Furosemide ototoxicity: Clinical and experimental aspects

Authors

  • Leonard P. Rybak MD, PhD

    Corresponding author
    1. Southern Illinois University, School of Medicine, Department of Surgery, Springfield, I
    • SIU School of Medicine, Department of Surgery, P. O. Box 3926, Springfield, IL 62708.
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  • From the Southern Illinois University, School of Medicine, Department of Surgery, Springfield, IL.

  • Presented as a Candidate's Thesis to the American Laryngological, Rhinological and Otological Society, Inc., 1985, receiving Honorable Mention

Abstract

Furosemide is an ototoxic diuretic. Furosemide injection is followed by a rapid, but reversible decrease of the Endocochlear potential and eighth nerve action potential with a more gradual decrease of the endolymph potassium concentration. In contrast to the reversible effects of furosemide alone on the cochlea, the combination of Kanamycin with furosemide resulted in irreversible changes in cochlear function which were associated with elevated levels of kanamycin in the blood and perilymph of the experimental animals. There was a striking similarity between the blood level measured by high pressure liquid chromatography at the time of recovery of auditory function in experimental animals and the ototoxic blood levels proposed by others in clinical literature. These findings help to provide a pharmacologic basis for the clinical observation of furosemide-induced hearing loss.

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