{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:52:52Z","timestamp":1786978372920,"version":"build-2736575974"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2012,1,24]],"date-time":"2012-01-24T00:00:00Z","timestamp":1327363200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2012,2]]},"abstract":"<jats:p>Drug\u2010associated ototoxicity is a potentially irreversible adverse event. Among the several 3\u2010hydroxy\u20103\u2010methylglutaryl coenzyme A reductase inhibitors (statins) available in the United States, only atorvastatin is associated with tinnitus, but none are associated with any forms of hearing loss. A search of the published literature (1950\u2013August 2011) revealed no published case reports of ototoxicity associated with statins. To our knowledge, we describe the first case of progressive, irreversible hearing loss in a 32\u2010year\u2010old man 18\u00a0months after starting atorvastatin therapy. He began taking atorvastatin 20\u00a0mg every evening for treatment of hypercholesterolemia. Six months later, he complained of occasional episodes of tinnitus, which resolved spontaneously. An audiogram was obtained and was normal. By 18\u00a0months, the tinnitus became continuous. Another audiogram revealed bilateral \u201ccookie\u2010bite\u201d middle\u2010frequency hearing loss. Atorvastatin was immediately discontinued, and the patient was fitted with hearing aids. Four years after drug discontinuation, his hearing loss had neither progressed nor regressed. Use of the Naranjo adverse drug reaction probability scale indicated a possible (score of 2) temporal and causal relationship between the patient's hearing loss and atorvastatin. Causes of \u201ccookie\u2010bite\u201d hearing loss include chronic exposure to loud noises, presbycusis, genetic predisposition, and drugs. The manufacturer of atorvastatin has received three unpublished cases of deafness, but claims that causal relationships were not established. Despite these claims by the manufacturer, based on this case report, we recommend that clinicians and patients be aware of the risk of atorvastatin\u2010associated tinnitus and permanent hearing loss. Further research is needed to better understand the mechanism and frequency of this adverse event.<\/jats:p>","DOI":"10.1002\/phar.1040","type":"journal-article","created":{"date-parts":[[2012,9,5]],"date-time":"2012-09-05T03:54:57Z","timestamp":1346817297000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Irreversible Atorvastatin\u2010Associated Hearing Loss"],"prefix":"10.1002","volume":"32","author":[{"given":"Michael","family":"Liu","sequence":"first","affiliation":[{"name":"The Department of Pharmacy Practice Arnold and Marie Schwartz College of Pharmacy and Health Sciences Long Island University Department of Pharmacy Services Kingsbrook Jewish Medical Center Brooklyn New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Alafris","sequence":"additional","affiliation":[{"name":"The Department of Pharmacy Practice Arnold and Marie Schwartz College of Pharmacy and Health Sciences Long Island University Department of Pharmacy Services Kingsbrook Jewish Medical Center Brooklyn New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony J.","family":"Longo","sequence":"additional","affiliation":[{"name":"Scientific Affairs UCB Pharma Rochester New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Cohen","sequence":"additional","affiliation":[{"name":"The Department of Pharmacy Practice Arnold and Marie Schwartz College of Pharmacy and Health Sciences Long Island University Department of Pharmacy Services Kingsbrook Jewish Medical Center Brooklyn New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,1,24]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/circ.106.25.3143"},{"key":"e_1_2_5_3_1","unstructured":"USAToday.FDA statement on Baycol withdrawal. 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