Furosemide-Induced Ototoxicity

Mechanism and Risk Factors

• Furosemide inhibits the Na+-K+-2Cl- cotransporter in the ascending limb of the loop of Henle, which is also present in the marginal and dark cells of the stria vascularis, leading to ototoxicity 1, 2, 3
• The American College of Cardiology states that furosemide acts at the loop of Henle, thus it is called a loop diuretic 1, 2, 3, 5

Medication Comparison

• Chlorthalidone acts at the distal tubule and is not associated with ototoxicity, according to the American College of Cardiology and Circulation guidelines 1, 2, 4
• Ramipril, metoprolol, insulin, and atorvastatin are not ototoxic agents, as stated by the American College of Cardiology 1, 2