus, while the affirmative association comes from secondary reporting that does not establish causation.

Why lisinopril may not be the only explanation

Lisinopril is often used to treat high blood pressure, and high blood pressure itself is associated with tinnitus. This overlap complicates the timeline: the condition being treated and its treatment may both appear relevant even when neither can be identified as the cause from timing alone.

The National Institute on Deafness and Other Communication Disorders identifies multiple possible causes or associated factors, including:

• Hearing loss
• Loud-noise exposure
• Earwax blocking the ear canal
• Ear infection
• Head or neck injuries
• Blood-vessel problems
• Other medications
• Chronic health conditions
• High blood pressure

NIDCD also notes that certain medicines can cause tinnitus, particularly at high doses. Its examples include nonsteroidal anti-inflammatory drugs, certain antibiotics, anticancer medicines, antimalarial drugs, and antidepressants. The examples do not specifically name lisinopril or ACE inhibitors, so that guidance neither confirms nor excludes a lisinopril connection.

The practical implication is that a medication review should extend beyond one prescription. Include nonprescription pain relievers, recently started medicines, supplements, and products taken only occasionally. A clinician can then compare the complete medication list with the onset of tinnitus and any changes in blood pressure, hearing, or ear symptoms.

Other events in the same period may also matter. These include a respiratory illness, ear blockage or infection, a noticeable hearing change, a head or neck injury, or exposure to concerts, machinery, firearms, power tools, or other loud sounds.

Use this checklist before contacting the prescriber

A short written record can help your prescriber assess whether lisinopril is a plausible contributor and whether another explanation needs evaluation.

Record:

• The date you started lisinopril
• Your current dose
• The date and details of any dosage change
• When the tinnitus began
• Whether it is constant or intermittent
• Whether it affects the left ear, right ear, both ears, or seems centered in the head
• How you would describe the sound
• Whether the sound appears to follow your heartbeat
• Recent blood-pressure readings and when you took them
• Any hearing loss, muffled hearing, ear pressure, pain, or drainage
• Any dizziness or balance trouble
• Any recent respiratory illness or ear infection
• Any recent loud-noise exposure or head or neck injury

Bring a complete list of prescriptions, over-the-counter medicines, vitamins, herbal products, and supplements. Include recent additions, dosage changes, and products you use only occasionally. Another medication or a combination of factors may be relevant even if lisinopril is the newest prescription.

Use the following guide to organize the next conversation:

Situation	What to record	Next step
Tinnitus began after starting lisinopril or changing the dose	Start date, dose history, symptom onset, blood pressure	Contact the prescriber and explain the timeline
Other contributors may be involved	Ear and hearing symptoms, illness, noise exposure, all medicines	Request a broader ear, hearing, blood-pressure, and medication review
Tinnitus occurs with new hearing changes, dizziness, or balance trouble	When each symptom began and whether it is changing	Report the combination of symptoms promptly so a clinician can determine the appropriate timing of assessment
You are considering stopping lisinopril	Why you want to stop and how the symptom affects you	Speak with the prescriber before changing treatment

Do not try to diagnose the significance of one-sided or heartbeat-synchronous tinnitus yourself. Describe those features clearly when you contact a medical professional so they can decide what evaluation is appropriate.

Depending on the circumstances, an assessment may include a review of your medication and medical history, an examination for earwax or infection, and a hearing evaluation. The appropriate scope depends on your symptoms and clinical history.

Do not stop lisinopril on your own

Do not stop, reduce, replace, or otherwise change prescribed lisinopril without consulting the prescriber. Lisinopril is used for high blood pressure, as an additional treatment for heart failure, and after a heart attack. The consequences of interrupting it depend on why it was prescribed and on the individual’s health.

Your prescriber can compare the tinnitus timeline with your dosage history, blood-pressure readings, other medications, hearing changes, ear symptoms, illnesses, injuries, and noise exposure. That review may lead to observation, an ear or hearing assessment, or a treatment change. There is no single replacement blood-pressure medicine that is appropriate for everyone, and changing treatment cannot be assumed to make tinnitus disappear.

If you suspect an adverse reaction, tell the prescriber what happened and when. A suspected reaction can also be reported to FDA MedWatch using the reporting information in the DailyMed lisinopril label. A report documents a suspected event; by itself, it does not prove that lisinopril caused the tinnitus.

Lisinopril remains a possible but unproven contributor. The safest course is to document the symptom and related factors, report new or changing symptoms clearly, and let the prescriber evaluate the complete picture before any medication decision is made.