A Case of Sudden Sensorineural Hearing Loss Associated with Phosphodiesterase Type 5 Inhibitors

Abstract

The phosphodiesterase type 5 (PDE5) inhibitors —sildenafil, vardenafil and tadalafil— are used in the treatment of erectile dysfunction, pulmonary hypertension and benign prostatic hyperplasia (BPH). Recently, hearing loss associated with PDE5 inhibitor use has been reported. We report a patient who developed unilateral sudden hearing loss possibly related to the use of tadalafil. This is the first case report of sudden sensorineural hearing loss related to the use of a PDE5 inhibitor drug in Japan.

A 64-year-old male was started on treatment with tadalafil for BPH. Eight days after the start of treatment, the patient developed sudden right-sided hearing loss. He was referred our hospital, as his hearing did not recover despite oral prednisolone treatment (PSL 40 mg/day for 5 days) prescribed by an ENT specialist. An audiogram revealed sensorineural hearing loss in the right ear, with normal hearing in the other ear. DP-OAE elicited no responses in the right ear. The patient had no tinnitus or disequilibrium, and no nystagmus was observed. The patient was restarted on prednisolone (60 mg/day), which was administered for three days, with the dose tapered over 9 days and discontinuation of tadalafil. An audiogram after the corticosteroid therapy showed complete recovery of the hearing on the right side. The acute sensorineural hearing loss in this patient was probably caused by the ototoxic effects of the PDE5 inhibitor drug.