Tinnitus
Perception of sound without external source. AAO-HNS 2014 and NICE NG214 note there is no evidence-based pharmacotherapy for tinnitus. Sound therapy, cognitive behavioural therapy, and hearing correction for hearing loss are recommended. Ginkgo biloba, vinpocetine, piracetam, and cinnarizine are not included in these documents.
ICD-10 H93.12 drugs
Also known as: Ringing in the ears
Marketing claims without evidence base
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
- DGinkgo biloba extractNot recommended · Herbal agents for cognitive disordersGinkgo biloba extract is a herbal product promoted for ringing in the ears, usually on the idea that it improves blood flow. For tinnitus it has not shown convincing benefit, and solid evidence for this use is lacking. With persistent tinnitus it makes sense to have an ENT specialist look for a cause first, while the approaches that more reliably help are sound therapy and cognitive behavioral therapy, which make the symptom less intrusive.
- FPiracetam + cinnarizineNot recommended · Combination nootropic (local classification)AAO-HNS 2014 and NICE NG214 note the absence of evidence-based pharmacotherapy for tinnitus. Fezam is not in these recommendations. Russian practice of prescribing it 'for ear ringing' is not considered substantiated.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit