Abstract
A few cases of mild to moderate, gradual and reversible sensorineural hearing loss (SNHL) with prolonged doses of nonsteroidal anti-inflammatory drugs has been reported. We present a case of sudden irreversible SNHL in a 60-year-old female after taking a single dose of diclofenac. The patient was a known case of diabetes mellitus and hypertension and was on regular treatment. We postulate that the patient's hearing loss was the result of diclofenac's ototoxic effects which may have been potentiated as a result of her long standing diabetes, hypertension and old age. Accordingly, we recommend the cautious use of diclofenac in patients with underlying diseases where diclofenac induced ototoxicity could potentially result in adverse otologic consequences.
Highlights
INTRODUCTIONDepartments of General Medicine and 1Clinical Pharmacy, JSS Hospital and Medical College, JSS University, Mysore, Karnataka, India
Quick response code: Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly used medications in everyday clinical practice.[1]. It is recommended for the long-term treatment of rheumatoid arthritis, osteoarthritis and ankylosing spondylitis and short-term treatment of acute musculoskeletal injury, postoperative pain and dysmenorrhea.[2]
While standard doses of drugs are based on the pharmacokinetic data obtained from a pool of randomly selected healthy individuals, inherent differences between individuals may result in variations in drug metabolism
Summary
Departments of General Medicine and 1Clinical Pharmacy, JSS Hospital and Medical College, JSS University, Mysore, Karnataka, India. A 60-year-old female patient presented to the medicine unit with complaints of intermittent fever with severe myalgia since the past 5 days Her past medical and medication history was collected. She was a documented case of hypertension and diabetes since 9 years and was on glimepiride, metformin, telmisartan and hydrochlorothiazide She was initially injected diclofenac 75 mg and her regular antihypertensives and antidiabetic medications were continued. The patient was found to be afebrile, morbidly obese with body mass index of 43 kg/m2 Her heart rate was 80 beats/min, regular and felt in all the peripheries. Patient’s audiogram and tympanogram showed bilateral severe to profound hearing loss [Figure 1] In her ear, nose and throat examination, Rinne’s. Severity of the reaction was evaluated using modified Hartwig and Siegel scale and was categorized as severe (level 6 reaction)
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